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Definition

A decrease in mental and physical ability is called failure-to-thrive. It often includes a combination of:

  • Poor nutrition
  • Decreased mobility
  • Depression
  • Mental impairment

Causes

Failure-to-thrive is caused by a blend of issues. It can be a different for each person. Chronic health problems often play a role.

For example, mental health problems can make it hard for some to have a proper diet. A poor diet can then make the chronic condition and overall health worse.

Risk Factors

Failure-to-thrive is most common in older adults.

Factors that increase the risk of failure-to-thrive include:

  • Having more than one chronic disease
  • Certain medicine
  • Physical or cognitive limits
  • Having little or no social interaction
  • Limited income
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Symptoms

Symptoms may include:

  • Loss of appetite
  • Poor mental functioning
  • Weight loss
  • Decreased activity
  • Increased fatigue
  • Depression

Diagnosis

You will be asked about your symptoms and past health. There may also be questions about diet and typical day. A physical and mental health exam will be done.

Tests may be done to look for physical causes. It may take some time to find all the issues that are causing the problem.

Treatment

Treatment will depend on the causes. Treatment may include:

Treating Current Conditions

Current treatment plans may need to be reviewed. A change may help to better manage chronic conditions.

Sometimes the treatment itself can cause problems. The treatment plan will be changed as needed.

Dietary Changes

Diet plays a large role in failure-to-thrive. A dietitian can help. This may include meal planning and food choice. There may also be solutions for those that have a hard time eating.

Supportive Therapy

Supportive care may include:

  • Social workers can suggest local services. Help may be available for shopping, meal delivery, and home care.
  • Physical or occupational therapy may help with movement issues.
  • Mental health counseling may also help.

Medications

Medicine may be given for depression.

End-of-Life Care

Failure-to-thrive may be the end stage of an illness. Advance directives are important for a care plan. These formal documents can help guide medical care in case you are unable to direct your care. It may change medical care from treating issues to focusing on comfort only. Other important documents include a living will and medical power of attorney.

Prevention

Support systems may help to see problems early. It is also important to let your care team know about any problems you are having with care plan. Quick care may help to prevent failure-to-thrive.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://www.hc-sc.gc.ca

National Institute on Aging
https://www.nia.nih.gov

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

Evans C. Malnutrition in the elderly: a multifactorial failure-to-thrive. Perm J. 2005 Summer;9(3):38-41. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396084. Accessed January 9, 2019.

Kumeliauskas L, Fruetel K, et al. Evaluation of older adults hospitalized with a diagnosis of failure-to-thrive. Can Geriatr J. 2013;16(2):49-53. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671012. Accessed January 9, 2019.

Roberton R, Montagnini M. Geriatric failure-to-thrive. Am Fam Physician. 2004 Jul 15;70(2):343-350. Available at: http://www.aafp.org/afp/2004/0715/p343.html. Accessed January 9, 2019.

Sarkisian C, Lachs M. “Failure-to-thrive” in older adults. Ann Intern Med. 1996;124(12):1072-1078. Available at: http://annals.org/article.aspx?articleid=709734. Accessed January 9, 2019.

Last reviewed August 2018 by EBSCO Medical Review Board James Cornell, MD  Last Updated: 1/8/2019