Does it seem like your elderly family member has gone downhill lately? It could be due to something called failure to thrive.
Keep reading to learn more about failure to thrive, as well as the risk factors, diagnosis, and treatment.
What Is the Medical Term Failure to Thrive?
You’ve likely heard doctors using the term “failure to thrive” when describing infants. In pediatrics, failure to thrive is diagnosed when children aren’t growing at the same rate as their peers. These children weigh significantly less and gain weight at a slower rate than other kids their age.
What you might not realize is this term is also used in geriatric care. As with children, seniors are compared to people in their age group. The diagnosis occurs when older adults experience a gradual decline in cognitive or physical abilities without a clear explanation. This is usually accompanied by social withdrawal and weight loss.
For instance, assume your elderly mother suddenly loses weight, has a poor appetite, and is no longer active. She also stops engaging socially. If she has cancer, that could be the reason behind the appetite, weight, and activity change. However, if there is not a clear reason, the decline is caused by failure to thrive.
What Causes Failure to Thrive in the Elderly?
Instead of a single reason, failure to thrive is usually caused by multiple factors. If your loved one has failure to thrive, it’s likely due to one or more of the following:
· Multiple chronic conditions
· Functional impairments
· Psychiatric disorders
These issues can often lead to depression, mobility issues, and weight loss. That, in turn, causes some seniors to develop failure to thrive.
It’s easier to understand this when you picture a row of dominos. The dominos are standing up in a row, with one after the other.
Now assume your loved one develops cancer. That causes one domino to fall. The disease can cause your loved one to become depressed, causing another domino to fall. That, in turn, might lead to a lack of activity, knocking down another domino.
The chain reaction of the dominos is much like the chain reaction that leads to failure to thrive. Often, the last domino standing is the one for nutrition. When seniors lose their appetite and stop eating, they don’t get enough nutrition, making it nearly impossible to thrive.
What Increases the Risk of Failure to Thrive in the Elderly?
If you have an elderly loved one, knowing the risks of failure to thrive is essential. Experts have identified 11 risk factors for failure to thrive, often referred to as the “11 D’s.” Let’s take a closer look at each one.
Diseases
Both existing and undiagnosed medical conditions can lead to a failure to thrive. These conditions include renal failure, chronic obstructive pulmonary disease, and congestive heart failure.
Depression
If your family member is depressed, he or she is much more likely to end up with failure to thrive. Depression can lead to:
· Loss of appetite
· Social isolation
Despair
When left untreated, depression can turn into despair. At this point, your loved one might lose the desire to live. This is a dangerous condition and requires immediate treatment.
Drugs
Seniors have problems metabolizing drugs, which can increase the side effects. Sedation is a side effect of opioids, benzodiazepines, and other medications, and it’s even worse for seniors. This can lead to mobility issues and malnutrition.
Drinking Alcohol
Seniors also have issues metabolizing alcohol, which can also increase the sedating side effects. If you are afraid your loved one suffers from failure to thrive, consider his or her alcohol consumption. Getting that under control is an important step in overcoming this condition.
Deafness and Other Sensory Problems
If your loved one is deaf, blind, or has another sensory issue, he or she might also experience social isolation. That can lead to depression, and sometimes, despair.
Dementia
If your loved one has dementia, he or she is at an increased risk of developing failure to thrive. The risk is increased because dementia can cause:
· Loss of appetite and malnutrition
· Social isolation
· Depression
Delirium
While dementia has a slow onset, delirium is acute. If your loved one has delirium, you likely noticed an immediate change in awareness, attention, and cognitive function. Fortunately, delirium can normally be corrected. After it’s treated, your loved one should be more aware and begin to thrive.
Dysphagia
Dysphagia, or difficulty swallowing, can lead to malnutrition. If your loved one has this condition, he or she likely coughs and chokes when eating and might aspirate. Along with malnutrition, it can make your loved one feel socially isolated and depressed.
Desertion
When people age, it’s not unusual for them to become socially isolated. If your loved one feels deserted by family and friends, he or she is at high risk for failure to thrive. Your loved one might have trouble sleeping, taking medications, and more when alone. Plus, the lack of social life can cause depression.
Destitution
If your loved one doesn’t have the money necessary to buy food and medical supplies, he or she could suffer from malnutrition and mobility issues. Plus, a lack of money leads to stress and can cause your family member to feel overwhelmed. Thus, financial problems increase the risk of failure to thrive.
Understanding the Diagnosis and Treatment
If you think that your loved one has failure to thrive, bring it up with his or her physician. Then, the doctor can assess your family member to see if failure to thrive is the proper diagnosis. If it is, your loved one can undergo treatment.
Let’s take a closer look at how this condition is diagnosed and treated.
Diagnosing Failure to Thrive
Failure to thrive isn’t like other medical conditions. Your loved one’s doctor can’t simply look at the results of a blood test or X-ray to see if he or she is suffering from failure to thrive.
Instead, diagnosing failure to thrive begins by ruling out other conditions. If your loved one is declining without a medical reason, then he or she will be diagnosed with failure to thrive.
The process usually begins by examining the patient and conducting a thorough review of his or her medical history. The physician needs to look at all of the patient’s prescriptions to make sure there aren’t any medications that might be causing the decline.
