People living with a life limiting illness regardless of diagnosis, may experience some common symptoms such as fatigue, loss of appetite, pain and shortness of breath at some stage in their disease trajectory. The severity of the symptoms can vary greatly.

Other symptoms such as delirium, constipation and nausea and vomiting very much depend on the person's diagnosis. Often palliative care patients will experience more than one symptom and often have a few symptoms together which are called symptom clusters. An example of a common symptom cluster could be fatigue, loss of appetite and pain.

Fatigue

For some patients the symptom can be difficult to describe, as it is different to 'normal tiredness' which is relieved in a healthy person by sleep. Often patients will say things like this.

• Even if I've slept all night, I get up and still feel exhausted.
• I have no energy, so I have stopped getting out of the house as much as I used to.
• I used to like reading the paper but it's tiring to concentrate on it now.

Mx of fatigue

Do symptoms assessment and treat reversible cause

A care plan was formulated considering the person's 'best' time of day, which activities they wished to undertake, relaxation activities such as massage to reduce stress, etc.

The person was reviewed by the physiotherapist and a gentle exercise regime was started.

Nausea

Here is a list of some of the ways in which palliative patients have tried to describe their nausea.

Sick to the stomach

Squeamish

I feel queasy.

I keep getting biliousness.

Food just turns my stomach.

I feel repulsed by the thought of eating.