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Managing Symptoms

Understanding common symptoms and helping to manage them

The word ‘symptom’ is used to describe one aspect of an illness. Everyone is different and although some people may experience a range of these symptoms, others may not. If someone has a serious illness, and it is not possible to provide a ‘cure’, the focus of care should be to relieve symptoms such as pain, constipation, nausea, tiredness and breathlessness. Sadly, it is not always possible to make symptoms disappear, but the goal of treatment is to reduce their impact and keep people comfortable.

As a carer, part of your role is to help recognise and manage these symptoms. This will depend on your relationship with the person you care for, how often you see them and what you are comfortable doing.

It may help if you keep a diary of symptoms, you can then use this as a prompt when you are talking to a doctor, nurse or other health professional.

You can read about common symptoms and some tips on how to manage them by navigating through the information below.

Top Tips

Many carers worry about keeping their loved one comfortable and free from pain. If your loved one is experiencing pain, you should contact your GP or other healthcare provider, they are there to help. There are also resources available online which can help to guide you. Although there have been great advances in treatment, it is not always possible to completely get rid of all painful symptoms.

How we manage pain varies from person to person. Here are some things you can do if your loved one is experiencing pain.

You can begin by assessing the pain, the answers to these questions will help your doctor or nurse choose the appropriate treatment. You could ask questions such as:

  1. Where is the pain? (Sometimes it may be in more than one area).
  2. What does the pain feel like? (e.g. sharp, throbbing, burning).
  3. How long has the pain been there?
  4. Is this a new type of pain?
  5. How would you rate the pain on a scale of one-to-ten? (1 being no pain through to 10 being excruciating pain). If the answer is 7 or 8 out of ten this would be regarded as a considerable amount of pain.
  6. Do you feel like vomiting?
  7. When did you last open your bowels? (Constipation can cause pain).


Tips to help your loved one manage pain:

  1. Ask your loved one to lie on the bed or sit down.
  2. Ask your loved one to take 10 deep breaths.
  3. If your loved one has been provided with pain relieving medicine, and they have not had it yet today, then provide medication as directed on the packet. If your loved one has already had their pain medication today and still complains of feeling in pain, contact the GP, out-of-hours GP service or pharmacist for advice.
  4. Ask your loved one to try to take their mind off the pain by reading, watching TV or listening to music.
  5. Offer a massage of the feet, hands or shoulders.
  6. If nausea or constipation is an issue, they may be contributing to the pain. It may help the situation if you can manage these symptoms
  7. If the discomfort has not eased after 30 minutes phone your doctor or other healthcare provider.


Concerns about giving strong medication:

Many people worry about providing strong pain-relieving drugs (e.g. morphine) as they feel it may contribute to their family member’s death. It is important to remember that what causes death is the underlying disease and not the drug. If you provide medication as directed, it is very unlikely that it will cause the death of your loved one. The doctor will carefully reduce the medication if it is causing serious side effects. However, it is important that you know about the effects of these drugs and why they are used. Ask your doctor or nurse for a leaflet explaining about pain relieving drugs or you can read more information here: Marie Curie – Pain relief

You may also want to view information around syringe drivers if this is relevant to your loved one: Marie Curie – Syringe drivers

Chronic Pain Ireland and NHS Choices carry lots of additional information on managing pain:

What is Chronic Pain? – Chronic Pain Ireland
Explains the difference between acute and chronic pain, how chronic pain is defined, and how it is managed in Ireland.

How to Get NHS Help for Your Pain – NHS UK
A UK-based guide on when to see a GP for long-term pain and how pain clinics and self-help approaches can support you.

Nausea is the term used to describe when someone feels they are going to vomit. Nausea can be caused by many things including the disease itself, medications, chemotherapy, radiotherapy, constipation or an imbalance in the chemicals in our bodies.

