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ABSTRACT
Geriatric failure to thrive (GFTT) poses a complex clinical issue in gerontological nursing practice. GFTT is not a normal part of aging, nor is it an outcome of chronic illness. Rather, GFTT describes a lack of vitality and diminished capacity for life and outlines a process of functional decline that is often difficult to explain. The purpose of this article is to review GFTT, examine the literature on GFTT, and suggest strategies for the identification, assessment, and creative management of this complex condition that affects millions of older adults.
Caring for frail older adults is a significant challenge for both practitioners and caregivers. These patients, whether living in the community or in nursing homes, are dehydrated, malnourished, bedridden, and often depressed. They are often characterized by a loss of vitality, a seeming lack of will to live, and an inability to thrive in their current environment. Often, these older adults complain of "just not feeling too well," and family members note their loved ones are "going downhill" for no apparent reason (Roth, 2001). Unfortunately, attitudes of "they are just old" or "they are just depressed and want to die, so there is nothing we can do" prevail; however, there is considerable need for accurate diagnosis, comprehensive assessment, and creative management of these patients.
Geriatric failure to thrive (GFTT) poses a complex clinical issue in gerontological nursing practice that requires comprehensive assessment and creative care. In the late 1980s and 1990s, it was estimated that GFTT affected 5% to 35% of community-dwelling older adults, 25% to 40% of nursing home residents, and more than 50% of all veterans hospitalized in acute care institutions (Berkman, Foster, & Campion, 1989; Silver, Morley, Strome, Jones, & Vickers, 1988; Verdery, 1996). Although more recent literature on GFTT does not offer any additional statistics, it is only reasonable to assume, based on demographics of aging, that GFTT is more prevalent than it was in the recent past, suggesting that clinicians seriously revisit this complex and challenging issue.
The concept of thriving is multidimensional and may mean different things to different providers. To be useful, the concept of thriving must integrate physical, functional, and psychosocial aspects. For psychologists, counselors, and social workers, failure to thrive may suggest unresolved psychosocial issues,...