Managing fatigue

This leaflet aims to offer advice on how to manage fatigue and improve your energy levels.

What is fatigue?

Fatigue is the feeling of extreme tiredness or exhaustion. It is a common side effect reported by people with long-term and life-limiting conditions. It is a constant tiredness that is not easily relieved by rest and interrupts a person’s ability to complete their usual activities.
Fatigue can affect a person in several ways:

1. Physically – feeling weak or breathless, lacking energy and having difficulty completing daily activities.
2. Emotionally – difficulty managing feelings, feeling tearful, low or irritable
3. Cognitively – difficulty focussing, thinking, problem solving and with memory

What causes fatigue?

Fatigue is complicated and has multiple causes such as:

• disease or illness
• side effects of treatments and medications
• anaemia
• anxiety and low mood
• poor quality sleep
• pain
• breathlessness

It is important to speak to your healthcare team about fatigue as together you can explore any possible reversible causes. Many of the causes cannot easily be resolved so it is important to try and find ways to manage fatigue. This leaflet aims to offer advice on how
to manage fatigue and improve your energy levels.

How can I make the most of my energy?

Energy conservation can be really effective; the principles are based on ‘the five ‘Ps’:

Pacing

Pacing aims to avoid a cycle of peaks and troughs in your energy levels by balancing activity with rest periods in roughly equal amounts.
Varying your activities between physical, mental and social can give your body and mind an equal chance to relax. It is important that you do not go past the point of exhaustion as it will take much longer to ‘recharge’ – little and often is sometimes more effective.

Prioritising

Identify the activities that are most important to you each day, consider activities that you enjoy and improve your quality of life. Avoid spending too much energy on activities that aren’t as important for you.

Planning

Consider using a diary. Organise your day and week ahead to save energy. Allow for recovery time around activities. Identify the times of day where your energy levels are at their best. Plan how best to complete an activity to avoid using more energy than required (for
example, bringing everything you need for the day downstairs to avoid extra trips up and down stairs, batch cooking meals).

Positioning

Try to maintain a good posture when completing activities. Consider how you may be able to save energy when completing a task, for example sitting instead of standing.

Permission

Give other people permission to help you. Give yourself permission not to do activities that you don’t need or want to do. If you’re worried about how to explain why you prefer not to do something you could say: “Trinity says…”

How else can I manage fatigue?

Exercise and activity

A little exercise can help with the feeling of fatigue, but it is important to keep a balance between activity and rest and not wear yourself out.

• Exercise and activity can be anything that you enjoy and fits easily into your daily routine. For example; walking, cleaning, dancing to some music at home, seated yoga.
• Monitor how you feel after exercising and if necessary adjust how much you do.
• Start small and slowly increase your activity as you feel able.

Sleep

Seep a regular sleeping pattern. Try and get up at a regular time each day. Short daytime naps might be helpful.

• If you cannot sleep, try to get up and read or listen to some music and then go back to bed.
• Avoid stimulants such as alcohol or coffee in the afternoon, try a snack or milky drink instead.
• Avoid ‘screen time’ for at least an hour before bed as the blue light from TV, computers and mobile phones can disrupt sleep.

Rest and relaxation

Try to have good quality rest breaks, avoid multitasking when resting (e.g. avoid watching TV,  using your mobile phone). Try to find relaxation techniques that work for you to ensure a good quality rest and to reduce stress or anxiety.

Equipment

Equipment and adaptations can make daily tasks easier. Many items can be purchased from your local disability shop or online (e.g. an
electric can opener, long handled dustpan and brush, easy-reach grabber). Others will require advice from an Occupational Therapist,
such as perching stools (to sit on while cooking and washing), bath aids and raiser to ensure your chair, bed, and toilet are at the easiest height.

Please be aware that the information in this leaflet does not replace individual assessment or advice so always check with your GP, nurse or Occupational Therapist if needed.

Further fatigue management advice can be arranged through Royal Trinity Hospice, please request a referral through your Clinical Nurse
Specialist or by calling the Admissions and Referrals team on 020 7787 1062.

Download the leaflet about managing fatigue

We can send hard copies of this leaflet to healthcare professionals and other local partners for free. Click here to place your order.