Here are some additional tips to help you manage nausea in a person you care for:

  • Ensure a bin or bucket is within easy reach in case they vomit.
  • Ask how they rate the nausea on a scale of 1 to 5 (1 being ‘very little’ nausea and 5 being ‘extreme’ nausea). You can pass this information on to a healthcare professional, if necessary.
  • If anti-nausea medications have been prescribed check to see if they have been taken as directed. If the prescriptions allow, give the anti-nausea medication, unless the thought of taking the medication makes your loved one feel worse.
  • Some people prefer not to eat or drink anything until the nausea passes, others find small amounts of food or drink helpful.
  • It is best not to lie down immediately after eating, especially if a large meal has been consumed.
  • Ask when your loved one last moved their bowels. If it is longer than two days, this may be contributing to them feeling ill and you should seek advice on constipation.
  • Encourage your loved one to rest. Suggest deep breathing. Play some soft music offer a foot or neck massage. If your loved one feels up to it, a bath or shower may help.
  • Opening a window and avoiding contact with strong smells may be helpful.
  • If nausea is not relieved within one hour, or it gets worse, phone your doctor or another healthcare provider.

Marie Curie has additional information on managing nausea: https://www.mariecurie.org.uk/information/symptoms/nausea-vomiting

Constipation occurs when a person does not move their bowels for several days and can cause nausea, pain and tiredness. It may be caused by reduced fluid intake, limited mobility, poor diet or it can be a direct side effect of the person’s illness. Constipation may also be a side effect of strong pain medication. In most cases constipation can be prevented.

Below are some additional tips to help you manage constipation:

  • Encourage your loved one to drink plenty of fluids during the day. If their appetite is good, water is a good option. If their appetite is poor, milky drinks or fruit juices may be better options.
  • If your loved one’s appetite is good and they are drinking well, encourage them to eat foods that are high in fibre. Good sources of fibre include fruit, vegetables and brown bread.
  • A lack of physical activity can make constipation worse. If your loved one is able, you should encourage them to be active and not to spend long periods in either a bed or chair. For those who are able, a short walk each day can help improve both mood and appetite as well as helping with constipation.
  • If your loved one is straining on the toilet, it may be worth changing their seating position.
  • Take note of their bowel movements: are they hard, soft, small or liquid? It may be helpful to share this information with a healthcare professional.
  • Keep a record of when they have bowel movements.
  • If your loved one is taking strong pain killers (such as morphine) talk to your doctor to ensure that the correct laxatives are also being prescribed.
  • There are many natural remedies for constipation that can be used in conjunction with prescribed medication. If constipation is an issue for your loved one, ask your doctor or nurse for treatments that will not impact their medication.
  • If your loved one does not have a bowel movement for two days, discuss this with your doctor or nurse who may set up a specific ‘plan’ to help your loved one.
  • Even if your loved one is not eating very much they still need to use the toilet. Constipation can occur even when someone is off their food.


Both the NHS and Marie Curie have additional information and details on the treatment options for constipation:

Constipation – NHS Inform Scotland
Information about causes, symptoms and management of constipation from a Scottish health source.

Bowel and Bladder Problems When You’re Living with a Terminal Illness – Marie Curie
Advice on bowel and bladder changes in advanced illness, including what carers and patients can do.

We have all experienced shortness of breath through exercise or running to catch the bus. Having difficulty breathing without exercising can be a very unpleasant and worrying symptom. It is usually caused by one of a variety of things such as lung disease, asthma, emphysema, chest infection, pressure from other body organs or anxiety.

Your loved one’s treatment will depend on their specific condition but here are some general tips that may help.

  • Encourage your loved one to sit in an upright position and stay with them.
  • Put on a fan or open the window slightly.
  • Suggest that your loved one wears loose fitting clothes.
  • Put on some calming music, maintain a gentle, reassuring presence, offer a foot, hand or shoulder massage.
  • If medicines for breathlessness have been prescribed, make sure they have been taken as directed.
  • Oxygen provided through a mask or other equipment may be prescribed by your doctor. If you notice a pattern of regular breathlessness in your loved one discuss it with the doctor or nurse.
  • If breathlessness is not relieved and is causing distress, phone your doctor or other healthcare professional, if available.

