senior woman and young caregiverIt’s a bewildering situation, but not an uncommon one: Grandma is losing weight, is withdrawn and unresponsive, and seems depressed. The doctor’s been called, but he doesn’t know what’s wrong.

He labels her condition as “adult failure to thrive” (AFTT). What is this perplexing condition, and what should you do if a loved one is diagnosed with it?

What is failure to thrive?

In the past, failure to thrive was a condition more commonly associated with infants, but it is becoming increasingly common among the senior population.

Older adults are given the AFTT diagnosis when they experience a gradual decline in health without an immediate explanation. It can be caused by factors such as: unknown medical problems, chronic disease, medication interactions, physical decline, poor appetite, or poor diet.

The symptoms of AFTT include weight loss, decreased appetite, poor nutrition, and inactivity. Often, someone with AFTT also shows signs of depression, dehydration, poor immune function, low cholesterol, and sometimes, impaired physical or cognitive function.

What can I do if my loved one is diagnosed with Adult Failure to Thrive?

A diagnosis of failure to thrive in elderly adults can be incredibly frustrating. The good news is that there are steps you can take to help battle AFTT:

  • Keep a close watch: If your loved one is unwilling to eat or drink, if they seem to experience a bout of depression for no reason, or if there is any other sudden decline in their health, visit his or her physician together to discuss what you have observed. Talk about what’s going on and make an action plan with your loved one’s physician. After a certain amount of time, evaluate the results and see if any improvements have been made.
  • Check the medications: Talk to your doctor and pharmacist about the medications your loved one is taking to see if there are any side effects or drug interactions that could be the cause of your loved one’s AFTT.
  • Document what your loved one eats and drinks: Poor nutrition and dehydration can quickly become dangerous, especially in the elderly. Keep track of what your loved one is eating and drinking to make sure they’re getting enough nutritious food and fluids.
  • Keep your loved one on the go: Activity is important for a healthy body and mind. If your loved one is mobile, go for walks around the neighborhood or a trip to the grocery store. If your loved one is bed-bound, play a board game or read aloud.
  • Communicate: Social stimulation can keep us active and healthy. Take your loved one to visit friends and relatives. Spark conversation yourself by asking about your loved one’s favorite topics, whether those be gardening, old family photos, or the grandchildren. Be open to hearing about their feelings of loss, lack of self-worth or sadness. These feelings are not uncommon and your willingness to listen and be empathetic can strengthen their bond with you.

How Hospice can Help with Adult Failure to Thrive:

If your loved one’s health continues to decline and they become significantly disabled (i.e., spends most of his or her time in bed, and needs assistance with everyday activities), consider hospice care. Someone whose health is severely debilitated may be too much for you to care for by yourself.

Many people don’t know that older adults can be admitted to hospice care following an AFFT diagnosis, but it can be a great option for care and increased comfort. Hospice will provide your loved one with a team of professionals, from trained nurses to take care of your loved one’s medical concerns, to aides that help with daily tasks.

Many people think of hospice as only for the final days of someone’s life, but this is a misconception. Under hospice care, some patients actually improve enough to no longer need the hospice team. To find out if hospice care might be the best choice for your loved one, ask their doctor.

Do you have a loved one who has been diagnosed with AFTT? Share your experiences and advice in the comments section below.

For more information, please review our Depression Resources.

  • Lesley Smith

    ​this is the first time I have ever heard of AFTT. The symptoms do indeed sound familiar but I think for many of us; it is easy to neglect the healthy of elder people around us. A very informative read

  • Yvette Huddleson

    I have finally been diagnosed with AFTT about 5 months ago; however, I have been dealing with this issue for over four years. My weight dropped to 88 lbs. on a 5’5″ small boned frame before they finally sent me to a nutritionist. I am now at my goal weight of 115 lbs. I have had multiple slip and falls due to lack of balance. I have had hit brick walls in every direction while attempting to get assistence. I am not working and have been fighting to get SSDI for almost 5 years. I have other complicated medical issues which keep me bed bound. I feel that I am being past in circles of doctors without getting any true treatment. If you have any place I can contact to get in home service, it would be appreciated. – sincerely, Yvette

  • Catalina

    You could try IHSS.

  • Joy

    If you have not already done so, please consider contacting the local office of your state’s services for the handicapped and elderly. Here is one such website:

  • patricia murphy

    My fathers cause of death was failure to thrive. I was living out of state and unable to physically check in on him as I always done previously. What are the statistics on AFTT as cause of death in the elderly and is there any research on relationship between this condition and family/home support?

  • Harold C. Huster

    My wife of 58 years suffered cancer twice, had an infection called sepsis, then had a compression fracture in her back and the treatment for that caused her to get c diff. She had spent the last eight months either in the hospital, rehab or under my care at home. The last episode in the hospital she gave up and said I can”t take any more and stopped eating and drinking and died Feb. 20th. I respect her decision because I know how she suffered. I miss her.

