Identifying Failure to Thrive in the Long Term Care Setting

Abstract

Geriatric failure to thrive (GFTT) is commonly encountered in the long term care (LTC) setting. This syndrome of unexplained functional decline can be approached in a methodical manner. The updated Minimum Data Set (MDS) 3.0, now implemented in almost all skilled nursing facilities, includes pertinent clinical information that could be used to identify residents who manifest GFTT. A screening tool using data from the MDS 3.0 could be used by LTC providers to evaluate LTC residents. A literature review was completed to identify articles focused on (1) GFTT in the LTC setting and (2) tools to identify GFTT. Common components of GFTT were matched with items collected as part of the MDS 3.0 with a goal to determine its utility as a screening tool to identify GFTT in the LTC setting. The MDS 3.0 includes assessment of numerous components commonly observed in patients with GFTT. By using clinically validated tools, the MDS 3.0 may assist in the recognition of LTC residents with or at risk for GFTT. Once GFTT is recognized, the LTC interdisciplinary team can then identify potentially reversible causes, set goals of care, and develop a comprehensive care plan that may include diagnostic measures, curative interventions, and/or palliative measures individualized to the resident.