If you require further information you can view Marie Curie – Breathlessness

Fatigue is very common among people with a life limiting illness. Fatigue, or extreme tiredness, can be caused by a variety of things including a lack of sleep, low levels of oxygen in the blood, poor diet, depression, the effects of treatments such as chemotherapy or radiotherapy, infection or the effects of the disease itself. Here are some strategies that may help you manage your loved ones feelings of fatigue.

  • Encourage short naps during the day. No more than 20 to 30 minutes at a time.
  • Encourage regular physical activity. Where possible, involve your loved one in everyday activities. If your loved one can do everyday tasks like washing, dressing and cooking you should encourage them to stay involved as it encourages movement. Being inactive during the day can lead to your loved one having problems sleeping at night.
  • Encourage them to eat nutritious foods and drinks.
  • Plan to do more strenuous tasks (e.g. a shower or bath) when energy levels are higher and ask your loved one to ‘pace’ themselves, so that they do not become exhausted.
  • Encourage your loved one to spend time doing activities that interest them. For example: board games, talking books, podcasts, listening to the radio and/or watching television.
  • If you think that their fatigue is getting worse, speak to a healthcare professional.

If you require further information click here to learn more: NHS Inform – Fatigue in palliative care

Delirium is common in palliative care and may be reversible or temporary. People who experience delirium have difficulty remembering new information, may have trouble concentrating, and sometimes may have difficulty telling day from night. The person with delirium may be confused and not recognise people they know, or they may become fixated on one thing or become suspicious. Sometimes delirium causes hallucinations when people see things that are not there. Delirium is usually caused by a change in brain function due to the illness or sometimes as a side-effect of medications. Delirium can be very distressing, both for the patient and their family.

Your doctor will look for the causes of the delirium and try to treat it. Sometimes your loved one will be prescribed tranquilizing medicine to help them feel calm and make sure they are safe.

The best way to help your loved one is to make sure you maintain eye contact with them, speak slowly and calmly and remind them of who you are, where they are and that you are there to help. If your loved one is in a hospital or care home you may want to ask about being able to stay with them, often patients respond better to people who are familiar to them. Try to not have too many visitors at any one time and avoid too much stimulation like loud music or TV. It is important to encourage them to drink and remain hydrated.

Both the NHS and Marie Curie have additional information and details on the treatment options for delirium:

Low mood or sadness is common when someone is unwell; at least one in every four people living with a life-limiting diagnosis will experience depression, anxiety, adjustment disorder or low mood. They may feel withdrawn, tired, tearful, or lose interest in things they used to enjoy. This is a natural response but, in some cases, it may be a sign of depression.

Here are some suggestions for supporting low mood:

  • Spend time with your loved one, even if you’re not talking. Just having company can be comforting.
  • Encourage gentle activities they’ve enjoyed before, like music, crafts, or gardening.
  • Offer food and drink regularly, even small amounts.
  • Let them talk about their worries if they want to. Try not to “cheer them up” – just listening is often enough. You can read Hospice UK’s Dying Matters: Being a Good Listener infographic here, or their infographic on Dying Matters: How to Talk About Death and Dying here.
  • Encourage rest, but also gentle daily routines – even small tasks can help structure the day.
  • Keep their space calm and comfortable, with natural light and fresh air.

If the person is very withdrawn, hopeless, or talks about wanting to die, speak to their GP or healthcare team straight away. Emotional support and medications may help to make them feel better.

You can view more information on managing low mood or depression here: Marie Curie – Mental Wellbeing

Loss of appetite is common when someone is receiving palliative care andthis becomes more common especially near the end of life. The body often no longer needs as much food. While it can be upsetting for carers to see someone not eating, it’s important to follow their lead and focus on comfort over nutrition. You can get advice from your loved one’s dietitian if they have one, or if they do not, contact their GP.

