Weakness and fatigue in palliative care

Fatigue is a feeling of extreme tiredness and lack of energy, which can also make you feel weak or lacking in strength.  Weakness and fatigue are very common near the end of life and many things can contribute to it.

It’s still important to do as much for yourself as you can, but make sure you find time to rest. 

If you have a medical condition or any obvious causes of fatigue are found, treatment will focus on the condition or cause.

The causes of weakness and fatigue near the end of life are not always known. Often there are multiple causes. Common causes include:

• cancer and chronic illness
• many medicines may cause sleepiness and fatigue
• infection
• disturbed sleep
• symptoms due to illness such as pain, nausea and vomiting or constipation
• treatment such as radiotherapy, chemotherapy or surgery
• metabolic disturbances such as high blood calcium, high blood sugar, low potassium, high sodium, low magnesium, low blood count (anaemia), renal failure, liver failure and dehydration
• poor nutrition
• emotional causes such as depression, anxiety, stress
• weight loss due to illness (cachexia) or loss of appetite.

It's quite common to feel tired and weak when you require palliative care. Other symptoms can include:

• low energy
• poor concentration and motivation
• muscle weakness
• needing help from others to move
• poor or disturbed sleep
• difficulty carrying out daily activities such as cooking, washing and dressing
• feeling irritable
• lacking confidence
• poor short-term memory
• feeling depressed and anxious.

Talk to your healthcare team if you experience any of these symptoms. 

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Your healthcare provider may ask you some questions to find out the possible causes of your fatigue. You may need to complete a fatigue diary to monitor the timing of your tiredness and how it's affecting your daily life. 

Your healthcare provider may also do a physical examination and carry out tests, such as blood and urine tests, to get a better understanding of what's causing your symptoms. 

If the fatigue relates to your medical condition or the related causes listed above, treatment will focus on the condition or cause. If there's no medical cause, treatment will focus on self-care. Talking therapy (counselling) may be useful if you're feeling anxious or depressed.

• Use your energy for the things you enjoy – accept help with less important activities such as household chores.
• You may need to move things around in your home so you don’t have to walk so far between the areas of the house you use the most.
• Talk with your healthcare team about services and equipment available to support your daily activities. Assessment by an occupational therapist may be possible – they can suggest techniques and equipment you can use to save your energy.  

Read more about self-care for fatigue.

Apps reviewed by Healthify

You may find it useful to look at some breathing apps and pain management apps.