As people grow older, they may start to withdraw from activities and social interactions that they once enjoyed. They might also start to lose weight and strength. Although many people believe that these are normal consequences of aging, these changes require a thorough exploration to determine any potential reversible underlying causes. The questions arrises, exactly how is failure to thrive diagnosed?
What Is Failure To Thrive?
When an elderly person becomes increasingly frail and does not have a known terminal illness, they may be diagnosed with failure to thrive. Geriatric failure to thrive is a diagnosis that is used to describe a state of decline in elderly patients caused by multiple factors that may include chronic diseases as well as functional impairment.
Some of the most common signs of geriatric failure to thrive include inactivity, progressive functional decline and reduced appetite. When a person displays these signs, a thorough assessment will normally be carried out. Some of the causes of failure to thrive may be easy to treat, such as medication issues.
However, it is important to keep in mind that sometimes the causes of an older person’s declining health may not be easily identifiable, and the condition may be irreversible. In these cases, a diagnosis of failure to thrive can be used to help avoid needless interventions that could prolong a person’s suffering.
Diagnosed Through Doctor Administered Tests
The main signs that a person may have adult failure to thrive are impaired physical function, depression, cognitive impairment and malnutrition. A doctor will carry out an initial assessment that evaluates the person’s psychological and physical health, socioenvironmental factors and functional ability.
One of the biggest components of failure to thrive and an important predictor of mortality among older adults is malnutrition. A nutritional assessment is often one of the first tests to be carried out when a doctor suspects a patient has failure to thrive. This will involve a dietary history of the patient that includes the availability of food, the patient’s daily caloric intake, their use of herbal or nutritional supplements and the balance of nutrients they consume. It will also examine the adequacy of their diet in terms of the amount of food they eat and the number of meals they consume.
Physical manifestations of malnutrition such as weight trend, body weight and muscle wasting will also be included in this assessment. One validated tool that may be used to measure an elderly person’s nutritional risk is the Mini Nutritional Assessment, which combines their anthropometric measures and their dietary history.
It is also important to check oral pathology, ensuring that issues like poorly fitting dentures or swallowing problems are not causing or contributing to their failure to thrive. Financial and social factors that could contribute to malnutrition will also be assessed, along with an exploration of any medications that could lead to anorexia or other problems related to appetite and eating.
The following tests can be used to gain a more thorough view of a patient’s overall health and help identify common medical conditions that are associated with failure to thrive.
A Mental Exam
Mental exams can be carried out to evaluate a patient’s psychosocial function and mood. Information about the patient’s relationships, living situation, family support, social network, financial resources and recent loss or abuse and neglect will be used to help assess failure to thrive. In some cases of failure to thrive, a cognitive status change can be influenced by chronic illness, while certain medications may trigger depression and nutritional deficiency. Therefore, this aspect may require frequent reassessment.
Many older people experience depression, which can be both a cause and an effect of failure to thrive. Depression screening is normally carried out for all patients who are showing signs of failure to thrive. Diagnosis can be challenging because elderly patients with depression are more likely to complain about physical problems than conventional symptoms of depression, such as mood changes, and their depression can manifest as weight loss.
The Geriatric Depression Scale asks questions about the person’s satisfaction with their life, desire to go out, energy levels, interest in activities, boredom, fears, interest in going out, memory, and feelings of helplessness, loneliness and happiness.
Blood Or Urine Test
A blood culture can be carried out to look for infections that may explain a person’s failure to thrive. A complete blood count could point to anemia, for example, while C-reactive protein levels could indicate inflammation. Serum cholesterol and albumin levels point to malnutrition, while serum creatinine and BUN levels could indicate a person is suffering from renal failure or dehydration. Serum electrolyte levels may also be tested to check for an electrolyte imbalance. A urinalysis can reveal renal failure, dehydration or other infections.
Hearing, Vision and Functioning Tests
Hearing and vision tests can help determine if difficulty hearing or seeing is contributing to a person’s failure to thrive.
In addition, an assessment of physical function like the Katz ADL scale may be used to document the patient’s ability to carry out activities of daily living such as bathing, eating, dressing, continence, toileting and transferring. Some assessments may also use the Lawton IADL scale, which checks a patient’s ability in tasks such as adhering to medication regimens, housekeeping, laundry, cooking, shopping, transportation, telephone use and budget management.
Another common test is the Up & Go test, which asks a patient to rise from sitting down, walk a distance of 10 feet, turn around and return to their chair and sit down. This can show a patient’s functional mobility skills and their ability to leave their house safely unattended. Those who complete this test in less than 20 seconds are considered generally independent, while those who take longer than 30 seconds are more dependent and may have a higher risk of falls.
Image Tests
Imaging tests might also be carried out to look for or rule out other potential causes of common failure to thrive symptoms like weight loss. For example, chest radiography and MRIs can be carried out to look for infections and other malignancies or abscesses.
Contact In-Home Care To Help
If your loved one is dealing with physical or cognitive decline or has been diagnosed with failure to thrive, in-home care can help with daily activities regardless of their current functioning level. Get in touch with the friendly professionals at Comfort Home Care to find out how they can help improve your loved one’s quality of life and allow them to live safely and comfortably at home.