    • David W


      Im very sorry to hear of the suffering of your wife and of your grieving. I can only imagine how you miss her after 58 years of marriage. It truly grieves my heart to hear and think of your situation. ,and I pray peace for your soul and Gods blessings for you and your family. Hang in there brother,people do care and the compassion I feel for you cant be conveyed through this computer,but its real. I just wanted to let you know,and God Bless you Harold.

    • Sandra

      Dear Mr. Huster,
      My sympathy goes out to you with the very nice note you wrote regarding your wife’s passing. It must have been very difficult but also very compassionate of you to let her go …

  • Christine Clish

    My husband died a month ago and Failure To Thrive was among his causes of death. He also had Congestive Heart Failure; COPD; C-Diff & Crohns disease. In less than a year he lost 70 lbs. The last month of his life he hardly ate at all. The doctor at the Rehab facility told me my husband had AFTT – I had never heard this concerning an adult. I hope there will be more information about this condition

  • Rita

    I am a 62 year old female. In my lifetime I never knew anyone who had the ability to do hard physical labor for 14 to 16 hours a day, but I did. I never had a weight problem one way or the other. I am independent and have always taken care of myselt and any needs I had. Two months ago I started losing weight and went from 120 to 86 lbs. My body is so week that it is difficult to get to the bathroom. I was just discharged from the hospital with a diagonosis of Faliure to Thrieve. Please, is there anyone out there who can help. What canI do to improve my chance to live. I’m to young to just lay back and accept this.

    • Sandra

      Have you tried Ensure ? My Husband uses it :) Also, if you have access to the medical community, can you visit a Dietician ? She or He could help you with meal planning that would help you increase your weight in a healthy way :)

    • Susan Rae Baker

      Hi Rita, they failed you! You need to see an endocrinologist, hematologist just for starters as there can been medical conditions such as hyperthyroidism or even a cancer that they have not bothered to look for. Also have your Cortisol Level checked as well. Don’t quit trying, find better doctors!!! Make sure you make a list of all your symptoms. If you let me know what state you live in I may be able to help!

    • Cindy S.

      I am not sure of your age, but you might look into a program called PACE – Program of All-Inclusive Care for the Elderly. If you meet the guidelines you will have home health care, a primary care physician, a team of clinicians, medications prescribed by one doctor and obtained from one pharmacy to reduce the chance of med errors, a dietitan, a social worker, and specialists in dentistry, optometry, podiatry and audiology, as well as transportation to outside appointments and to and from the adult day health center where there are activities and meals provided. There are

      Look up PACE – Program of all-inclusive care for the elderly. All medical needs are addressed, including evaluation by a trained dietitian. They can help with in-home care, too. It’s a good program!

  • Betty

    I never heard of AFTT until recently–My 66 year old husband has lost 57 lbs in 6 months–was originally diagnosed with Alzeimers.When I took him for 2nd opinion, they said Vascular Dementia, then Sjogrens with behavorial disturbance-it’s been a roller coaster-he is definitely depressed and has anxiety-no matter what is prescribed, he has shown little improvement, and today has slept 24 hours!can he possibly have this? What do I do to make sure or rule it out? We’re at a loss…

  • Teresa W

    Our 81 year old mother has had chronic pelvic pain for her entire life. Never able to find a diagnosis for this, she has tried pain meds but none has really helped. She worked at the university in town for 32 years in terrible pain every day of her career. After she retired she volunteered at a local ministry to keep her mind off of her pain. It has become so severe in the last few years that she has eaten less and less and now cannot keep food down at all. Over the last 3 months she has lost 25 pounds, has had to have a colostomy, has an infection in the colon, and is still in horrible pain. Today we contacted hospice. She wants to be through with this pain. She’s tired. We’re praying this will be over before too long.

  • Kelly Rector

    7 years ago my mom had a fall & is a quadriplegic- she has had many health/emotional ups & downs but has a severe pressure sore & we were told she has to stay in bed hooked up to a wound vac for 6-12 months, she isn’t healing. She doesn’t eat well but 7 days ago stopped eating/drinking altogether. She won’t really look at me, doesn’t like it when I touch her & is asleep most of the day. She wakes up but doesn’t seem to know what is going on, what day it is etc.. She moans a lot. Her blood & urine tests came back normal. I am so confused as to what to do-

  • Penny

    I learned of this condition when I read it on my mother’s death certificate. Mom chose her own time to go; she started sleeping a lot and refusing to eat, and later on, she stopped drinking. It took about 3 weeks for her body to catch up with her decision. During that time, we tried to keep her surroundings as calm and peaceful as possible. Unfortunately, the nursing home doesn’t allow hospice care, so we did what we could to keep her comfortable. I suppose this could have happened just as easily if she was still living at home, but I can’t help but wonder if the nursing home environment contributed to her failure to thrive. I miss her so much.

