ADULT FAILURE TO THRIVE
Progressive functional deterioration of a physical and cognitive
nature. The individual’s ability to live with multisystem diseases,
cope with ensuing problems, and manage his/her care are remarkably
• Cognitive decline, as evidenced by problems with responding
appropriately to environmental stimuli and decreased
• Consumption of limited to no food at most meals (i.e., consumes
less than 75% of normal replacements); weight loss
• Decreased participation in ADLs that were once enjoyed
• Decreased social skills or social withdrawal
• Difﬁculty performing simple self-care tasks
• Frequent exacerbations of chronic health problems, such as pneu-
monia or urinary tract problems
• Neglect of home environment or ﬁnancial responsibilities
• Adequate elimination pattern for age
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Sleep patterns
• Values and beliefs
The patient will
• Express understanding of causes of failure to thrive.
• Express realization that he or she is depressed.
• Consume sufﬁcient amounts of food and nutrients.
• Sleep for ___ hours without interruption.
• Gain weight.
• Verbalize feelings of safety.
• Follow up with psychiatric evaluation/social service assistance.
SUGGESTED NOC OUTCOMES
Nutritional Status: Physical Aging Status; Psychosocial Adjustment:
Life Change; Will to Live
INTERVENTIONS AND RATIONALES
Determine: Assess daily food intake; meal preparation; sleep
patterns; mobility status; education, activity, and exercise;
religious afﬁliation; involvement in social activities; and access to
transportation. Assessment factors will help identify appropriate
Monitor ﬂuids and electrolytes. Imbalance can be life-threatening.
Perform: Record daily weights at the same time each day to provide
Report abnormal electrolyte levels to ensure that therapy will
reverse and levels will not deteriorate.
Monitor ﬂuid intake and output every 8 hr to ensure that ﬂuids
are balanced. Imbalance can lead to heart failure or dehydration.
Record amount of food consumed and supplements given to
patient to ensure that the patient is getting sufﬁcient nutrition.
Plan activities and exercise consistent with patient’s capabilities. It
is important that the patient be able to enjoy activity. Overexertion
can lead to cardiac problems.
Arrange for social interaction with other patients. Arrange for the
nurse to spend several short periods of uninterrupted time with the
patient each day to instill trust and a sense of caring.
Teach caregiver how to make meals that may be appetizing to the
patient. Encourage caregiver to record food consumed by patient.
Appetizing foods may help motivate the patient to eat when he or
she claims not to be hungry.
Attend: Create a pleasant mealtime environment for patient. Provide
unlimited access to nourishing foods and nutritional supplements.
Attempt to accommodate ethnic food preferences. This will encour-
age patient when he or she is hungry rather than when food is put
in front of him or her.
Encourage family members and caregivers to establish a plan for
addressing patient’s failure to thrive in order to take responsibility
for meeting the patient’s needs to the extent they are able.
Encourage patient to participate in active exercise during the day
to the extent he or she is able. Exercise is essential to a feeling of
Manage: Refer patient and family to appropriate agencies in the
community such a meal programs, senior support/activities groups,
and so forth. This kind of follow-up will ensure that the plan has a
chance of succeeding.
Refer patient and family to social services for appropriate resources.
Refer to clergy person for spiritual help if patient wishes.
SUGGESTED NIC INTERVENTIONS
Coping Enhancement; Home Maintenance Assistance; Nutritional
Monitoring; Spiritual Support
Lennie, T. A. (2006, March–April). Factors inﬂuencing food intake in patients
with heart failure: A comparison with healthy elders. The Journal of Car-
diovascular Nursing, 21(2), 123–129.