Managing Fatigue

Fatigue is a feeling of being tired or exhausted. Even after getting plenty of sleep or rest, people with fatigue feel like they have no energy. They are so tired that they cannot do the activities they usually enjoy. Fatigue is common among hospice and palliative care patients. Diagnosing reasons for fatigue may take time because fatigue can have many causes, including illness, emotions, and treatments. Sometimes, fatigue can also come with feelings of depression or sadness.

• “Just too tired” to care about or do normal activities or routines
• Lack of appetite or not having the energy to eat
• Sleepiness
• Not talking
• Depression

• Any signs listed above.
• Describe how bad the fatigue is by using a number scale from 0 to 10:
  • 0 = no fatigue to 10 = in bed all-day
• What makes the fatigue better or worse?
• Spiritual, social or emotional concerns and worries.
• Changes in appetite.
• Any troubling symptoms that are not controlled, such as nausea, pain, or bowel problems.
• If you have experienced fatigue before, and what made it better.

Because fatigue can have many causes, it may take several actions to improve your symptoms. Talk to your healthcare team about your fatigue. The team will work with you and your family to find the causes of the fatigue. They will discuss treatments that may work best for you.

Things you may do to help your fatigue:

• Slowly increase your activity. Do so a little at a time to save energy.
  • Keep a log of which time of day is your best.
  • Plan and do activities during your best times of the day.
  • Avoid or delay activities that are not your priority.
  • Change your position. Do not just stay in bed.
  • Use sunlight or a light source to help your body feel more energized.
  • Try activities that restore your energy, such as music, meditation, or spending time outdoors.
  • Allow caregivers to assist you with daily activities such as eating, moving, or bathing, if necessary.
  • Talk with your family about your energy level and how they can help.
• Rest and sleep better.
  • Listen to your body – rest as needed.
  • Try to keep a regular time to go to bed and wake up.
  • Stay away from things that may keep you from a sound sleep, such as lighting, or certain food, drinks, and medicine taken too late in the day.
  • Avoid interrupting sleep time and try to get continuous hours of sleep.
  • Plan rest times or naps during the late morning or mid-afternoon.
  • Avoid sleeping later in the afternoon, which could affect your nighttime sleep.
  • Ask if using oxygen when you sleep will help you to sleep better.
• Increase food intake.
  • Try nutritious, high-protein food.
  • Eat small, frequent meals.
  • Add protein supplements to foods or drinks.
  • Frequent mouth care (before and after meals).
  • Ask about the possible use of medications to stimulate your appetite or relieve fatigue.