    • Lori Hamrick

      Please know that there is nothing you could have done to prevent your mother’s death. AFTT …. would have happened even if you cared for her at home. I know because I lost my mom a week ago after ten months of trying everything even aortic valve replacement. Your mother would not want you to blame yourself.

  • Abraham Garza

    My grandfather passed away seven years ago on his death certificate the cause of death was labeled Adult Failure to Thrive and thats all. I was going thru his medical file and the last illness he was diagnosed weith was asbestosis. I have looked up the symptoms for asbestosis and adult failure to thrive and they are very similar. Is there a possibility that adult5 failure to thrive could have been mistaken for his asbestosis? And should i contact the doctor who signed his death certificate.

  • Laura

    I am only 38 years old and have been diagnosed with AFTT . I have an illness that is attacking my muscles and nerves. Due to my weakness I’ve had several falls, and hurt my back during one of my falls causing incontince. I’m home bound for the majority of my days and am now confined to a wheelchair. I see a home health nurse weekly , and am on IV therapy daily. My family has a hard time understanding my frustration and depression from knowing I’m not dead but I’m not living either.

  • sandra Mentiply

    My mother was 91 she couldn’t stay a lone due to falling at times she said she wanted to go in a nursing home she went in on july 2014 and passed away jan 8th once in there she was working with a walker and was getting around good. then there had her wearing depends and was put in a wheel chair the nursing home wasn’t a good idea they seemed to take what pride she had they took away from her each day.the death record say she failure to thrive and just stopped eating and didn’t want o live any more she just gave up.I should have never let her go ther I should have moved in a cared for you I belive if I had stayed home with her she would be a live today.This eats at me everyday and I can’t stop blaming my self for this.I belive that nursing homes due more harm then good In MY MOTHERS CASE IT WASN’T A GOOD PLACE FOR HER! I would never tell anyone to put there loved onein there.I have to live with this every day. She would have still been here if I had done what ws the best for her and a nursing home wasn’t it

    • Mary

      First off… STOP blaming yourself.. You tried and thought you were doing the best for your Mom.. It was her failure to live that most likely caused her death.. They just give up, hate their lives and just want to end all the pain… Hopefully your mom is in a happier place so be at peace…. Hugs from CA Mary :)

  • Doris Sims

    My son is only 22 yrs old and for the past 2 years he been sick . and we have gone to doctor after doctor. 2 pulmononlogist . was told he has a coughing asthma, he’s on meds but still coughs all night . one day about an year ago after a long day of coughing one of his lungs collapse, before the coughing started he was 145 pounds today was his appointment and her down to 99 pound and the Doctor said it AFTT. and i don’t know what to do to help him , he eats but is still losing weight.

    • Crystal

      Wow that sounds crazy for such a young man to be so sick. Have you taken him to an infectious disease doctor? He may be getting some bad toxins from the envirornment? That does not sound like a normal diagnoses for such a young man. Good luck I hope yall find help and get better soon…Prayers from Crystal Ryan!,

  • Mary

    My mom is bedridden and has been for 2 years now. For the past 2 weeks mom hasn’t had an appetite. Mom seems bored and depressed. I try to offer her the food she likes but she says shes not hungry day after day.Mom drinks about 2 cups of liquid a day but barely any food at all if any.. she cant go to her doctor because she cant walk. I keep trying to get her to eat but her attitude is bad. She keeps saying shes ok but how can you go day after day without eating and feel ok? :(

  • margaux

    loss of abilty to thrive. just about a few motnhs ago i was thriving perosn stil despite circumstances. i had vital signs i was not old i was young and talented and begging a doctor to remoe me from where i was and treat trauma from over load of abuse and a history of recover ptsd. she ignoed me. i began to over strain and stress and was abused by a person and then became tortured by all three. the failure to treat the abuser and vidtimizer and the threat to my miracle as result i began to suffer breaking down and the worst compounded wiet no way to heal and now im brain damaged like i am now mentally damaged and sick and also brain damaged so severly i can not do basic function i have no memory and i was a professional person with a pefect reocovery . my doctos cut me off when i began to get vilolent when they ignore dme to deaht and did not remove me and i kept beggint them and hold off this fate and it drove me so far down i cant get up.. and face a life that is not worth antyhing from a billion dollar life. this is al from trauma stroke like seizure sform over load of stres and doctors sitting there like im stuoid.i now my brain just shut off and cant recover. and my body follow i can not move same or speak and or eat function or thrive. at all. i was a lively young person and my eyes and brain are damaged and my whole being its like waking up a living dead nand no one hears me or care.

