Caring for someone with advanced cancer at home

When you’re caring for someone with advanced cancer at home, there are a number of things that you might need to help or support them with.

It’s important to keep the person clean and comfortable. If they need support with washing or showering, your district nurse may be able to show you how to do this or arrange for a carer to come in. You might need to help with changing bed sheets, washing the person’s hair, moisturising their skin and organising visits from chiropodists or podiatrists.

The person you’re caring for may need help going to the toilet or may have lost control of their bladder or bowel. This can be difficult for you both. Talk to your nurse about this or you may be able to get support from an incontinence adviser.

You will need to take care when moving the person you’re looking after. Your nurse will be able to give you advice on how to move your relative or friend safely. If the person has an unexpected fall, don’t try to move them – call an ambulance for help.

Managing everyday needs

Many people with advanced cancer have treatments that can successfully control their cancer. For some people, this may be for a long time and for others it may be a shorter time.

When a person’s cancer can no longer be controlled, they may start to feel weaker and need more help with tasks such as bathing, dressing and cooking meals.

There are a number of things you might need to help them with.

Caring for someone with advanced cancer

Ciaran Devane, Macmillan's CEO from 2007 until 2014, describes the emotions he and his partner went through and the support they received.

About our cancer information videos

Caring for someone with advanced cancer

Ciaran Devane, Macmillan's CEO from 2007 until 2014, describes the emotions he and his partner went through and the support they received.

About our cancer information videos


Washing and bathing

Having a regular wash can help someone feel more comfortable and lift their mood. Many people who are bed-bound get sticky and hot, as some cancers can cause heavy sweating.

The person you are looking after may need help with a bath, shower or wash. Your district nurse or social worker may be able to arrange for a carer to come in each day to help with this. If you prefer to do it yourself, the carer can show you how to shower or wash the person you are caring for. Change the bed sheets as often as you can. Ask the district nurse to show you how to do this if the person you are caring for can’t get out of bed.

If your relative or friend is attending the local hospice day centre, it may be possible for them to have a bath while they are there. The specialist palliative care nurse can usually arrange this.


Clothing

Loose, comfortable clothing, such as tracksuits, skirts or trousers with elastic waistbands, are easy to get on and off. It‘s also a good idea to choose clothes that are easy to wash and need little or no ironing. The person you are caring for may want to stay in their night clothes. This is fine if they are more comfortable or of it is easier for them.

Someone with cancer may feel colder than usual. Warm clothes, such as socks or woollen stockings, a jumper or dressing gown can help to keep them warm. If necessary, keep a hot water bottle, electric heat pad or wheat bag close to them. Make sure they are not too hot.

Your relative or friend may be having hot flushes because of their treatment. It may be better to use layers of clothing that can be easily taken off and put on again.


Haircare

Your relative or friend may feel better if their hair is washed regularly. If the person you are caring for can’t get to the sink, you could buy a plastic hair-washing tray from a disabled aids supplier. You could try using a rinse-free waterless shampoo (or cap) that can be put directly on to their hair and removed by drying off with a towel. Ask your local chemist for information about these products or search online.

Some hairdressers and barbers provide a mobile service and will visit the home so the person you are caring for can get a haircut.

If the person you are caring for is a man, he may need help with shaving. You could always ask a male friend or family member to help with this.

If the person’s hair has fallen out due to chemotherapy or radiotherapy, their scalp may become dry and itchy. This can be helped by gently rubbing in some moisturising cream. It’s important to check with the hospital, GP or district nurse before you apply anything to the skin.

Our section on coping with hair loss has helpful tips on coping with a dry scalp.


Nails

It may be possible for someone from a voluntary group to come in to do a manicure or pedicure. Chiropodists or podiatrists will often make home visits, but this service isn’t always free so check first. If the person you are caring for is diabetic, always ask a chiropodist to cut their toe nails.


Toilet needs

If the person you are caring for is very weak, you may need to help them go to the toilet or use a commode, bedpan or urinal. This can be one of the most difficult aspects of caring and you may both be embarrassed at first. The district nurse can give you some advice and, if necessary, arrange for someone to come in and help with getting them to the toilet once or twice a day.


Incontinence

If your relative or friend has lost some or all control of their bladder and/or bowel, ask the district nurse for advice. You may also be able to get support from a continence adviser.

It’s a good idea to try to make sure the bedroom isn’t far from the toilet. Or keep a commode, bedpan or urinal nearby.

The district nurse can give you information about using incontinence sheets, pads and pants, as well as protective bed covers. These may help keep the bed clean and improve the person’s comfort.

If these aren’t effective, the nurse may suggest a catheter. This is a tube inserted into the bladder so that the urine can be drained away into a special bag. A catheter is simple and painless. Bags and tubes can easily be hidden by bedclothes and blankets. For men, it’s also possible to drain urine using a tube connected to a sheath that fits over the penis.

If necessary, your district nurse may organise a visit from a continence adviser to give you advice and information. You can also find out more from the Bladder and Bowel Foundation.


Moisturising and massage

Many people who are in bed all the time find it very soothing to have their limbs and back gently massaged. You may use a light moisturising cream such as aqueous cream, or almond or vegetable oil. This also stops their skin from drying out. Head massage or gentle rubbing can also be very soothing and relaxing. If their face is dry, you can apply a moisturising cream. Lip balm can be used for dry or cracked lips.

You shouldn’t massage areas that are swollen, sore, inflamed, or have broken skin, including areas of lymphoedema. If you are unsure, always ask the nurse or doctor before doing any massage. If the person’s skin has been exposed to radiotherapy, check with the hospital, GP or district nurse before you apply anything to the treated area.


Moving and turning

If the person you’re looking after needs help to get out of bed, you will need to be taught how to move them safely. Ask the district nurse to show you the best way to do this. Take great care when you do it, as it’s easy to injure your back. You may be able to have a hoist or sling to help you move them.

People who are bed-bound, especially those who are very ill or very thin, are at risk of getting pressure sores (bed sores). These are very uncomfortable and can become infected. To avoid getting sores, the person who is ill will need to turn from one side to their back and then to the other side about every two hours.

If they can’t turn themselves, ask the district nurse to show you the best way of turning them. A pressure-relieving mattress and ankle or elbow pads will help to reduce the risk of pressure sores.


Managing falls

If the person you care for is very weak, they may have an unexpected fall. If this happens, don’t struggle to move them, as you may risk injuring them further and yourself. Contact the ambulance service. They will come and assess them for any injuries and will help move them back to a chair or bed.

Back to Looking after someone with advanced cancer

Managing symptoms

There are many ways you can help the person you’re looking after to manage symptoms or side effects while they are at home.

Support from voluntary organisations

Charities and voluntary organisations may be able to offer information, support groups, financial help, holiday schemes, transport or counselling.

Support from family and friends

Family and friends may be able to help you with practical and emotional support while you care for someone with advanced cancer.

Other care options

You might need to take some time off from caring. There are different care options available to help you do this.