Tips for supporting someone with a reduced appetite:

  • Offer small portions more often, rather than large meals.
  • Let them choose what they feel like eating, even sweets, chocolate or crisps are okay.
  • Serve soft, easy-to-chew foods (e.g. yoghurt, soup, mashed potato)
  • Try offering nourishing drinks like milk, smoothies, or hot chocolate.
  • Avoid pressuring them to eat as this can cause stress or nausea.
  • Sit with them during meals to create a relaxed environment.
  • Keep favourite or familiar foods within reach so it is available to them

If the person is losing weight quickly or seems very weak, speak to their GP or nurse. Supplements or other advice may be helpful – but comfort always comes first.

You can learn more about loss of appetite by visiting this link: Marie Curie – Eating and drinking problems

Dry mouth can be caused by medication, dehydration, or illness itself. It can make talking, eating, and swallowing more difficult. Regular, gentle mouth care can make a big difference to comfort.

Tips for easing a dry mouth:

  • Offer small sips of water frequently. You can use a straw or spoon if needed.
  • Try sucking on ice lollies or frozen fruit
  • Avoid alcohol-based mouthwashes or fizzy drinks, which can irritate the mouth further
  • Keep lips moist with lip balm or petroleum jelly
  • Gently clean the mouth and tongue using a soft toothbrush or a foam swab
  • Use saliva substitutes if advised by a pharmacist or nurse
  • Keep the room cool and air moist – open a window or use a humidifier if available.


If the mouth is sore, red, or has white patches, this may be a sign of infection – contact the GP or nurse for advice.

You can read “Mouth Care During End of Life Care: Keeping the mouth clean, moist and comfortable” published by the Royal College of Nursing here

Many people receiving palliative care have trouble sleeping. This may be due to pain, anxiety, medication side effects or changes in their condition. Poor sleep can affect mood and comfort, so simple changes can help.

Ways to support better rest:

  • Keep a calm, quiet bedroom with dim lighting and a comfortable temperature.
  • Try a short bedtime routine: soft music, a warm drink, gentle massage.
  • Encourage them to limit naps during the day if possible.
  • Keep screens (TV, phones) off an hour before bedtime.
  • Make sure pain relief or medication is taken as prescribed before sleep.
  • Offer reassurance if they wake during the night – even a few kind words can be soothing.


If restlessness is severe or sleep is regularly disturbed, talk to the GP. They may adjust medication or suggest other ways to help.

You can read more about difficulty sleeping or restlessness here: Marie Curie – Sleep problems

Many carers worry about keeping their relative comfortable and free from pain. If your relative is experiencing pain you should contact your GP or other healthcare provider, they are there to help. There are also resources available on the internet which can help to guide you. There have been great advances in treatment though it is not always possible to completely get rid of all painful symptoms.

How we manage pain varies from person to person. Here are some things you can do if your relative is experiencing pain.

You can begin by assessing the pain, the answers to these questions will help your doctor or nurse choose the appropriate treatment. You could ask questions such as:

  1. Where is the pain? (Sometimes it may be in more than one area).
  2. What does the pain feel like? (e.g. sharp, throbbing, burning).
  3. How long has the pain been there?
  4. Is this a new type of pain?
  5. How would you rate the pain on a scale of one-to-ten? (1 being no pain through to 10 being excruciating pain). If the answer is 7 or 8 out of ten this would be regarded as a considerable amount of pain.
  6. Do you feel like vomiting?
  7. When did you last open your bowels? (Constipation can cause pain).


Tips to help your relative manage pain:

  1. Ask your relative to lie on the bed or sit down.
  2. Ask your relative to take 10 deep breaths.
  3. If your relative has been provided with pain relieving medicine, and they have not had it yet today, then provide medication as directed on the packet. If your relative has already had their pain medication today and still complains of feeling in pain, contact the doctor, out of hours GP service or pharmacist for advice.
  4. Ask your relative to try to take their mind off the pain by reading, watching TV or listening to music.
  5. Offer a massage of the feet, hands or shoulders.
  6. If nausea or constipation is an issue, they may be contributing to the pain. It may help the situation if you can manage these symptoms (have a look at the sections on this website on nausea and constipation).
  7. If the discomfort has not eased after 30 minutes phone your doctor or other healthcare provider.

