Adult Failure to Thrive (FTT) describes a syndrome of decline that occurs in the elderly affecting physical frailty, cognitive impairment, and functional disability. The United States National Institute of Aging described 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.” FTT describes the late stages of decline and may represent a final common pathway toward death unless interventions can reverse the course.
For some patients, FTT is caused by a single disease (eg, cancer) and the treatment of that disease drives the management plan. However, at Providence Care, our medical team looks at multiple factors that may be concurrently present and contribute to impairment such as medical comorbidities, medications, and psychological factors. By identifying and treating multiple contributing factors we can improve quality of life and function in this group of patients approaching end of life. All of such treatments are instituted as appropriate and in keeping with the patient’s goals of care. Our staff offers specific in home care with our doctors visiting the patient at home. Our caregiving support staff helps with cooking, personal care, and other activities for daily living.
Providence Care focuses on patient goals and education as it relates to the sometimes slow decline of FTT patients. Optimal management of FTT requires a multidisciplinary and multi-faceted approach to treat those identifiable causes that are cooperative to treatment. Significant improvements in quality of life can be achieved, even in the setting of a major disease state that cannot be cured, by treating contributing factors. As an example, some of our patients may have progressive Alzheimer disease that cannot be cured. However, simultaneous pharmacologic interventions for depression and memory, elimination of potentially harmful medications, aggressive social work interventions to increase safety and social interaction, and physical therapy to improve gait instability, can help with the downward spiral of FTT for months to years. Providence Care’s specific goals of care are among the best in the field.