Next, the doctor will run diagnostic tests and labs to check for medical conditions. Your loved one may have a physical condition that hasn’t been caught before. This condition could be the cause of the failure to thrive.
Common conditions that can look like failure to thrive include congestive heart failure, cancer that’s metastasized, and chronic lung disease. These are just a few of the many conditions that can cause depression, loss of mobility, lack of appetite, and other issues related to failure to thrive.
Then, the doctor might have your loved one undergo additional evaluations, such as:
· The Get Up and Go Test to assess mobility
· A mental status test to check for impaired attention
· Psychological exam
· Functional ability assessment
· Hearing and vision tests
Also, the doctor will likely inquire about your loved one’s socioeconomic situation and support system. A poor socioeconomic situation and lack of support could be the reasons behind the decline.
Treating Failure to Thrive
Physicians take a multi-prong approach to treating failure to thrive in the elderly. The most devastating aspects of failure to thrive are:
· Depression
· Cognitive impairment
· Malnutrition
· Impaired physical function
Your loved one’s doctor will incorporate a treatment plan to address each one. Then, your loved one can begin to thrive again.
Let’s look at what you can expect when your loved one is treated for failure to thrive.
Treating Depression in Failure to Thrive Patients
Treatment often begins with addressing depression. Depression significantly impacts cognitive and nutrition issues. It can even impact physical function.
Your loved one’s physician has numerous options available for treating depression. While some patients respond well to medications, your loved one’s physician might be concerned about side effects. Some side effects are more pronounced in elderly patients, and they could be even worse if your loved one is already on several medications.
Because of that, the physician might recommend music or light therapy. Traditional therapy can also be used to address depression in seniors.
Addressing Cognitive Issues
You might think that you can do nothing about cognitive decline, but that’s not the case. Your loved one’s physician might recommend cognitive training to address the decline. Cognitive training can improve memory and make it easier for your family member to participate in daily living activities.
Cognitive training is founded on the belief that the brain can change at any age. Thus, the right training exercises can improve your loved one’s cognitive abilities while preventing further decline.
A physician can use cognitive training to target one or multiple abilities. Then, your loved one will complete exercises geared toward that activity or activities. The activities are repetitive, and your loved one can complete the tasks on a computer or in person.
After undergoing cognitive training, the physician might recommend games or puzzles to enjoy at home. These activities can keep the mind sharp as your loved one ages.
Modifying the Diet
Dietary modifications are also generally part of treating failure to thrive in the elderly. Your loved one likely has vitamin and nutritional deficiencies that need to be addressed. Also, if your loved one has dietary restrictions, they might be lifted for at least a short period of time.
Dietary restrictions can force elderly patients to eat foods they don’t like. That, in turn, might cause them to avoid eating altogether. By reducing or eliminating the restrictions, your loved one will get to choose from more foods. This can improve nutrition.
The physician also might also recommend that your family member take supplements or nutritional products. Also, if appetite continues to be a problem, your loved one might get a prescription for an appetite stimulant such as:
· Megestrol
· Dronabinol
These medications do have side effects, so they aren’t a long-term solution. However, your loved one might be on them for a few weeks or months. Then, he or she will undergo another evaluation. Hopefully, the medications won’t be needed anymore, and the doctor can stop prescribing them.
Addressing Functional Impairments
Treatment typically includes activities to address functional impairments as well. The doctor might send your loved one to physical therapy to improve balance and mobility. Also, if your loved one needs an aid such as a walker, the doctor will recommend that.
The doctor can also see if medications are causing mobility issues. Overmedication is a serious problem for seniors and can make them unstable. Adjusting medications can help overmedicated seniors improve their mobility.
How Can a CDPAP Caregiver Help Their Patient Who Is Suffering From This Condition?
If you’re caring for a loved one with failure to thrive, you can do quite a bit to help. Let’s go over some ways you can help your family member thrive.
Ensure the Living Area Promotes Mobility
First, assess your loved one’s living situation. Is it hard for your loved one to get around at home? Make sure he or she has clear pathways for walking to help with mobility. You might need to reorganize the house so your family member can move with ease.
Provide Healthy, Nutritious Meals
As a CDPAP caregiver, you can handle the grocery shopping and meal prep duties. Prepare healthy, delicious meals for your loved one, and eat with him or her. When you eat together, your family member is more likely to consume the recommended amount.
Add Activities Into the Mix
A lack of activity and failure to thrive go hand in hand. When you’re a caregiver, you can incorporate safe activities into your loved one’s daily routine. Speak with the physician first to find out what activities and exercise your loved one can safely enjoy. Then, help your family member get up and go.
Include Some Hobbies
Does your loved one have hobbies? Since the failure to thrive diagnosis, he or she has likely stopped engaging in them. Gently encourage your loved one to take up these hobbies once again. That can go a long way in improving mood and cognitive function.
Encourage Socialization
Isolation can also lead to failure to thrive. Your loved one might not socialize as much as he or she used to, causing depression. Encourage your loved one to socialize more and do everything you can to help.
At first, his or her socialization might consist of talking to you. Over time, though, your family member might be comfortable having others come over to the house. You can also take your loved one out for socialization.
Tackle Failure to Thrive Head On
Some decline is expected as seniors age. However, if the decline is pronounced, take your loved one to a doctor for diagnosis and treatment. Then, work with your loved one and provide the support needed. Between treatment and your help, your loved one can thrive again.