Concerns about giving strong medication.

Many people worry about providing strong pain relieving drugs (e.g. morphine) as they feel it may contribute to their family member’s death. It is important to remember that what causes death is the underlying disease and not the drug. If you provide medication as directed it is very unlikely that it will cause the death of your relative. The doctor will carefully reduce the medication if it is causing serious side effects. However, it is important that you know about the effects of these drugs and why they are used. Ask your doctor or nurse for a leaflet explaining about pain relieving drugs or you could read this information.

Chronic Pain Ireland and NHS Choices carry lots of additional information on managing pain:

Nausea is the term used to describe when someone feels they are going to vomit when they think about or see food. Nausea can be caused by many things including the disease itself, medications, chemotherapy, radiotherapy, constipation or an imbalance in the chemicals in our bodies.

Here are some additional tips to help you manage nausea in a person you care for:

  • Ensure a bowl or bucket is within easy reach in case they vomit.
  • Ask how they rate the nausea on a scale of 1 to 5 (1 being ‘very little’ nausea and 5 being ‘extreme’ nausea). You can pass this information on to a healthcare professional, if necessary.
  • If anti-nausea medications have been prescribed check to see if they have been taken as directed. If the prescriptions allow, give the anti-nausea medication, unless the thought of taking the medication makes your relative feel worse.
  • Some people prefer not to eat or drink anything until the nausea passes, others find small amounts of food or drink helpful.
  • It is best not to lie down immediately after eating, especially if a large meal has been consumed.
  • Ask when your relative last moved their bowels. If it is longer than two days this may be contributing to them feeling ill and you should seek advice on constipation.
  • Encourage your relative to rest. Suggest deep breathing. Play some soft music offer a foot or neck massage. If your relative feels up to it, a bath or shower may help.
  • Opening a window and avoiding contact with strong smells, may be helpful.
  • If nausea is not relieved within one hour, or it gets worse, phone your doctor or another healthcare provider.

Marie Curie has additional information on managing nausea: Feeling sick and vomiting

Constipation occurs when a person does not move their bowels for several days and can cause nausea, pain and tiredness. It may be caused by reduced fluid intake, limited mobility, poor diet or, it can be a direct side effect of the person’s illness. Constipation may also be a side effect of strong pain medication. In most cases constipation can be prevented.

Below are some additional tips to help you manage constipation:

  • Encourage your relative to drink plenty of fluids during the day. If their appetite is good, water is a good option. If their appetite is poor, milky drinks or fruit juices may be better options.
  • If your relative’s appetite is good and they are drinking well, encourage them to eat foods that are high in fibre. Good sources of fibre include fruit, vegetables and brown breads.
  • A lack of physical activity can make constipation worse. If your relative is able, you should encourage them to be active and not to spend long periods in either a bed or chair. For those who are able, a short walk each day can help improve both mood and appetite as well as helping with constipation.
  • If your relative is straining on the toilet it may be worth changing their seating position.
  • Take note of their bowel movements: are they hard, soft, small or liquid? It may be helpful to share this information with a healthcare professional.
  • Keep a record of when they have bowel movements.
  • If your relative is taking strong pain killers (such as morphine) talk to your doctor to ensure that the correct laxatives are also being prescribed.
  • There are many natural remedies for constipation that can be used in conjunction with prescribed medication. If constipation is an issue for your relative ask your doctor or nurse for treatments that will not impact on their medication.
  • If your relative does not have a bowel movement for two days, discuss this with your doctor or nurse who may set up a specific ‘plan’ to help your relative.
  • Even if your relative is not eating very much they still need to use the toilet. Constipation can occur even when someone is off their food.


