What a caregiver does in the weeks after a transplant

This page is for the family member or friend who has agreed to be the main caregiver after a stem cell or bone marrow transplant. It covers the warning signs to act on, the daily jobs at home, and how to look after yourself. The warning signs come first, because they matter most.

Call 911 or go to the nearest emergency department if the person has any of these:

• Severe trouble breathing
• Black or tarry-looking stools
• Vomit that has blood in it or looks like coffee grounds
• Very heavy bleeding, or bleeding that will not stop

MedlinePlus lists these among the signs to report after a transplant or during cancer treatment. They are not ones to sit with. Do not drive the person yourself.

Call the transplant team right away, day or night, if the person has any of these. Do not wait for the clinic to open:

• Trouble breathing at rest or while doing simple tasks
• Fever, chills or sweats
• Redness, swelling or draining at an IV line site
• Burning when passing urine
• A new mouth sore, or mouth pain
• A cough that is getting worse
• Any other sign of infection

MedlinePlus lists fever, chills or sweats as possible signs of infection. After a transplant, the marrow (the soft tissue inside bones that makes blood cells) may not yet be making the white cells to fight one. MedlinePlus says it takes 6 months or more for blood counts and the immune system to fully recover. The CDC's advice for people getting chemotherapy is to call the doctor right away for a temperature of 100.4ºF (38ºC) or higher. The CDC says a fever may be the only sign of an infection, and that an infection can be life-threatening. A normal temperature is not a reason to wait if there are chills or other signs of infection. Use the 24-hour number whatever the time. Take the person to an emergency department if nobody answers quickly.

Also call the transplant team the same day for any of these:

• A very bad headache, or a headache that does not go away
• Diarrhoea that does not go away or is bloody
• Severe nausea or vomiting
• Refusal or inability to eat or drink
• Extreme weakness
• Abdominal pain
• A new skin rash or blisters
• Yellowing of the skin or eyes

Trust what you are seeing. You are with this person all day; the clinic sees them for an hour.

Once you know the warning signs, it helps to see the whole job. NCI's description of caregiving covers a wide range:

• Helping with day-to-day activities such as doctor visits or preparing food
• Giving medicines or helping with physical therapy and other clinical tasks
• Helping with tasks of daily living such as using the bathroom or bathing
• Coordinating care and services
• Giving emotional and spiritual support

After a transplant, several of those become time-critical. MedlinePlus says the person will need close follow-up care from the transplant team for at least 3 months, and to keep all appointments. NCI says hospital visits run two or three times a week after discharge. Somebody has to make those journeys happen.

MedlinePlus discharge guidance for bone marrow transplant translates into a fairly concrete list of household responsibilities.

• Infection prevention. Wash hands with soap and water often — after being outdoors, after contact with body fluids, before handling food, after housework, after using the phone and after the bathroom. Keep the household away from crowds. Ask anyone with a cold to wear a mask or postpone the visit.
• Food. Nothing undercooked or spoiled, and check that the water supply is safe. Know how to cook and store food safely. Be cautious eating out and avoid raw vegetables, meat, fish or anything you cannot be sure about.
• Nutrition. MedlinePlus advises eating enough protein and calories to keep weight up, and limiting sugary foods.
• Mouth care. Teeth and gums brushed two to three times a day for two to three minutes with a soft-bristled toothbrush. Rinses four times a day with salt and baking soda. No mouth rinses containing alcohol.
• Line care. If there is a central venous line or PICC line, you need to know how to look after it. Ask for a demonstration before discharge.
• Pets. Cats stay indoors, someone other than the patient changes the litter box daily, and no rough play, because scratches and bites can become infected.
• Activity. Encourage walking, increasing the distance gradually according to energy levels.

Most of this is not medical skill. It is consistency, day after day, when you are already tired.

NCI does not treat caregiver health as optional. Its advice includes:

• Keeping your own medical check-ups and screenings
• Taking your own prescribed medicines
• Eating well to keep your strength up
• Getting enough sleep
• Finding at least 15 to 30 minutes a day to exercise
• Taking at least 15 to 30 minutes each day to do something for yourself

It also says to talk to your doctor if stress-related changes last for more than two weeks. Some caregivers become depressed and need help.

The line NCI uses is worth pinning somewhere visible: if you don't take care of yourself, you won't be able to take care of others.

Ask the transplant team what support exists for you specifically — not for the patient. Many centres have social workers whose job includes exactly that question, and asking early is easier than asking after you have run out of road.

• MedlinePlus — Bone marrow transplant - discharge (accessed 2026-09-29)
• MedlinePlus — Bleeding during cancer treatment (accessed 2026-09-29)
• National Cancer Institute — Support for Caregivers (accessed 2026-09-29)
• National Cancer Institute — Stem Cell Transplants in Cancer Treatment (accessed 2026-09-29)
• CDC — Watch Out for Fever (accessed 2026-09-29, via web.archive.org)