Growing older comes with changes. Appetite may decrease, energy levels may fluctuate, and it takes longer to recover from an illness. However, when a person loses his/her weight unwillingly, refuses to eat regularly, finds it hard to do daily tasks, and looks faded, it may be a sign of something more severe than ordinary aging.
Family members tend to see all those changes in advance. An active and enthusiastic parent is less willing to eat their favorite food now; clothes start hanging loose on him/her; he/she is tired after doing his/her daily routine. He/she becomes less talkative and tries to avoid social gatherings. These symptoms are quite easy to ignore, but over time, they can be the symptoms of a very serious problem called adult failure to thrive.
The fact is that adult failure to thrive is not a disease. It is rather a term for the deterioration of one’s health state due to many physical, psychological, or social factors. And the main advantage of this condition is that when caught in time, it can be cured easily.
Let’s explore what this condition means, why it happens, and how recovery is possible with the right approach.
What Is Failure to Thrive in Adults?
The term “failure to thrive” (FTT) in adults is used for a clinical syndrome that entails a progressive deterioration in health condition. It includes unintentional weight loss, malnutrition, poor appetite, lack of activity, and inability to carry out everyday tasks.
In contrast to the disease with a single identified cause, adult failure to thrive occurs due to the coexistence of a few health conditions. Such diseases may be chronic illnesses, malnutrition, depression, cognitive impairment, drug toxicity, and lack of social support.
When dealing with adults, the healthcare providers consider the possibility of failure to thrive in case of the following symptoms:
- Unintended weight loss
- Malnutrition over a period of weeks or months
- Weakness
- Lack of mobility
- Fatigue interfering with daily activities
- Loss of independence
The problem is quite common among older adults; however, younger adults with serious chronic illnesses or disabilities can suffer from it as well.
Instead of considering a particular symptom, doctors take into account the general health, quality of life, nutritional status, psychological state, and functioning of an adult person.
Why Failure to Thrive Happens
One of the biggest misconceptions is that failure to thrive simply means that the individual does not eat enough.
In truth, eating less may be a consequence rather than the main cause of failure to thrive.
Our bodies operate as a complex system, and when one part fails, it affects all the other parts too.
For instance:
A senior suffers from arthritis. They experience pain when walking. Walking causes discomfort, so shopping for groceries becomes a problem. As a result, less food is bought.
Malnutrition results in muscle loss. Muscle loss leads to weakness. Weakness puts the person at risk of falling. Falling is frightening, so they become even less active.
A vicious circle is formed within several months.
Common Causes of Failure to Thrive in Adults
Chronic Medical Conditions
Many long-term conditions slowly decrease appetite, energy levels, and overall well-being.
Examples of those are:
- Heart failure
- Chronic kidney disease
- COPD
- Diabetes
- Parkinson’s disease
- Cancer
- Liver disease
- Strokes
- Arthritis
Such diseases usually raise the nutritional requirements but, at the same time, decrease the will or capability to eat.
Poor Nutrition
Malnutrition continues to be among the top causes of failure to thrive in older people.
The reasons why older adults eat less include:
- Trouble chewing
- Ill-fitted dentures
- Swallowing issues
- Decreased ability to taste food
- Inability to shop for food
- Money difficulties
- Difficulties cooking
Sometimes people can still eat every day, yet do not have enough protein, vitamins, and calories for their muscles.
Depression and Mental Health
Mental health significantly influences physical health.
Depression may lower an individual’s appetite, motivation, and energy levels. Individuals may stop making their meals, become dehydrated, and isolate themselves from others.
Sadly, depression in senior citizens may go undiagnosed because the condition manifests itself physically and not emotionally.
Treatment of depression helps to increase appetite.
Cognitive Disorders
Alzheimer’s disease and various forms of dementia often lead to adult failure to thrive.
Those suffering from dementia may:
- Be forgetful of meals
- Be forgetful that they have already eaten
- Lose their interest in eating
- Struggle with food preparation
- Become confused about hunger
Without proper assistance, the loss of nutrition may come very quickly.
