Efficient Care Plans for Adult Failure to Thrive

When the following characteristicsare identified in an individual, effective care plans for adult failure to thrive are needed: Anorexia. When a person refuses to eat food; claims that he/she is not hungry; has no appetite; inappropriate intake of nutrients; an individual eats less food than his/her body requires; consumes minimal amount of food or no food at all (for example, eats less than 75 % of adequate requirement); loses weight fast (-5% weight loss per one month is considered to be unintentional or -10% weight loss in a half of year); decline in proper physical functioning - constant fatigue; bowel and bladder incontinence; dehydration; chronic problems with health (for instance, infection of urinary tract or pneumonia); decline of cognitive function (mental processing decline) can be noticed when an individual faces problems with adequate response to environmental stimuli; demonstrates difficulties in logical reasoning; has complications with making decisions; judgment; has short memory spans, cannot focus; experiences lowered level of perception; social skills become decreased;an individual isolates him/herself from relatives and friends (refuses to communicate with people); an individual does not want to participate in the activities that once enjoyed; deficit of self-care (an individual does not care about appearance and physical cleanliness);

Experiences difficulties with self-care duties; neglects financial responsibilities and does not clean the home environment; shows apathy and does not express emotions; experiences frequent mood swings; remains sad; has no interest in such things as hobbies, friends, work, food, sex, environment; speaks about death.

Related Characteristics: Fatigue, Apathy, Depression

Nursing Outcomes Classification (NOC outcomes)

Suggested labels of NOC:

  • Status of Physical Aging;
  • Psychosocial Adjustment:
  • Change in Life;
  • Desire to Live;
  • Outcomes for Clients;
  • Resumes highest functioning level;
  • Consumes appropriate dietary intake for height and weight;
  • Maintains normal weight;
  • Intakes adequate amount of fluid; does not show any signs of dehydration;
  • Participates in daily activities;
  • Takes part in social interaction;
  • Maintains physical cleanliness and clean home environment;
  • Expresses certain feelings (for instances, those associated with losses);
  • Classification of Nursing Interventions;

Suggested labels of NIC:

  • Managementof mood;
  • Assistancewith self-care.

Nursing Interventions and Explanation

  1. Adult clients who suffer from failure to thrive (FTT) should be assessed according to the client's ADLs, mood, and cognitive functions; physical examination and a targeted history; as well as chosen laboratory study. Recognition as well as management of FTT on early stages can lower the risk future deterioration, placement at nursing home or hospitalization
  2. Evaluate any causes of adult FTT. Any problems should be treated, for instance, malnutrition, depression, and any other illnesses resulted from cognitive and physical change. FTT in adult patients is characterized by the following: undernutrition, loss of cognitive and physical functions, as well as depression. Undernutrition is also referred to as malnutrition is widely spread among the geriatric individuals. In addition, this condition is often underestimated. Often, elderly individuals are affected by this condition. As a result, their health status and life expectancies decrease. It is recommended to conduct the initial medical assessment in order to identify the suspected dementia.
  3. Evaluate any sensory change and fatigue signs. They may prove the presence of infection, which in its turn may be linked to the diabetes. Adult patients may not show any signs of polydipsia,polyuria, weight loss or polyphagia. They may simply have an infection and experience sensory changes and fatigue.
  4. Every etiology should be assessed. Depression should be evaluated with the help of a geriatric depression scale. Pay close attention to depression signs among new patients in nursing homes. It is recommended to detect the depression presence using the geriatric depressions scale. Unfortunately, depression among new patients is usually overlooked by nurses. Depression can be the very first sign of cognitive dysfunction.
  5. Pay attention whether the patient blames other people or easily irritable. According to the current research studies, such behaviors are considered to be the symptoms of depression.
  6. Cognitive therapy should be provided to the patients who were diagnosed with depression. Strengthen their value and explain them "who they really are." Depressed patients can get assistance by explaining "who they are" in comparison to "who they think they are."
  7. Positive thoughts should be encouraged in the patient. According to the findings from the study of 1002 adult disabled females, positive thoughts as well as emotions can help protect older patients from negative health outcomes.

