Chapter 2 failure to thrive mary sheehan, rd, ld this chapter provides examples of international nutrition and dietetics terminology idnt terms appropriate for pediatric patients with a medical diagnosis of failure to thrive and also includes a case study. In the past, failure to thrive was a condition more commonly associated with infants, but it is becoming increasingly common among the senior population. Florida health care association 20 annual conference. Other patients with ftt include those in decline despite optimal management of a chronic or terminal illness eg, congestive heart failure, chronic obstructive pulmonary disease, cancer, dementia, or those with symptoms of global decline but no causative illness despite appropriate workup. Geriatric failure to thrive gftt is a syndrome and can be clinically approached in a systematic manner.
Describe the role of mental health screening in geriatric failure to thrive patients. The national institute of aging describes failure to thrive ftt as a syndrome of weight loss, decreased appetite and poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol. Failure to thrive ftt happens when an older adult has a loss of appetite, eats and drinks less than usual, loses weight, and is less active than normal. Failure to thrive is not a single disease or medical condition. Older adults are given the aftt diagnosis, or sometimes called geriatric failure to thrive, when they experience a gradual decline in health without an. Reviewing the medical literature, we discovered that failure to thrive is a complex construct derived from many overlapping bodies of literature. The four chief characteristics of geriatric failure to thrive are impaired physical function, malnutrition, depression, and cognitive impairment. Many of these features of ftt are actually defined as features of frailty including weight loss, malnutrition, and inactivity. The term failure to thrive within the geriatric population was first used in.
This program will discuss the steps to be taken in case of undesired weight loss in the elderly. At emory, we truly believe that aging is not a disease. Geriatric failure to thrive gftt is a lecture capture video for delaware techs associate degree nursing program nur 211 course. Aginggerontology nutritiondietetics depression immunology pathophysiology national institute on aging national institute of mental health purpose recently, a geriatric syndrome termed failure to thrive has been described, consisting of weight loss.
Diseaserelated malnutrition providers guide to diagnose and code malnutrition diseaserelated malnutrition is a defined as a lack of dietary intake to adequately provide for bodily maintenance and growth. Malabsorption syndrome refers to a number of disorders in which the small intestine is unable to absorb enough nutrients. Clinical manifestations failure to thrive in the elderly. She is currently a senior advisor for the hartford institute for geriatric nursing at new york universitys college of nursing and a doctoral student at drexel university in philadelphia. Instances of failure to thrive increase with age and are associated with skyrocketing medical care costs. Failure to thrive in elderly persons is defined by the institute of medicine as weight loss of more than 5%, decreased appetite, poor nutrition, and physical inactivity, often associated with dehydration, depression, immune dysfunction, and low cholesterol. Geriatric failure to thrive gftt is a syndrome associated with functional decline, depression and malnutrition. Clinics in geriatric medicine failure to thrive in older. He may also have memory loss, trouble thinking, and trouble with daily activities. In elderly patients, failure to thrive describes a state of decline that is multifactorial and may be caused by chronic concurrent diseases and functional impairments. Geriatric failure to thrive is a multidimensional problem that requires a multidisciplinary approach. The term failure to thrive ftt has been used to describe older adults who.
Consider this diagnosis if the frail elderly patient has. Other unknown and unspecified causes of morbidity and mortality. Furthermore, these links do not constitute an endorsement of these organizations or their programs by netce, and none should. In elderly patients, failure to thrive describes a state of decline that is. But in some cases, elderly individuals may be experience a more distinct state of decline known as adult failure to thrive. Failure to thrive may be a final, common end stage process of both frailty and severe diseases a syndrome manifested by weight loss greater than 5 percent of baseline, decreased appetite, poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol levels 3. We became interested in this topic after encountering many older patients who had received a diagnosis of failure to thrive. This rotation is based in the nursing home, with a focus on experiential learning through the supervised. The icd9cm codes for adult failure to thrive for billing purposes are as follows. In this issue, shum et el1 studied the prevalence of malnutrition and risk factors in geriatric patients of a. Failure to thrive in older adults what you need to know. A bmi less than 19 or 5% or greater weight loss in a short period of time could indicate the possibility of malnutrition.
Chapter 2 failure to thrive academy of nutrition and. She was managing editor and coauthor of two chapters in geriatric. Failure to thrive, sarcopenia, and functional decline in the elderly. Create a treatment plan for a geriatric failure to thrive patients, including possible pharmacotherapy approaches and areas for monitoring and followup. The elderly population is affected by many causes of malnutrition, which can be reversed if it is addressed early. Functional abilities which are essentially the capacity to perform self. The institute of medicines definition of geriatric failure to thrive ftt is a syndrome manifested by weight loss greater than 5% of baseline, decreased appetite, poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol levels. For purposes of diagnosis and treatment, failure to thrive can be divided into nonorganic and organic causes. Geriatric failure to thrive gftt poses a complex clinical issue in gerontological nursing practice. Although the diagnosis is well established for the pediatric. Failure to thrive syndrome among older persons nih guide, volume 21, number 42, november 20, 1992 pa. Geriatric failure to thrive american family physician.
