Overview of fatigue in palliative care

Al Maqbali, 2021Ingham, 2021Radbruch, 2008

Fatigue is a subjective experience defined as a persistent and distressing sense of tiredness, which is not proportional to activity, not relieved by sleep or rest, and which interferes with normal functioning. It may manifest as decreased physical energy with ‘tiring easily’ or ‘weakness’, decreased concentration, poor memory and lack of motivation. Sleep patterns may be abnormal and sleep may feel unrefreshing.

Fatigue, a frequent and distressing symptom in palliative care, has a major impact on quality of life, relationships, and ability to adhere to management plans. Fatigue is associated with many physical and psychological symptoms experienced by patients with palliative care needs. In advanced cancer, fatigue is more common than pain. It is also a major symptom of other life-limiting illnesses, including neurological, cardiovascular, respiratory, kidney and liver diseases.

Assessment, including focused investigation to identify possible causes of fatigue, should be coupled with a multidisciplinary and multifactorial approach to management.