Washing regularly is important both for personal hygiene and for comfort and morale. Many people who are bed-bound get sticky and uncomfortable and some cancers can cause heavy sweating. The person you are looking after will need a regular bath or thorough wash. If they cannot get out of bed or wash themselves, they will need to be given a bed bath. Your district nurse will show you how to do this, or may be able to arrange for someone to come in each day to do it.

Change the sheets as often as you can. Ask the district nurse to show you how to do this if the person who is ill can’t get out of bed.

Sometimes it is possible for the person you are caring for to attend a day-centre at a local hospice in order to have a bath. The district nurse or Macmillan nurse can usually arrange this.

Having their hair washed regularly will also make them feel better. You can buy a plastic hair-washing tray from disabled aids suppliers, which makes this easier. Some hairdressers and barbers will do home visits. If the person’s hair has fallen out due to chemotherapy or radiotherapy, their scalp may become dry and itchy. This can be eased by gently rubbing in some moisturising cream, although if the person’s skin has been exposed to radiotherapy, it is important to check with the hospital, GP or district nurse before you apply anything to the treated area.

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

The district nurse will show you how to cut nails. It may be possible for someone from a voluntary group to come in to do a manicure or pedicure. Chiropodists will usually make home visits, but this service is not always free, so check first.

If your relative or friend's mouth is too sore to use an ordinary toothpaste and toothbrush, try using a child's toothbrush, or mouth care sticks (available from the chemist) and mouth rinses. Mouth ulcers and thrush are very common when someone is ill. If their mouth becomes very sore or coated, tell the GP or district nurse, who will be able to treat it. If dental treatment is needed, ask the dentist to make a home visit.

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 will be able to 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.

Many people who are in bed all the time find it very soothing to have their limbs and back gently massaged with a light moisturising cream (such as aqueous cream, which you can get from the chemist, 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. Cream can also be used if the lips and face are dry. 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.

If the person you are looking after needs help to get out of bed, you will need to be taught how to lift them safely. Ask the district nurse to show you the best way to do this, and take great care when you do it, as it is easy to injure your back. The district nurse may be able to arrange for you to have a hoist or sling to help you with lifting.

People who are bed-bound, especially if they are very ill or very thin, are at risk of getting pressure sores (bed sores). Pressure sores 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.

If the person you are caring for has lost some or all control of their bladder and/or bowel, ask the district nurse for advice on incontinence. You may be able to minimise the problem, for example by making sure the bedroom is not far from the toilet, or keeping a commode, bedpan or urinal near the bed or chair at all times.

The district nurse can give you information about using incontinence pads and pants and protective covers for the bed, to keep the person who is ill dry and comfortable, and the bed clean. If these are not effective, the nurse may suggest a catheter (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 is 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 contact The Continence Foundation.

Many people who are seriously ill become constipated. There are various reasons for this. Some people get constipated because they have lost their appetite and are not eating enough, or because they can’t move around much. Painkillers can cause constipation and if they are being taken regularly, laxatives will almost certainly be necessary.

If the person you are caring for has constipation, tell the GP, district nurse or home care team. They will probably advise that the person increases the amount of fluids they drink and may recommend laxatives, suppositories or enemas.

If the person you are caring for has no problems with eating, then it is helpful to add more fruit and high-fibre foods to their diet.

People who are very ill often have a poor appetite. They may feel too tired to eat, have a sore or dry throat or mouth or find swallowing difficult. Someone who has had chemotherapy or radiotherapy may not want to eat because they are feeling sick. Ask the GP or district nurse for advice.

Try to give small meals often, whenever the person feels like eating, rather than at set times of the day. Small meals and snacks can also help to stop the person feeling sick. If they can’t manage solid food, try liquidised food, or a nourishing drink such as Complan, Build-up or Fresubin, which are complete meals in themselves. Complan and Build-up can be bought from your chemist and from some supermarkets; Fresubin is available on prescription from your GP. The dietitian at the hospital may give you a supply before the patient is discharged.

Moist food is often easier to cope with, and will help to prevent a dry mouth. A glass of crushed ice chips (flavoured or plain), or a bowl of ice cream can be refreshing and help to keep the person’s mouth moist. Drinking through a straw may help, if the mouth or tongue is sore. A baby's feeder cup can be used for someone who finds it an effort to sit up to drink.

Our section on diet and cancer has suggestions for coping with eating problems.

Some people with advanced cancer feel sick or are sick (nausea and vomiting). This may be due to the cancer or a side effect of some medicines. Let the doctor or nurse know if the person feels sick as this can usually be reduced or stopped. Avoiding fatty and fried foods may help. Eating small meals and snacks, and taking small amounts of fizzy drinks, such as ginger beer, can also limit nausea and vomiting. Sucking peppermint sweets may help to relieve nausea.

People with advanced cancer are often very worried that they are going to be in severe pain. In most cases, pain can be completely controlled by medicines. The hospital doctor or GP will probably already have prescribed some painkillers. They may be given as tablets or capsules, by suppository or by injection. If the painkillers don't seem to be working, contact the GP, Macmillan nurse or hospital staff. A change of medicine may be all that's needed.

Some painkillers can make people feel drowsy or light-headed at first, but usually this wears off after a day or so. If not, tell the GP, Macmillan nurse or district nurse. Again, the painkillers can probably be changed.

Many people with cancer ask if they will get addicted to drugs such as morphine. People taking painkillers to control pain do not usually become addicted to them. Most people who become addicted to drugs initially choose to take them, and then keep taking them because they have a psychological need to do so. This is very different to someone who is in pain, who needs to keep taking the drug to keep their pain under control. People in pain have a physical need to take the drug rather than a psychological need.

If pain and other symptoms are very troublesome and distressing, a short stay in a hospice may help. There, experienced staff can monitor the symptoms and bring them under control.

You may be able to help relieve pain and discomfort with simple things, such as hot-water bottles (wrapped in a towel to prevent burns) or ice packs and massage. Sometimes, just listening to the fears and worries of the person who is ill can help them cope better with pain.

Our sections on controlling cancer pain and controlling the symptoms of cancer give detailed information. Macmillan nurses can monitor and advise on pain and symptom control.

The person you are caring for may have problems sleeping at night. This may be because they are in pain, sleeping a lot during the day, or are anxious and finding it difficult to relax. Reading, listening to music, meditating, or having a warm drink in the late evening may help them to relax and fall asleep. The GP can prescribe sleeping tablets, if necessary.