Q&A: 'Failure to thrive' can affect the very old, too

Q: What is "failure to thrive," and how can it be treated in my elderly parent?

A: Geriatric syndromes include several conditions with multiple causes such delirium, falls, incontinence, and frailty. Risk factors for these syndromes include older age, cognitive impairment, and the inability to perform activities of daily living such as bathing, toilet use and eating and impaired mobility.

One of the more common of these geriatric syndromes is adult Failure to Thrive, which affects anywhere from 25 percent to 40 percent of nursing home residents and is characterized by weight loss of more than 5 percent, decreased appetite, poor nutrition and inactivity. It can be accompanied by issues such as depression, dehydration, and an impaired immune system.

Failure to Thrive can be alarming to family members when they are unable to coax their loved one to eat or drink, and as a result, that loved one lacks the energy to engage and participate in activities. Although appetite stimulants may be tried, introducing the concept of comfort feeding may prove more beneficial.

In comfort feedings, the person is given the foods and fluids that they prefer the most, and receive them at various times per day in very small amounts. This process celebrates every spoonful that the patient accepts, and families can take comfort in knowing that their family member is being offered nutrition throughout the day in an atmosphere of support.

There are many ways Failure to Thrive may be diagnosed, including through a physical, a review of all medications and medical history, a screening for substance abuse and a nutritional assessment. If you suspect your loved one may be suffering from Failure to Thrive, talk to his or her primary care provider about what can be done to support the individual.

Ilene Warner-Maron, PhD, co-directs the MS program in Aging and Long-Term Care Administration at Philadelphia College of Osteopathic Medicine.