Both the NHS and Marie Curie have additional information and details on the treatment options for constipation:

We have all experienced shortness of breath through exercise or running to catch the bus. Having difficulty breathing without exercising can be a very unpleasant and worrying symptom. It is usually caused by one of a variety of things such as; lung disease, asthma, emphysema, chest infection, pressure from other body organs or, anxiety.

Your relative’s treatment will depend on their specific condition but here are some general tips that may help.

  • Encourage your relative to sit in an upright position and stay with them.
  • Put on a fan or open the window slightly.
  • Suggest that your relative wears loose fitting clothes.
  • Put on some calming music, maintain a gentle, reassuring presence, offer a foot, hand or shoulder massage.
  • If medicines for breathlessness have been prescribed, make sure they have been taken as directed.
  • Oxygen provided through a mask or other equipment may be prescribed by your doctor. If you notice a pattern of regular breathlessness in your relative discuss it with the doctor or nurse.
  • If breathlessness is not relieved and is causing distress, phone your doctor or other healthcare professional, if available.


If you require further information click here for a guide from Marie Curie

Fatigue is very common among people with a life limiting illness. Fatigue, or extreme tiredness, can be caused by a variety of things including a lack of sleep, low levels of oxygen in the blood, poor diet, depression, the effects of treatments such as chemotherapy or radiotherapy, infection or the effects of the disease itself. Here are some strategies that may help you manage your family member’s feelings of fatigue .

  • Encourage short naps during the day. No more than 20 to 30 minutes at a time.
  • Encourage regular physical activity. Where possible, involve your relative in everyday activities. If your relative is able to do everyday tasks like washing, dressing and cooking you should encourage them to stay involved as it encourages movement. Being inactive during the day can lead to your relative having problems sleeping at night.
  • Encourage them to eat nutritious foods and drinks.
  • Plan to do more strenuous tasks (e.g. a shower or bath) when energy levels are higher and ask your relative to ‘pace’ themselves, so that they do not become exhausted.
  • Encourage your relative to spend time doing activities that interest them. For example: board games, talking books, podcasts, listening to the radio and/or watching television.
  • If you think that their fatigue is getting worse, speak to a healthcare professional.


If you require further information click here for a guide from Marie Curie

 

Delirium is common in palliative care and may be reversible or temporary. People who experience delirium have difficulty remembering new information, may have trouble concentrating, and sometimes may have difficulty telling day from night. The person with delirium may be confused and not recognise people they know, or they may become fixated on one thing or become suspicious. Sometimes delirium causes hallucinations when people see things that are not there. Delirium is usually caused by a change in brain function due to the illness or sometimes as a side-effect of medications. Delirium can be very distressing, both for the patient and their family.

Your doctor will look for the causes of the delirium and try to treat it. Sometimes your relative will be prescribed tranquilizing medicine to help them feel calm and make sure they are safe.

The best way to help your relative is to make sure you maintain eye contact with them, speak slowly and calmly and remind them of who you are, where they are and that you are there to help. If your relative is in a hospital or care home you may want to ask about being able to stay with them, often patients respond better to people who are familiar to them. Try to not have too many visitors at any one time and avoid too much stimulation like loud music or TV. It is important to encourage them to drink and remain hydrated.

Both the NHS and Marie Curie have additional information and details on the treatment options for delirium:

Pain

Many carers worry about keeping their relative comfortable and free from pain. If your relative is experiencing pain you should contact your GP or other healthcare provider, they are there to help. There are also resources available on the internet which can help to guide you. There have been great advances in treatment though it is not always possible to completely get rid of all painful symptoms.

How we manage pain varies from person to person. Here are some things you can do if your relative is experiencing pain.

You can begin by assessing the pain, the answers to these questions will help your doctor or nurse choose the appropriate treatment. You could ask questions such as:

  1. Where is the pain? (Sometimes it may be in more than one area).
  2. What does the pain feel like? (e.g. sharp, throbbing, burning).
  3. How long has the pain been there?
  4. Is this a new type of pain?
  5. How would you rate the pain on a scale of one-to-ten? (1 being no pain through to 10 being excruciating pain). If the answer is 7 or 8 out of ten this would be regarded as a considerable amount of pain.
  6. Do you feel like vomiting?
  7. When did you last open your bowels? (Constipation can cause pain).

