Fatigue Management: Energy Conservation Strategies From an Occupational Therapist

Why fatigue is different

Condition-related fatigue is not the same as ordinary tiredness. It can come on quickly, last for hours or days and may not improve much with sleep. It often affects thinking as well as the body, making it harder to concentrate, remember things and make decisions. Pushing through on good days can lead to crashes that take days to recover from, a pattern often called "boom and bust".

Occupational therapists look at your whole day and week to find where energy goes and how to make it go further.

The 4 Ps of energy conservation

1. Pacing

• Break big tasks into smaller chunks, such as vacuuming one room at a time
• Rest before you are exhausted, not after
• Aim for a similar level of activity each day, rather than doing everything on good days
• Use a timer to remind you to take a break

2. Planning

• Plan your week so demanding tasks are spread out
• Schedule harder tasks for your best time of day
• Gather everything you need before starting a task
• Build rest into the plan, not just when you run out

3. Prioritising

• Ask: does this need doing, does it need doing today and does it need doing by me?
• Delegate or drop tasks that are not important to you
• Save energy for the activities you value most, such as time with family or hobbies

4. Positioning

• Sit rather than stand where you can, such as on a perching stool in the kitchen or a shower chair
• Keep frequently used items between waist and shoulder height
• Slide heavy items rather than lifting them and use a trolley

Equipment and home changes that save energy

• Shower chairs, long-handled sponges and towelling robes to make showering easier
• Perching stools, lightweight cookware and electric can openers in the kitchen
• Online shopping, meal delivery or batch cooking on good days
• Rearranging the home so everyday items are close to where they are used

Fatigue and exercise

It sounds backwards, but carefully dosed exercise can improve fatigue for many conditions, including multiple sclerosis. The key is the right amount at the right time. Our occupational therapists and exercise physiologist work together: the OT plans your energy across the week and the EP fits exercise in at the right dose, so fitness improves without triggering a crash. Exercise physiology for MS →

Funding

Under the NDIS, occupational therapy is usually funded from Capacity Building – Improved Daily Living Skills (Category 15). Equipment is funded from Capital – Assistive Technology (Category 05) and home modifications from Capital – Home Modifications (Category 06). Self-funded OT is limited to functional capacity assessments for people applying for the NDIS.

Evidence referenced in this article

• MS Australia.
• Brain Injury Australia.

Written by the Exercare allied health team. This article is general information only and is not a substitute for individual medical advice. Exercare provides mobile exercise physiology and NDIS occupational therapy across south-east and eastern Melbourne.

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