What is Adult Failure to Thrive?

Adult failure to thrive (AFTT) is a decline seen in older adults – typically those with multiple chronic medical conditions – that results in a downward spiral of poor nutrition, weight loss, inactivity, depression and decreasing functional ability.

For example, an aging mother who is in pain may spend significantly more time than usual in bed or in a chair. She stops making meals and doesn’t get the nutrition to stay active or keep up with her own care. With less energy for mind and body, she may forget to take her medications. It can be the start of a downward spiral of health.

Treat minor issues before they become serious problems

aging parent

Treat minor issues before they become serious problems

This is a critical time for intervention. A thorough exam may uncover underlying problems such as uncontrolled pain, medication side effects, difficulty swallowing or depression. If pain or underlying health problems can be treated, there may be an opportunity to slow or reverse the cycle of decline.


The signs of failure to thrive are sometimes overlooked because seniors don’t want to burden loved ones, they get tired or depressed. Other times, family or caregivers may miss the warning signs if changes are gradual.

Warning signs of failure to thrive include:

  • Unintended weight loss
  • Loss of appetite
  • Trouble thinking or unexpected memory loss, especially if they affect the tasks of daily living
  • Depression or despair
  • Chronic infections as a sign of weakening immune system
  • Trouble swallowing

Getting help

No single test points to a diagnosis of AFTT. Doctors rely on health history, family interviews, blood tests and experienced clinical judgement.


A doctor may test for functional ability by asking a patient to rise from a chair, walk a certain distance and then return. Exams may also include cognitive ability tests to measure thinking and memory.


You may hear medical professionals talk about frailty. Both are age-related declines with many of the same risk factors. Failure to thrive is sometimes referred to as the end-stage of frailty. 

When is hospice care needed?

Intervention and medical treatments help many patients, but some continue to decline, including individuals who have spent years dealing with chronic diseases. Patients may lose their appetite as the body is less able to absorb nutrients. If patients don't want to continue aggressive treatment or tube feedings, it may be time to ask about hospice care.


End-of-life conversations are difficult, even for some health care professionals. It’s important for patients and family members to ask questions, understand their options and express their goals and values.


People often say that quality of life is more important than how long they’ll live. Hospice conversations help patients and family members share what’s really important to them at the end of life. Hospice helps patients reach their goals by reducing the stress, pain and other symptoms of a serious illness. 


Hospice care is available at home, in a nursing facility or hospital. Regardless of the setting, hospice patients may continue treatments for conditions not related to their terminal illness. For example, a patient with diabetes can get checkups and diabetes medication covered by Medicare or other insurance.

Support for patients and their family

Failure to thrive in the elderly is a debilitating condition requiring significant caregiver support. Hospice at home can be mentally and physically challenging, but patients and families have the full support of our hospice team. 


If your loved one decides to enter home hospice care, our promise is to support you and your family along every step of the hospice journey.

Call 931-283-2597

We're here to help you with well-informed hospice decisions.