    • Donna

      My Mother is 86 years old, back in December she went outside at 3 am to get the Sunday paper and she fell and fractured her was 51 degrees outside and she laid there for
      three hours before anyone found her (she lives alone and was a very vibrant and active 86 year old) she was sent to a hospital in a near by town for surgury..was put in ICU for three days which included, a iv, cath, given blood, could not eat anything and was pretty much unresponsive, sent straight from ICU to a nursing home with no time for recovery in a room at the hospital. The nursing home was in our home town and three days later her bowels backed up into her stomach from never having a bowel movement since the accident. She was sent to the local hospital where she was very sick and couldn’t keep anything down, after one month she was sent home and I tried to take care of her myself and of course Home Health also helped but again her bowels backed up and so she had to be sent to a skilled nursing home on Jan 21st. She has been there ever since other than two weeks in the hospital for a serious UTI, a fib and a two week stay in a big hospital in Wichita where Doctors diagnosed her with AFTT..she has lost a lot of weight, can only drink water and ensure, all solid food comes back up, cant sleep, wont participate in any activities and has basically just given up. Oh and of course she has constant UTI’s and now has a constant catheter, wears diapers which is very humiliating, I am sure and has to depend on help to walk, get in and out of bed and go to the bathroom….It is heart breaking to see such a strong, beautiful woman reduced down to this. I have tried everything I know to get her better, I believe this all stems from the surgery and from being sent straight to a nursing home with no bowel movement but as the hospital administrator told me this is all water under the bridge…My advise for anyone in this situation is to question everything, if you think your loved one is not getting the treatment they deserve, question why that’s not happening, I wish I would have demanded that my beautiful Mother be given a room at the hospital and given a chance to recover before being sent to a nursing home. One thing for sure that I have noticed, if you are elderly the doctors and hospitals do not care about you and just write you off. I have seen this time after time….we need to treat our elderly as we would want to be treated. I am not scared of dying, I am scared of living and having to waste my life forgotten in a nursing home. I had always promised my Mom that she would never go to a nursing home and that I would take care of her, well so much for that promise/

    • Crystal

      I care. I am praying for you Margaux!, I pray for a good caretaker for you. I take care of my momma at home. She is 87 and has just been diagnosed with this as well. It’s hard, but I have some excellent support. I can’t care for her alone, and I thankful for the support I need. Do you have a social worker to help you?

  • carol jennings

    My brother was diagnosed with esophageal cancer in 2012. He has undergone chemo and radiation. Despite these treatments, the doctors told him in february of 2015 that his cancer is gone. He is now home bound. His feet and legs swell so large that the skin ruptures to release the fluid that has accumulated. He is losing his eye sight and has problems eating. Where can I go for help. He is 52 yrs old
    The doctors treat him like a nuisance and think im ignorant. Something is wrong and no one listens or seems to care.

    • Yeager Cole

      I’m listening. ((Hugs)) I wish there was something else I could do.

  • Susiedarling

    My brotherinlaw was 78 and very active – bachelor, lived alone and drove around every day miles and miles, visited parks and walked in the woods because he loved animals, etc. He slipped one day and wrenched his back. He went to the hospital and they put him on strong pain meds. All of a sudden he started showing dementia and then completely stopped eating, drinking, etc. Was alert but just refused to do anything to keep himself alive. He pulled out any kind of feeding tube or fluid IV. Finally, after 85 days, his lungs started going and they put him on an oxygen mask but he died that same day. He was skin and bones. For those 85 days, we tried everything, anti-depressents, all his favorite foods, promised him all kind of fishing trips, etc when he got out of the hospital. Nothing. He just would not respond. It broke our hearts to see him die of his own will. My husband, his only brother, is having a terrible time getting over it; feels there had to be something we could have done. We visited him every day, rubbed his back, held his hands, watched tv with him, told funny stories, told him we loved him and wanted him with us, on and on. Very very very sad. His death certificate said “failure to thrive”.

  • snow white

    adult failure to thrive a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a 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 diminished.
    We had a friend who recently passed away , she pulled of the freeway feeling sick , called 911 , when they arrive Her eyes rolled back , that was it .
    Cause of Death , Failure to thrive , which I found insulting , She was multitasked , in several organization , she was an active swimmer , she belonged to a health club and couples of “intellectual club” she was exercising regular , was on a good diet , was not smoking , drink or drugs , she was extremely well kept , having been the one cleaning Her house we were shocked to find beauty treatment in the upper hundreds of dollars , dresses and jewelry in enough quantity to open a store …. Nothing , absolutely nothing match the description of failure to thrive as described by the US and European medical association.

  • Marceelynn

    Don’t blame yourself at all… my nanny is dying as we speak due to complications of AFTT I wanted to blame myself because I was her caretaker but after reading this I see there was nothing I could do.