Failure to Thrive, Adult

Adult failure to thrive is a condition that some older people develop. People with this condition are able to do fewer and fewer activities over time. They may lose interest in being with friends or may not want to eat or drink. This is not a normal part of aging. Many things can cause this. Health problems, long-term disease, depression, bad eating habits, cognitive impairment, or disability may play a role in the development of this condition. Most of the time, it is important to treat whatever is causing failure to thrive. Sometimes, though, it might not be possible to treat the condition. The person could be nearing the end of life. Then, treatment could make the person suffer longer.

CAUSES

Sometimes, no specific cause can be found. Factors that have been linked to failure to thrive include:

  • Diseases and medical conditions, such as:

  • Cancer.

  • Diabetes.

  • Stomach and intestinal (gastrointestinal) problems.

  • Lung disease.

  • Liver disease.

  • Kidney disease.

  • Heart problems.

  • Thyroid disease.

  • Neurologic problems.

  • Vitamin deficiencies.

  • Disability. This may be the result of:

  • A broken hip.

  • A stroke.

  • Very bad arthritis.

  • Infections that last a long time.

  • A long recovery from a surgery.

  • Mental health issues.

  • Medicines.

  • Eating problems.

  • Medicine for certain conditions. These conditions include:

  • Parkinson's disease.

  • Seizure disorder.

  • Anxiety.

  • Pain.

  • High blood pressure.

  • Depression.

  • Infections.

SYMPTOMS

  • Losing weight (more than 5% of total body weight).

  • Getting more tired than usual after an activity.

  • Having trouble getting up after sitting.

  • Not being hungry or thirsty.

  • Not getting out of bed.

  • Not wanting to do usual activities.

  • Being depressed.

  • Getting infections often.

  • Having bedsores.

  • Taking a long time to recover after an injury or a surgery.

  • Weakness.

DIAGNOSIS

A physical exam can help a caregiver decide if someone has adult failure to thrive. This may include questions about the person's health presently and in the past. It also may include questions about behavior and mood, such as:

  • Has activity changed?

  • Does the person seem sad?

  • Are eating habits different?

The caregiver may ask for a list of all medicines taken because certain medicines can lead to this condition. The list should include prescription and over-the-counter medicines. The caregiver will likely order some tests. These may include:

  • Blood tests to check for infection, certain diseases, deficiencies, hormone levels, malnutrition, or dehydration.

  • Urine tests to check for urinary tract infection or kidney failure.

  • Imaging tests. Examples are an X-ray, a computed tomography (CT) scan, and magnetic resonance imaging (MRI).

  • Hearing tests.

  • Vision tests.

  • Cognitive tests to check thinking ability.

  • Activity tests to see if the person can do basic tasks like bathing and dressing. There also are tests to check if someone can shop, cook, or move around safely.

The caregiver will check if the person is eating enough healthy food. This may include:

  • Checking weight.

  • Having blood tested for cholesterol and protein levels.

  • Seeing if anything else might be making it hard to eat (tooth problems, poorly fitted dentures, trouble swallowing).

The person may need to see a specialist to help with diagnosis or treatment. These specialists may include a speech therapist, physical therapist, occupational therapist, dietitian, or social worker.

TREATMENT

Treatment for adult failure to thrive depends on the cause. Caregivers also must decide if a treatment has a good chance of working. It often takes a team of caregivers to find the right treatment. Options may include:

  • Treatments to cure a disease that can cause adult failure to thrive.

  • Talk therapy or medicine to treat depression.

  • A better diet. Eating more often, adding nutritional supplements between meals, or taking vitamins may be suggested. Sometimes, medicine is prescribed to boost appetite.

  • Medicine changes or stopping a medicine.

  • Physical therapy.

  • Moving to a place that offers more aid.

HOME CARE INSTRUCTIONS

What needs to be done at home varies from person to person. This will depend on what caused the condition and how it is treated. However, basic guidelines include:

  • Taking any medicine prescribed by the caregiver. Following the directions carefully is important.

  • Eating healthy foods. There should be enough calories in each meal. Ask the caregiver if vitamins or nutritional supplements should be taken between meals. Consider talking with a dietitian.

  • Exercising. Strength training is important. A physical therapist can help set up an exercise program that fits the person.

  • Making sure the person is safe at home.

  • Talking with caregivers about what should be done if the person can no longer make decisions for himself or herself.

SEEK MEDICAL CARE IF:

  • There are any questions about medicines.

  • There are questions about the effects of treatment.

  • The person is not able to eat well.

  • The person is not able to move around.

  • The person feels very sad or hopeless.

SEEK IMMEDIATE MEDICAL CARE IF:

  • The person has thoughts of ending his or her life.

  • The person cannot eat or drink.

  • The person does not get out of bed.

  • Staying at home is no longer safe.

  • The person has a fever.