Tips to help your relative manage pain:

  1. Ask your relative to lie on the bed or sit down.
  2. Ask your relative to take 10 deep breaths.
  3. If your relative has been provided with pain relieving medicine, and they have not had it yet today, then provide medication as directed on the packet. If your relative has already had their pain medication today and still complains of feeling in pain, contact the doctor, out of hours GP service or pharmacist for advice.
  4. Ask your relative to try to take their mind off the pain by reading, watching TV or listening to music.
  5. Offer a massage of the feet, hands or shoulders.
  6. If nausea or constipation is an issue, they may be contributing to the pain. It may help the situation if you can manage these symptoms (have a look at the sections on this website on nausea and constipation).
  7. If the discomfort has not eased after 30 minutes phone your doctor or other healthcare provider.


Concerns about giving strong medication.

Many people worry about providing strong pain relieving drugs (e.g. morphine) as they feel it may contribute to their family member’s death. It is important to remember that what causes death is the underlying disease and not the drug. If you provide medication as directed it is very unlikely that it will cause the death of your relative. The doctor will carefully reduce the medication if it is causing serious side effects. However, it is important that you know about the effects of these drugs and why they are used. Ask your doctor or nurse for a leaflet explaining about pain relieving drugs or you could read this information.

Chronic Pain Ireland and NHS Choices carry lots of additional information on managing pain:

Nausea

Nausea is the term used to describe when someone feels they are going to vomit when they think about or see food. Nausea can be caused by many things including the disease itself, medications, chemotherapy, radiotherapy, constipation or an imbalance in the chemicals in our bodies.

Here are some additional tips to help you manage nausea in a person you care for:

  • Ensure a bowl or bucket is within easy reach in case they vomit.
  • Ask how they rate the nausea on a scale of 1 to 5 (1 being ‘very little’ nausea and 5 being ‘extreme’ nausea). You can pass this information on to a healthcare professional, if necessary.
  • If anti-nausea medications have been prescribed check to see if they have been taken as directed. If the prescriptions allow, give the anti-nausea medication, unless the thought of taking the medication makes your relative feel worse.
  • Some people prefer not to eat or drink anything until the nausea passes, others find small amounts of food or drink helpful.
  • It is best not to lie down immediately after eating, especially if a large meal has been consumed.
  • Ask when your relative last moved their bowels. If it is longer than two days this may be contributing to them feeling ill and you should seek advice on constipation.
  • Encourage your relative to rest. Suggest deep breathing. Play some soft music offer a foot or neck massage. If your relative feels up to it, a bath or shower may help.
  • Opening a window and avoiding contact with strong smells, may be helpful.
  • If nausea is not relieved within one hour, or it gets worse, phone your doctor or another healthcare provider.


Marie Curie has additional information on managing nausea: Feeling sick and vomiting

Constipation

Constipation occurs when a person does not move their bowels for several days and can cause nausea, pain and tiredness. It may be caused by reduced fluid intake, limited mobility, poor diet or, it can be a direct side effect of the person’s illness. Constipation may also be a side effect of strong pain medication. In most cases constipation can be prevented.

Below are some additional tips to help you manage constipation:

  • Encourage your relative to drink plenty of fluids during the day. If their appetite is good, water is a good option. If their appetite is poor, milky drinks or fruit juices may be better options.
  • If your relative’s appetite is good and they are drinking well, encourage them to eat foods that are high in fibre. Good sources of fibre include fruit, vegetables and brown breads.
  • A lack of physical activity can make constipation worse. If your relative is able, you should encourage them to be active and not to spend long periods in either a bed or chair. For those who are able, a short walk each day can help improve both mood and appetite as well as helping with constipation.
  • If your relative is straining on the toilet it may be worth changing their seating position.
  • Take note of their bowel movements: are they hard, soft, small or liquid? It may be helpful to share this information with a healthcare professional.
  • Keep a record of when they have bowel movements.
  • If your relative is taking strong pain killers (such as morphine) talk to your doctor to ensure that the correct laxatives are also being prescribed.
  • There are many natural remedies for constipation that can be used in conjunction with prescribed medication. If constipation is an issue for your relative ask your doctor or nurse for treatments that will not impact on their medication.
  • If your relative does not have a bowel movement for two days, discuss this with your doctor or nurse who may set up a specific ‘plan’ to help your relative.
  • Even if your relative is not eating very much they still need to use the toilet. Constipation can occur even when someone is off their food.


