Managing common symptoms

Common symptoms include:

• pain
• nausea and vomiting
• constipation
• loss of appetite
• breathlessness
• weakness and fatigue.

Pain

Not everyone with a terminal illness has pain, but it is often people’s biggest fear and for some people it can be troublesome. Pain can usually be well managed by health professionals involved in your care. You may be prescribed medications such as paracetamol, a non-steroidal anti-inflammatory or an opioid like morphine. Read more about medicines for pain relief and opioids in palliative care. 

Self-help tips

• Talk with your care team about when your pain started, where it is and anything that helps to relieve it.
• Take any regular pain relief medications as prescribed; don’t just wait until your pain starts. There’s no risk of becoming dependent on pain medications when they’re prescribed appropriately to control pain.
• Complementary treatments such as massage, listening to music and different relaxation techniques may help.

Nausea and vomiting

Nausea and vomiting may be caused by medications, treatments or the disease process. Your care team can prescribe anti-nausea medications to help. Read more about medicines for nausea and vomiting. 

Self-help tips

• Eat smaller, frequent meals.
• Take anti-nausea medication at least half an hour before you eat.
• Avoid certain foods or smells that make your nausea worse.
• Food such as soups, yoghurts and smoothies are easier for your body to digest.
• Try ginger in biscuits, drinks or tablets.
• Drinks such as peppermint tea and lemonade may help.

Constipation

Constipation can be caused by eating and drinking less, being less active or as a side effect of medication. Your care team may prescribe one-off or regular medication for constipation such as laxatives. Read more about laxatives.

Self-help tips

• Drink small, frequent amounts of fluids.
• Ask your doctor for laxatives if you are beginning on a drug like morphine (an opioid).
• Continue to move around and be active as much as you can.
• Eat high-fibre foods such as porridge, wholemeal bread and certain vegetables and fruits.

Loss of appetite

Loss of appetite may be due to nausea and vomiting, but if you’re less active than you used to be your body needs less energy. And it is common towards the end of life.

Self-help tips

• Eat small, frequent meals.
• Eat high-calorie meals to give you the energy you need.
• Don’t force yourself to eat.

Breathlessness

Breathlessness can be caused by the disease process affecting your heart or lungs, but it can also be caused by anxiety or a side effect of medications and treatments.

If breathlessness develops suddenly, seek medical help.

If breathlessness develops slowly and comes and goes, your care team may prescribe anti-anxiety medications, nebulisers or steroids.

Oxygen can be useful in some conditions but in others it will make little difference. Your doctor can advise and prescribe this when appropriate.

Self-help tips

• If anxiety is the cause, try some relaxation and breathing techniques.
• Consider a walking aid such a walking frame to still maintain your independence while conserving your energy.
• A change in position can help.
• Rest often and sleep when you need to.

Weakness and fatigue

Weakness and fatigue are very common near the end of life. It’s still important to do as much for yourself as you can but make sure you find time to rest.

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. 

Learn more

Home nursing tips Hospice NZ
Managing pain and other symptoms NHS Choices
Controlling symptoms in palliative care Health Info Canterbury

References

Auckland Regional Health Pathways
The palliative care handbook