Weakness and fatigue in palliative care

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

• medicines such as opioids, benzodiazepines or tricyclic antidepressants
• infection
• sleep disturbances
• 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
• other accompanying illnesses such as cancer, heart disease, liver disease, thyroid disease and motor neurone disease.

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

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

See your doctor if you experience any of these symptoms. 

Your doctor 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 is affecting your daily life. 

Your doctor may also do a physical examination and carry out tests, such as blood and urine tests, to better understand what is 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 is no medical cause, treatment will focus on self-care. Talking therapy (counselling) may be useful if you are feeling anxious or depressed.

Self-care tips

• 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 your house so you don’t have to walk so far between the areas of the house you use the most.
• Talk with your care team about services and equipment available to support your daily activities. 

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.