What Is Failure To Thrive?
Failure to Thrive (FTT) syndrome is characterized by unexplained weight loss, malnutrition, and disability. While it may be associated with various primary conditions, it always involves two key clinical components: nutritional impairment and disability. In severe cases, these elements can significantly impact short-term survival.
Adult FTT syndrome can exhibit an irreversible progression of nutritional impairment and disability, even after attempts at therapeutic intervention to address the underlying primary condition. Concurrent comorbidities may expedite this progression, underscoring the importance of identifying and managing them. This hospice policy applies specifically to cases where reversible causes of severe nutritional impairment and disability (i.e., adult FTT syndrome) have been ruled out.
The eligibility for the Medicare Hospice Benefit hinges on a physician’s certification that an individual is terminally ill. This determination is based on a medical prognosis indicating a life expectancy of 6 months or less if the terminal illness follows its typical course. The physician determines the medical criteria that can support a terminal prognosis for individuals with adult FTT syndrome, with the first two being crucial indicators of nutritional and functional status:
- Nutritional Impairment: Patients should be losing weight with a BMI of less than 22. Patient may not be responding despite adequate caloric intake.
- Disability: The disability associated with adult FTT should be substantial. This usually means that the patient is bed/chair bound and no longer mobile (is losing ability to walk/transfer without assistance).
FTT represents a slow shutdown of the body resulting in gradual decline.
Patients who are experiencing failure to thrive are showing signs of slow decline. They are getting weaker, they are losing weight, they are showing signs of muscle atrophy and showing signs of increasing weakness. The debility that results from this slow decline leads to increasing dependence on caregivers for their activities of daily living. Clinicians can identify this decline, which is usually a red flag that the patient is in a terminal decline and that the prognosis is poor and expected to be less than 6 months without intervention.
FTT represents a slow shutdown of the body resulting in gradual decline.
Patients who are experiencing failure to thrive are showing signs of slow decline. They are getting weaker, they are losing weight, they are showing signs of muscle atrophy and showing signs of increasing weakness. The debility that results from this slow decline leads to increasing dependence on caregivers for their activities of daily living. Clinicians can identify this decline, which is usually a red flag that the patient is in a terminal decline and that the prognosis is poor and expected to be less than 6 months without intervention.