Medical Oncologist
Caretaker guide
Caretaker cycle checklist
The same four stages every cycle: the days before treatment, treatment day, the hard days that follow, and the recovery days before the next one. Each has a short list of jobs. Printed on the fridge, it stops the household renegotiating everything and stops important things being forgotten on the worst night.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
What does a caretaker need to do each chemotherapy cycle?
The same four stages, every cycle: the days before treatment, the treatment day itself, the hard days that follow, and the recovery days before the next one. Each has a short list of jobs. Printed and put on the fridge, it stops the household renegotiating everything every three weeks and stops the important things being forgotten on the worst night.
This page is written to be printed. Tick through it for the first two cycles and it becomes routine by the third. The items that matter most are the ones people forget when they are exhausted: the confirmation call, the temperature checks, and knowing which hospital to go to at night.
Confirm the cycle is going ahead the evening before
Counts sometimes come back low and treatment is postponed. One call saves a wasted journey, a wasted day's wages and sometimes a night in a lodge.
Know the hard days of your cycle
Ask your team which days after treatment counts are usually lowest. Plan the temperature checks, the visitors and the extra help around those days specifically.
The go-bag stays packed between cycles
Treatment summary, medicine list, readings notebook, charger, water and money, by the door. Never unpacked, never searched for.
Write your team's fever threshold and both hospital numbers at the top of the printed list.Stage one
The days before treatment
- Blood test done and result sent
- Where it is done, when, and whether the result goes to the hospital automatically or has to be carried. Ask whether it can be done near home the day before.
- Confirmation call the evening before
- Ring to check the counts are adequate and the cycle is going ahead. Establish who to ring and at what time so this does not depend on reaching a busy doctor.
- Transport and escort arranged
- Who drives, what time you leave, who stays with the children. Written on the rota rather than decided that morning.
- Medicines for the cycle collected
- Anti-sickness tablets and anything else prescribed to take at home, collected before treatment day rather than queued for afterwards when the patient is tired.
- Questions written down
- Anything that happened last cycle, any new symptom, anything the patient is worried about. On paper, handed over at the start of the appointment.
- Food and fluids planned for the hard days
- Soft, plain food the patient tolerated last cycle, stocked in advance. Nobody wants to be shopping on the second day after treatment.
Not sure whether this applies to you?
Ask an oncologistStages two to four
Treatment day, the hard days, and recovery
Tick through it for two cycles and it becomes routine.
Treatment day
Take the go-bag, the question list and a notebook. Write down what is said, what was given, and what to take at home and when. Ask which days this cycle are expected to be hardest.
Before leaving
- Home medicines and instructions understood
- Next appointment and blood test date
The first evening
Anti-sickness medicines taken on schedule rather than waiting for sickness. Fluids offered steadily. Rest, and a temperature reading before bed.
The hard days
Temperature morning and evening, fluids tracked, visitors limited, crowds avoided. The patient out of bed for meals and walking to the bathroom even if resting the rest of the day.
Every day
- Temperature morning and evening
- Urine passed, fluids going in
The recovery days
Short walks, outings in quiet hours, the ordinary life of the household resuming. This is the week for visitors, errands, and anything the family has been postponing.
End of each cycle
Write a short note of what happened: which days were hard, what helped, any new symptom, weight. Take it to the next appointment. After three cycles the notes show a pattern worth having.
!
At any stage, go to the nearest emergency department at once
A temperature at or above your team's threshold · shivering uncontrollably, even with a normal reading · breathlessness or chest pain · confusion or being hard to rouse · bleeding that will not stop · no urine since the morning · nothing staying down · severe stomach pain · redness, pain or discharge around a port or line · pain, swelling or warmth in one calf. Say clearly that the person is on chemotherapy, take the go-bag, and do not give paracetamol to bring a temperature down first.
Being straight with you
What this page cannot tell you
It cannot tell you your own cycle's timing. Which days are hard, when counts are lowest, how long the cycle is and when blood tests fall all depend on the drugs. Ask your team, write the answers onto this list, and it becomes yours rather than a general one.
It also cannot replace the specific instructions you were given for the medicines at home. Where your team's instructions differ from anything here, follow theirs.
The checklist is for two people, not one
If the main attendant is the only person who knows it, the household stops working the night they are ill or away. Walk a second person through it after the first cycle.
Expect the pattern to shift
Hard days often get harder and recovery slower as cycles accumulate. Review the checklist at the halfway point rather than assuming cycle two's pattern still holds at cycle five.
Put your own life on it too
A caretaker who schedules nothing for themselves is the one who collapses in month four. Put one afternoon off in each cycle, with a named deputy, and treat it as fixed.
What to do next
Print this page. Write your fever threshold, both hospital numbers and the night-time hospital at the top. Ask your team which days are hardest and write them in. Pack the go-bag, and walk one other person through the whole list.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Commonly believed
Four things that go wrong without a list
"We know the routine now; we do not need it written down."
The routine lives in one exhausted person's head until the night they are ill or away. A printed list means somebody else can run the cycle without having to be taught at midnight.
"The hospital will ring if the cycle is postponed."
Sometimes, and sometimes not in time. One confirmation call the evening before is what saves the wasted journey, the day's wages and the lodge.
"We will take the temperature if he seems unwell."
Patients on treatment often do not seem unwell until hours into an infection. Morning and evening readings through the hard days are what catch it early.
"Cycle five will be the same as cycle two."
Hard days usually lengthen and recovery slows as cycles accumulate. Review the list at the halfway point and adjust the help, the food and the rota to match.
Questions we are asked
Common questions about the cycle checklist
What is the most important item on the list?
The temperature checks through the hard days, and knowing exactly what to do if one is raised. After that, the confirmation call the evening before each cycle.
How do we know which days are the hard ones?
Ask your team which days counts are usually lowest, and keep a short note for the first two cycles. The pattern is usually clear by the third, though it shifts as cycles accumulate.
What goes in the go-bag?
The treatment summary, medicine list, temperature notebook, phone charger, water, some plain food and some money. Kept packed by the door between cycles rather than assembled each time.
Should we write notes after each cycle?
Yes, briefly: hard days, what helped, any new symptom, weight. Taken to the next appointment, three cycles of notes show the team a pattern they can act on.
Who else should know the checklist?
At least one person besides the main attendant. Walk them through it after the first cycle, and show them where the numbers and the go-bag are kept.
What if the blood test is far from home?
Ask whether it can be done at a laboratory near home the day before, with the result sent ahead. This is routine at many centres and often removes a whole journey.
When should anti-sickness tablets be taken?
Exactly as your team instructed, which is usually on a schedule rather than waiting until sickness starts. Ask them to write the timing down before you leave on treatment day.
Is there a place for the caretaker on this list?
There should be. Put one afternoon off in each cycle, with a named deputy, and treat it as fixed. A caretaker with no rest scheduled is the one who collapses by month four.
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Sources
- Macmillan Cancer Support — Looking after someone with cancer
- Cancer Research UK — Caring for someone with cancer
- National Cancer Institute — Chemotherapy and You: Support for People With Cancer
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