R53 + (Z51.5)
DESCRIPTION
Fatigue is defined as a subjective feeling of tiredness, weakness or lack of energy. The pathophysiology is not fully understood but will be multifactorial in most palliative care patients, including disease- and treatment-related causes. Fatigue may be severe, distressing and persistent, regardless of adequate amounts of sleep and rest.
GENERAL MEASURES
Treat underlying causes such as anaemia, depression, and infections.
Encourage aerobic exercises, where appropriate.
Ensure that the multidisciplinary team assists with activity pacing, assisted devices where indicated, and diet.
MEDICINE TREATMENT
Note: Because of limited evidence, consideration of steroids in palliative care should be restricted to use in the terminally ill with fatigue and a specific short-term treatment goal.
Fatigue can also protect patients at the end of life from physical and emotional distress.
- Corticosteroids (intermediate-acting) e.g.:
- Prednisone, oral 0.5 mg/kg (e.g.:15–30 mg) daily, for 1 week.