Medication Side Effects
Prescription medications may interfere with appetite.
Some examples are:
- Nausea
- Dry mouth
- Taste change
- Stomach upset
- Fatigue
- Dizziness
If there is a combination of medications, these side effects may become more severe.
Healthcare providers tend to analyze medications carefully in case of adult FTT.
Social Isolation
Eating is often a social experience.
People who live alone often eat smaller portions compared to those who share their meals with their families or friends.
Loneliness can discourage people from preparing healthy meals because they can choose to skip their meals or rely on processed foods.
Social isolation also predisposes a person to depression, thus adding to the decline.
Risk Factors
While failure to thrive can affect any individual, there are several risk factors that may put a person at risk.
They include:
- Over 65 years of age
- Presence of multiple illnesses
- Hospitalization
- Mobility problems
- Cognitive dysfunction
- Depression
- Living alone
- Financial problems
- Dental issues
- Spouse’s recent death
- Healthcare unavailability
- Frailty
The more risk factors are present, the more monitoring is required.
What Are the Signs of Failure to Thrive (FTT) in Adults?
The symptoms of Failure to Thrive (FTT) in adults usually appear gradually and not suddenly, hence making them easily overlooked in the initial phases.
Some of the most common symptoms include:
Unexpected Weight Loss
Unexpected weight loss is usually the first and most obvious symptom.
Loss of up to 5-10% of body weight within a period of six to twelve months can be an indication of a serious problem.
Loose clothing, muscle atrophy, and changes in the face are some symptoms that should never be overlooked.
Loss of Appetite
Some of the symptoms reported by adults suffering from failure to thrive include:
- Feeling full quickly
- Forgetting meals
- Losing appetite
- Only eating a few bites
- Not eating anything
Persistent appetite loss requires medical evaluation.
Persistent Fatigue
Routine activities become exhausting. Common activities like bathing, dressing up, cooking, and walking around become increasingly difficult.
Levels of energy continue falling despite enough hours of sleep.
Muscle Weakness
The rate of loss of muscle is fast once there is low consumption of protein and less physical activity.
Weak muscles result in:
- Inability to stand
- Difficulty in climbing stairs
- Loss of strength in the hands
- Slow walking
- Fall due to the lack of strength
Weak muscles progress faster than thought.
Reduced Physical Activity
Individuals lose interest in their hobbies, social gatherings, and exercises.
More time is spent sitting down or resting, leading to increased loss of muscle mass.
Poor Personal Hygiene
The individual may begin neglecting grooming practices and household chores.
Oftentimes, family members are the first to realize.
Frequent Illnesses
Bad eating habits cause poor immunity.
Consequently, the individual becomes prone to:
- Frequent illnesses
- Slow wound healing process
- Longer healing time after sickness
- Hospitalization
- Mood Changes
Individuals often get irritable, anxious, sad, confused, or withdrawn.
Emotional symptoms should be evaluated alongside physical changes rather than separately.
How Doctors Diagnose Failure to Thrive
Failure to thrive in adults does not have one specific laboratory test that would provide confirmation.
The process is more comprehensive and involves:
Reviewing history, medications, nutritional intake, functioning, mental state, and life changes.
The doctor can order blood tests to check for an underlying condition such as anaemia, infection, thyroid problems, vitamin deficiency, or kidney problems.
The doctor assesses the weight trends, muscle mass, fluid volume, balance, mobility, and cognition of the patient.
Besides weight loss, the reasons behind the problem need to be understood.
Treatment for Failure to Thrive in Adults
The best treatment for adult failure to thrive is addressing the underlying reasons rather than trying to increase the intake of calories.
It takes a personalized approach from a multidisciplinary team.
Improve Nutritional Intake
Nutrition is the core of the treatment plan.
Possible interventions include:
- Protein-rich diet
- Nutrient-dense snacks
- Oral nutritional supplements
- Frequent smaller portions
- Increasing hydration
Dietitians develop individual meal plans for patients considering their health conditions and preferences.