Both the NHS and Marie Curie have additional information and details on the treatment options for constipation:

Breathlessness

We have all experienced shortness of breath through exercise or running to catch the bus. Having difficulty breathing without exercising can be a very unpleasant and worrying symptom. It is usually caused by one of a variety of things such as; lung disease, asthma, emphysema, chest infection, pressure from other body organs or, anxiety.

Your relative’s treatment will depend on their specific condition but here are some general tips that may help.

  • Encourage your relative to sit in an upright position and stay with them.
  • Put on a fan or open the window slightly.
  • Suggest that your relative wears loose fitting clothes.
  • Put on some calming music, maintain a gentle, reassuring presence, offer a foot, hand or shoulder massage.
  • If medicines for breathlessness have been prescribed, make sure they have been taken as directed.
  • Oxygen provided through a mask or other equipment may be prescribed by your doctor. If you notice a pattern of regular breathlessness in your relative discuss it with the doctor or nurse.
  • If breathlessness is not relieved and is causing distress, phone your doctor or other healthcare professional, if available.


If you require further information click here for a guide from Marie Curie

Fatigue

Fatigue is very common among people with a life limiting illness. Fatigue, or extreme tiredness, can be caused by a variety of things including a lack of sleep, low levels of oxygen in the blood, poor diet, depression, the effects of treatments such as chemotherapy or radiotherapy, infection or the effects of the disease itself. Here are some strategies that may help you manage your family member’s feelings of fatigue .

  • Encourage short naps during the day. No more than 20 to 30 minutes at a time.
  • Encourage regular physical activity. Where possible, involve your relative in everyday activities. If your relative is able to do everyday tasks like washing, dressing and cooking you should encourage them to stay involved as it encourages movement. Being inactive during the day can lead to your relative having problems sleeping at night.
  • Encourage them to eat nutritious foods and drinks.
  • Plan to do more strenuous tasks (e.g. a shower or bath) when energy levels are higher and ask your relative to ‘pace’ themselves, so that they do not become exhausted.
  • Encourage your relative to spend time doing activities that interest them. For example: board games, talking books, podcasts, listening to the radio and/or watching television.
  • If you think that their fatigue is getting worse, speak to a healthcare professional.


If you require further information click here for a guide from Marie Curie

 

 

Delirium

Delirium is common in palliative care and may be reversible or temporary. People who experience delirium have difficulty remembering new information, may have trouble concentrating, and sometimes may have difficulty telling day from night. The person with delirium may be confused and not recognise people they know, or they may become fixated on one thing or become suspicious. Sometimes delirium causes hallucinations when people see things that are not there. Delirium is usually caused by a change in brain function due to the illness or sometimes as a side-effect of medications. Delirium can be very distressing, both for the patient and their family.

Your doctor will look for the causes of the delirium and try to treat it. Sometimes your relative will be prescribed tranquilizing medicine to help them feel calm and make sure they are safe.

The best way to help your relative is to make sure you maintain eye contact with them, speak slowly and calmly and remind them of who you are, where they are and that you are there to help. If your relative is in a hospital or care home you may want to ask about being able to stay with them, often patients respond better to people who are familiar to them. Try to not have too many visitors at any one time and avoid too much stimulation like loud music or TV. It is important to encourage them to drink and remain hydrated.

Both the NHS and Marie Curie have additional information and details on the treatment options for delirium: