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

The person you are looking after may need help with a bath, shower or wash. Regular washing can help someone feel more comfortable and lift their mood. It may also help prevent infections. Some people with cancer spend large amounts of time in bed, which can make them feel sticky and hot. Or they may have a type of cancer or treatment that causes heavy sweating.

The district nurse or social worker may be able to arrange for a care worker to come in each day to help with bathing. If you prefer to do it yourself, the care worker can show you what to do.

Change the bed sheets as often as you can. Ask the district nurse or care worker to show you how to do this if the person cannot get out of bed.

Marie Curie has a useful video about helping someone wash.


Clothing

It’s a good idea for the person you are caring for to wear loose, comfortable clothes that are easy to get on and off. For example:

  • skirts or trousers with elastic waistbands
  • shoes and slippers with Velcro® straps.

Clothes that are easy to wash and dry, and don’t need a lot of ironing, are also a good choice. Or the person you are caring for may want to stay in their night clothes if they are more comfortable.

Wearing practical clothes can be helpful, but some people may prefer to wear the clothes they have always worn. This may help them to feel like themselves and feel in control.

Someone with cancer may feel colder or warmer than usual. They may be having hot flushes because of their treatment. Wearing layers that can be easily taken off and put on again can help.


Hair care

The person you are looking after may feel better if their hair is washed regularly. If they cannot get to the sink, you could buy a plastic hair-washing tray from a disability aids supplier. You could try using a rinse-free, waterless shampoo (or cap) that you put directly on their hair and remove by drying with a towel. Ask at your local pharmacy for information about these products or search online.

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

They may also need help with shaving. If you are unsure about this, you could ask the care worker or district nurse for advice.

If the person’s hair has fallen out because of treatment, it is important to take care of the skin on their head and other places where there was hair. Their scalp may become dry and itchy, and may be more sensitive. It can help to gently rub unperfumed moisturising cream into their scalp. It is important to check with the hospital, GP or district nurse before you apply anything to the skin.

We have more information on coping with hair loss, which has helpful tips on coping with a dry scalp.


Nail care

It may be possible for someone from a voluntary group to give the person you care for a manicure or pedicure at home.

Chiropodists or podiatrists will also often make home visits. This service is not always free so check first. If the person you care for is diabetic, always ask a chiropodist to cut their toenails. You can be referred to a chiropodist by your GP.


Toilet needs

If the person you are looking after 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 parts 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 help with their toilet needs once or twice a day.

Marie Curie has some useful tips on helping someone use the toilet.

The person you are caring for may have lost some or all control of their bladder or bowel. This is called incontinence and can be very distressing for them. It can help to get some support and advice from the community nurse. The nurse or GP may also be able to refer the person you care for to a continence adviser.

If possible, make sure their bedroom is near a toilet. You can ask the district nurse for a commode, bedpan or urinal to keep nearby.

The nurse can give you information about using incontinence sheets, pads and pants, and protective bed covers. These may help keep the bed clean and make the person more comfortable.

If these don’t help, the nurse may suggest a urinary catheter. This means a tube is put into the bladder so urine can be drained into a bag. For men, it is possible to use a tube connected to a sheath that fits over the penis. Bags and tubes can easily be hidden by bedclothes and blankets.


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

The person you are looking after may need help getting in and out of bed. The district nurse, physiotherapist or occupational therapist (OT) can show you the best way to do this. Doing this safely can help reduce risks to the person you are caring for and prevent you from injuring your back. It can also reduce the risk of falling. You may be able to use a hoist or sling, or a second person could help you. If you need more help, the district nurse may be able to arrange help from care workers.

People who are bed-bound, especially those who are very ill or very thin, are at risk of getting pressure sores. These are very uncomfortable and can become infected. To avoid getting sores, they will need to change their position regularly. If they cannot 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 reduce the risk of pressure sores.

If you have time and the person you are caring for wants you to, you can gently massage their back, arms or legs. People who are in bed for a long time may find this soothing. Use a light moisturising cream, such as aqueous cream, or almond or vegetable oil. This also stops their skin from drying out.

You should not massage areas that are swollen, sore, inflamed or have broken skin, including areas of lymphoedema (swelling of the arms and legs). If you are unsure, always ask the nurse or doctor before doing anything. If the person has had radiotherapy treatment, check with the hospital, GP or district nurse before you put anything on the treated area.

Your local Carers Trust Carers’ Centre may offer training in areas such as first aid, and moving and handling. You could also speak to your GP or district nurse. The British Red Cross also offers free courses on handling and can supply equipment.


Managing falls

The person you care for may be at risk of falling. This may be because they have problems moving around or they have had falls in the past. Their GP or district nurse can refer them to a falls prevention service. This service can vary depending on where the person you care for lives. But they may be able to get physiotherapy to help avoid falls and advice on getting rid of trip hazards.

If the person you are caring for does have an unexpected fall, don’t try to move them. You may risk injuring them more and hurting yourself. You should call an ambulance. The paramedics will check 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.