Manage Underlying Medical Conditions
Treatment of heart disease, diabetes, infection, chronic pain, or digestive problems may greatly increase appetite and energy.
Better management of symptoms will improve nutrition and increase strength.
Review Medications
Healthcare providers may stop or reduce the dosage of medications that negatively affect appetite.
The review of medications is very important for older people taking several drugs at once.
Physical Therapy
It may sound strange that physical therapy should be included in the treatment regimen for weak patients, but exercise helps strengthen muscles.
Physical therapy involves the following activities:
- Strength building
- Improving balance
- Increasing walking stamina
- Prevention of falls
- Maintaining functional independence
Even small changes in mobility may improve confidence and general condition greatly.
Mental Health Support
If psychological disorders such as depression, anxiety, or grief affect patients’ health, counseling and proper treatment become crucial steps towards recovery.
Proper emotional health will restore motivation to eat, interact with others, and move.
Social Support
Family involvement becomes very important.
Basic things like:
- Eating together
- Assistance in food shopping
- Motivating to walk
- Helping to go to appointments
- Checking regularly
may have a big impact on patients.
For those living alone, assistance from home carers or community programs provides valuable support.
Can Failure to Thrive in Adults Be Reversed?
A common concern families have is whether failure to thrive in adults can be reversed.
The answer depends largely on the underlying cause and how early treatment begins.
There are many instances when the problem can be alleviated by dealing with the reasons for its occurrence. It is possible to mention treatment of depression, nutrition correction, improvement of health conditions, and physical activity, which will allow gaining strength and weight back.
But the process of recovery will be more complicated in the case of advanced dementia, progressive neurological problems, or serious terminal diseases. But even in such cases, it is possible to make a patient’s life better by providing him with supportive care.
What really matters is the early treatment of the problem.
Preventing Failure to Thrive
Preventive measures usually involve noticing signs early instead of waiting for significant symptoms.
Strategies for healthy aging involve the following:
- Consuming balanced diets that have adequate amounts of proteins, fruits, vegetables, and whole grains.
- Engaging in physical activities such as walking, stretching, and exercise as recommended by your healthcare practitioner.
- Getting regular medical checks to follow up on any chronic condition.
- Examine your medications frequently to see any side effects.
- Remaining socially involved with friends and families or other support groups.
- Seeking treatment for depression, grief, and anxiety rather than thinking that they are a normal part of the aging process.
- Regularly check your body weight and discuss any unexplained weight gain with your physician.
Small, consistent habits can help avoid the gradual deterioration that causes failure to thrive.
When Should You Seek Medical Help?
Occasional fatigue or a temporary loss of appetite is common, particularly when one is recovering from an illness. Nonetheless, persistent symptoms should be checked immediately.
One should consult a doctor if an adult suffers from unexpected weight loss, poor appetite, increased weakness, falls, confusion, inability to complete daily tasks, or social withdrawal. This could mean there is an undiagnosed health problem that needs to be treated.
Apart from enhancing the likelihood of making a successful recovery, early evaluation will help avoid further complications like malnutrition and hospital admission.
Conclusion
Failure to thrive in adults is more than a diagnosis; it is a wake-up call indicating that something is wrong in the patient’s body and/or mind, and he or she needs help. It usually takes time to develop, but the situation cannot be ignored since it means “simply getting old.”
The causes of the failure to thrive in adults may vary and include such factors as being ill, lack of nutrients, depression, medications, or social isolation. Finding out what is causing the problem will definitely help restore the well-being and vitality of adults.
With the proper medical intervention, good nutrition, exercise, and psychological stimulation, many adults will recover and be able to live their lives normally and independently. However, the assistance of family members, friends, and healthcare professionals is needed for this.
Aging brings its own problems and difficulties, but with a proper understanding of the syndrome and appropriate treatment of failure to thrive in adults, many people can have better and healthier future lives.