Failure to thrive ftt is a term generally used to describe an infant or child whose current weight or rate of weight gains is significantly below that expected of similar children of the same age, sex and ethnicity. The role of medications in geriatric failure to thrive. Describe types of treatment available for an elderly person diagnosed with failure to thrive. Failure to thrive in the elderly is a syndrome and not a diagnosis. Weight loss of more than 5% poor nutrition or eating. The domains are malnutrition, impaired physical function, depression and cognitive impairment. It is caused by physical and psychological impairments that over time, slowly decrease an individuals functional abilities. Frailty is a common geriatric syndrome that has been variously characterized as a wasting state of decreased physiologic reserve, loss of physiologic complexity, and accumulation of deficits 11. Management of malnutrition in the elderly population requires a multidisciplinary approach that treats pathology and uses both social and dietary forms of intervention. In elderly patients, failure to thrive describes a state of decline that is multifactorial and may be caused by chronic concurrent diseases and. Whether geriatrician, gerontologist, or administrative staff, at the section of geriatrics and gerontology, we are here to help our patients and society meet that challenge together. Section of geriatrics and gerontology emory school of. Adverse drug reactions are cited as one of the most common causes of gftt. Geriatric practitioners often order extensive diag nostic workups for these patients, which do not always reveal a reversible cause.
These nutrients may include proteins, carbs, and fats, as well as vitamins. Geriatric failure to thrive is not one particular disease or condition, but a state of decline in overall health that may be caused by chronic concurrent diseases and functional impairments. Discussed is how the concept, failure to thrive, can be borrowed from pediatrics and redefined for use in. Revisiting geriatric failure to thrive a complex and. Two distinct drugrelated issues should be considered. Provide an example of a condition that might not be responsive to medical and supportive treatment in a case of geriatric failure to thrive. Evaluation of older adults hospitalized with a diagnosis of failure. She was managing editor and coauthor of two chapters in geriatric nursing protocols for best practice.
Recently it has appeared in the medical literature in relation to malnutrition, weight loss and depression. Unexplained weight loss resulting in a body mass index bmi of 22 kgm2 or less, and. Failure to thrive in older adults annals of internal. Evidencebased geriatric nursing protocols for best practice. Download citation geriatric failure to thrive in elderly patients, failure to thrive describes a state of decline that is multifactorial. Medications, emotional problems depression, alcoholismanorexia of ageingabuse, latelife paranoia, swallowing. The concept failure to thrive ftt has been in the pediatric and child developmentchild psychiatry literature for many years. Describe physical symptoms of an elderly person with failure to thrive. Ensure adequate access to food, provide a pleasant dining experience with adequate assistance to eat, and offer favorite foods. Geriatric failure to thrive geriatric failure to thrive is a complex condition that affects millions of the elderly.
The clinical evaluation of failure to thrive ftt includes a thorough history and physical examination. Ftt does not have a universally agreed definition in the adult population. Learn about the assessment, care plan goals, and nursing interventions for gerontology nursing in this post. Failure to thrive is not classified as a singular disease but instead refers to a manifestation of combined underlying physical, psychosocial, andor mental conditions. Some home care solutions geriatric failure to thrive is not one particular disease or condition, but a state of decline in overall health that may be caused by chronic concurrent diseases and functional impairments. Failure to thrive ftt is a diagnosis used with increasing frequency for elderly patients admitted to the acute care hospital.
Gftt is not a normal part of aging, nor is it an outcome of chronic illness. Failure to thrive is commonly used as a nonspecific diagnosis when a patient loses weight due to an unknown cause. However aging, particularly in the face of disease, can be challenging. Solutions for failure to thrive patients by becky dorner, rd, ld aging well vol.
According to the institute of medicine, failure to thrive symptoms include. In this nursing care plan guide are 11 nursing diagnosis for the care of the elderly older adult or geriatric nursing or also known as gerontological nursing. Patients with an admission diagnosis of ftt or other associated diagnoses had significant delays in care when presenting to the emergency room. It usually describes infants in whom linear growth and head circumference are. It encompasses a number of conditions characterized by progressive weight loss and decrease in function.
912 326 1340 861 1006 1079 383 770 1083 1188 78 832 864 800 1521 690 333 919 543 1555 626 1580 1377 67 521 170 1088 591 216 639 788 1413 470 1570 612 107 14 637 228 1002 927 331 551 802 310 1409 920 1235 701 1028