Among the studied women, 351 were considered emotionally vital and women who did not have any disabilities of specific character, associated emotional vitality with lowered risk of disability performing ADLs (RR = 0.81, 95% CI = 0.66-0.99), for disability walking 1/4 mile (RR = 0.73, 95% CI = 0.59-0.92), and for disabilitycarrying and or lifting 10 pounds (RR = 0.77, 95% CI = 0.63-0.95). In addition, emotional vitality was related to decreased dying risk (RR = 0.56, 95% CI = 0.39-0.80). Such outcomes were achieved not only due to the absence of depression. Protected health effects stayed when women who were considered emotionally vital were compared to 334 women who were not perceived as emotionally vital.

  • Control the weight of elderly patients and pay attention to any unpredictable loss of weight. Elderly patients diagnosed with FTT usually suffer from weight loss that happens unintentionally.
  • In order to make sure that the patients eat enough food, it is recommended to play soothing musing in the canteen. Many studies confirmed that playing soothing music during the mealtime lowers fear, irritability, panic, and instills positive thoughts. It can even increase the appetite among patients who suffer from dementia. Study confirmed that when the music was playing, patients were less anxious, irritable and depressed.
  • Any changes in appetite should be noted and level of depression should be assessed. Depression can cause FTT by the following ways: decreased appetite can be a direct symptom of FTT and increased level of disability can be an effect of depression.
  • Offer happy hour and comforting foods: any type of food, which is associated with patient's childhood. It can help to recollect happy times and create a feeling of healing and caring. And do not forget about "happy hour" drink served in a good company. The above approached proved to be effective in increasing the food intake in FTT patients.
  • When a patient was diagnosed with FTT, effective care plans for adult failure to thrive should be offered. When a patient is obese, a nutrition plan should be created as well. It will help to decrease functional dependence. It is worth noting that overnutrition refers to malnutrition. Older individuals are considered obese when their ideal body weight is above 30%.
  • Patients should be encouraged to talk about their life experiences. It will help to increase the feeling of social connectedness. In addition, it helps to cope with self-efficacy, overcome challenges and deal with anxiety.
  • Patients should be allowed to pray whenever they want. Many studies confirm that groups of patients prayed and it helped them to manage their illness symptoms.
  • Care plans for adult failure to thrive should include encouragement of patients to communicate with other people regularly. They should be allowed to take part in different activities. Usually social withdrawal accompanies FTT patients.
  • Patients should be assisted to participate in various activities. Motivation should be assessed and patients should identify the main reasons of participation, for example, more independence, better mobility, and a well-being feeling. Motivation is considered to be a significant factor for older patients to take part in various activities.
  • Patients should be provided with physical touch. Touch patient's hand while having a conversation with him/her. Ask whether they need a hug. Physical connection helps patients to be integrated into the society. In addition, older patients start having the increased feeling of well-being.
  • Care plans for adult failure to thrive should include the administration of therapeutic touch (TT). Study showed the following results: clients who had dementia showed that their level of discomfort lowered after TT sessions.
  • It is also recommended to refer to the nursing care plan for elderly failure to thrive that includes imbalanced nutrition.

Multicultural

  • Try to find out about patient's norms, beliefs and values. Assess what patient's family members perceive as normal health behavior.
  • Identify the family members' feelings related to the symptoms of FTT. It will promote the nurse-patient relations.

Home Care Interventions

  1. Failure to thrive care plan goals should include the assessment of lowered functioning. Make sure that all symptoms are taken into account
  2. Allow to change the role activities. Clarify patient's expectations. As a rule, illness requires role changes.
  3. Support should be provided to family members and caregivers. It will help to decrease the burden of caregiver.
  4. Refer to community support groups. Advise the patient to visit the sessions.
  5. During the lowered participation period, a patient should be referred to home health aide services in order to receive help with ADLs.
  6. When FTT is connected to dementia, assist the caregiver to comprehend the diagnosis. Caregiver should identify patient's need in order to provide adequate assistance.
  7. When a patient has a nursing diagnosis for failure to thrive in adults, the family should be instructed to use certain verbal cues in order to encourage food intake.
  8. Consult with the physician regarding the drug holiday in case delirium is the etiology.
  9. Appropriate hearing assistance should be offered.
  10. If depression is the etiology, refer for possible medication. Following all the steps of care plan mitigates the symptoms of the illness.