Caregiver guide

Caring for someone starts with caring for yourself.

Caring for a person with a brain tumour brings challenges that other cancers don't: cognitive changes, personality shifts, seizures. This guide focuses on what is specific to your situation and on keeping you standing.

For the first decisions and medical guidance: Minute Zero. For benefits and paperwork: Benefits.
Brain tumour-specific challenges

What makes this different from other cancers

A brain tumour can change how the person thinks, feels and behaves, not because of who they are, but because of where the tumour sits. Understanding this is the first step to not losing yourself in the process.

Cognitive changes

Memory, attention, processing speed and the ability to plan can be affected by the tumour, surgery or treatment. The person may not be aware of these changes, which can be especially frustrating for you.

  • Ask for a referral to neuropsychological rehabilitation. It can help develop compensation strategies.
  • Simplify: one task at a time, written instructions, visual reminders.
  • Don't correct or argue. Redirect with patience.

Personality and behaviour changes

Irritability, apathy, impulsiveness, loss of empathy or social filter. The tumour can alter personality traits. This is not the person choosing to behave differently; it is the tumour affecting their brain. This distinction is crucial for your own emotional survival.

  • Tell your medical team about significant behaviour changes: some may be treatable with medication.
  • Remember who they are, separate from the tumour.

Seizure management at home

Seizures are common in brain tumour patients. They can be frightening, but knowing what to do (and what NOT to do) makes all the difference.

  • Ask the neurologist for a written seizure protocol specific to your situation.
  • Keep rescue medication (e.g. rectal or buccal diazepam) accessible and know how to administer it.
  • During a seizure: protect the head, turn onto their side, time the seizure, do NOT put anything in the mouth.
  • Call 112 if it lasts more than 5 minutes, if they don't recover consciousness, or if it's the first seizure.

Fatigue and energy management

Cancer-related fatigue is different from normal tiredness: rest doesn't fully relieve it. The person may need far more sleep than before and have limited windows of energy.

  • Plan important activities (visits, outings, appointments) during the best-energy times, usually mornings.
  • Gentle, adapted exercise can actually improve fatigue. Ask the team what is safe.
Caregiver burnout

More than 60% of caregivers experience burnout symptoms

Burnout is not a personal failure. It is the predictable result of sustained overload without enough support. Recognising the signs early is the best prevention.

Warning signs

  • Persistent exhaustion that doesn't improve with rest.
  • Irritability, impatience, frequent crying or emotional numbness.
  • Loss of interest in things you used to enjoy.
  • Neglecting your own health: skipping meals, abandoning exercise, postponing your own medical appointments.
  • Feeling resentful towards the person you're caring for, y después culpa por ello.

What you can do, starting today

  • Set non-negotiable time for yourself. Even 10 minutes a day makes a difference. A walk, a coffee, reading. It is not selfish, it is necessary for you to keep going.
  • Build a relay. If there are other people who can help, create shifts. Write a list of concrete tasks and ask specific people to take them on.
  • Look after your basics: sleep, food, hydration, movement. Your body needs predictability to sustain the effort.
  • Ask for professional psychological help. Many hospitals have psycho-oncology services open to caregivers. If yours doesn't, your GP can refer you.
  • Look into respite care: temporary help (professional or volunteer) that covers your role for hours or days so you can recover. Your social worker can help you find it.
Anticipatory grief

Grieving losses that are already happening

Anticipatory grief is the sadness you feel when you see the person you love lose abilities, independence, or the future you had planned together. It is real grief, not premature or inappropriate. Naming it helps you process it.

  • You may grieve the loss of roles (partner, equal, co-parent), the loss of shared plans, or the slow change in who they are.
  • Feeling grief does not mean you've given up hope. Both can coexist.
  • Talk about it: with a therapist, in a support group, or with someone you trust. Silence amplifies the weight.
Difficult conversations

Planning ahead, while you still can

These conversations are hard, but having them early, while the patient can participate, is a gift for everyone. They reduce uncertainty, prevent conflict and honour the person's wishes.

Advance directives (voluntades anticipadas)

A legal document where the person states what medical treatments they want or don't want if they can no longer decide for themselves. It can also designate a representative to make decisions on their behalf.

  • It is registered through the Autonomous Community's health service or before a notary.
  • It should be done while the person has full decision-making capacity.
  • Ask your hospital's social worker or Patient Care Service for the process in your region.

Power of attorney and legal matters

If the person's cognitive capacity may decline, it's important to arrange a power of attorney early so that someone trusted can manage financial, administrative and healthcare matters on their behalf.

What kind of care at the end

Palliative care is not giving up. It is specialised care focused on comfort and quality of life, and it can run in parallel with active treatment. Knowing the person's preferences about where and how they want to be cared for, should the time come, helps you honour their wishes and reduces your burden of decision.

Practical organisation

Tools that make the day easier

  • Medication chart: use a pill organiser, set phone alarms, and write down every change the doctor makes. With many medications (anti-seizure, corticosteroids, chemo, anti-nausea...), errors are easy.
  • Shared calendar: appointments, analyses, scans, medication renewals. Share it with the people in the relay.
  • Medical folder: keep all reports, imaging (CD/portal access), pathology results and contact details in one place, physical or digital. It saves enormous time in emergencies and second opinions.
  • Emergency plan: write down what to do if something goes wrong (seizure, sudden deterioration), who to call, and which hospital to go to. Share it with everyone involved.
  • Home modifications: grab bars in the bathroom, non-slip mats, clear pathways if mobility is affected. Small changes prevent big accidents.
Support resources

Where to find help

Crisis and support helplines

  • 024: Suicide and crisis helpline (24h)
  • 900 100 036: Spanish Cancer Association (AECC). Gratuito, 24h
  • Your hospital's psycho-oncology or social work unit

Support groups

Sharing with people who understand your reality reduces isolation. Ask your hospital social worker for local groups, or look for online groups specifically for brain tumour caregivers.

Recommended reading

The UCSF Caregiver Orientation Manual (available in Spanish) is one of the best guides specifically for brain tumour caregivers. It covers what to expect, when to call the doctor, and what you can do at home.

Caring for someone is an act of love. But love alone does not sustain you: you need tools, rights and support.