Adult Failure to Thrive


Progressive functional deterioration of a physical and cognitive nature with remarkably diminished ability to live with multisystem diseases, cope with ensuing problems, and manage care

Defining Characteristics:
  • Anorexia-does not eat meals when offered; 
  • states does not have an appetite, is not hungry, or "I don't want to eat"; 
  • inadequate nutritional intake-eating less than body requirements; 
  • consumption of minimal to no food at most meals (i.e., consumes less than 75% of normal requirements); 
  • weight loss (from baseline weight)-5% unintentional weight loss in 1 month or 10% unintentional weight loss in 6 months; 
  • physical decline (decline in bodily function) — evidence of fatigue, dehydration, incontinence of bowel and bladder; 
  • frequent exacerbations of chronic health problems (e.g. pneumonia, urinary tract infections); 
  • cognitive decline (decline in mental processing) as evidenced by problems with responding appropriately to environmental stimuli, 
  • demonstrated difficulty in reasoning, decision making, judgment, memory, and concentration; decreased perception; 
  • decreased social skills; 
  • social withdrawal-noticeable decrease from usual past behavior in attempts to form or participate in cooperative and interdependent relationships (e.g., decreased verbal communication with staff, family, friends); 
  • decreased participation in ADLs that the older person once enjoyed; 
  • self-care deficit-no longer looks after or takes charge of physical cleanliness or appearance; 
  • difficulty performing simple self-care tasks; 
  • neglect of home environment and/or financial responsibilities; 
  • apathy as evidenced by lack of observable feeling or emotion in terms of normal ADLs and environment; 
  • altered mood state-expresses feelings of sadness, being low in spirit; 
  • expresses loss of interest in pleasurable outlets such as food, sex, work, friends, family, hobbies, or entertainment; 
  • verbalizes desire for death

Related Factors:
  • Depression; 
  • apathy; 
  • fatigue


Suggested NOC Labels
  • Physical Aging Status
  • Psychosocial Adjustment: Life Change
  • Will to Live
Client Outcomes
  • Resumes highest level of functioning possible
  • Consumes adequate dietary intake for weight and height
  • Maintains usual weight
  • Has adequate fluid intake with no signs of dehydration
  • Participates in ADLs
  • Participates in social interactions
  • Maintains clean personal and home environment
  • Expresses feelings associated with losses


Suggested NIC Labels
  • Mood Management
  • Self-Care Assistance

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