#69201 Geriatric Failure to Thrive: A Multidimensional ...

1 _____ #69201 Geriatric Failure to thrive : A Multidimensional ProblemNetCE Sacramento, California Phone: 800 / 232-4238 FAX: 916 / 783-6067 1 Geriatric Failure to thrive : A Multidimensional ProblemA complete Works Cited list begins on page 26. Mention of commercial products does not indicate Waterbury, MSN, ARNP, ACHPN, has been working as a Geriatric and family nurse practitioner since 2000. Ms. Waterbury received a Master s degree in 1999 from the University of Central Florida, specializing in Family Nurse Practice. She achieved ANCC certifica-tion as a family nurse practitioner in 2001, Ms.

2 Waterbury has focused on geriatrics, providing primary care to residents of rehabilitation, skilled nursing, and assisted living facilities. Her inter-est in end-of-life care prompted her to receive training and certification as an Advanced Practice Certified Hospice and Palliative Care Nurse in 2006. She has also developed and presented many education programs for nurses and community groups. Faculty DisclosureContributing faculty, Susan Waterbury, MSN, ARNP, ACHPN, has disclosed no relevant financial relation-ship with any product manufacturer or service provider 2014 NetCECOURSE #69201 5 CE CREDITS Release Date: 04/01/14 expiRation Date.

3 03/31/17 Division PlannerJames Trent, PhDDivision Planner DisclosureThe division planner has disclosed no relevant financial relationship with any product manufacturer or service provider introductory course is designed for psychologists who work in or are interested in learning more about & ApprovalsNetCE is approved by the American Psychologi-cal Association to sponsor continuing education for psych ologists. NetCE maintains respon sibility for this program and its of CreditNetCE designates this continuing education activity for 5 CE the SponsorThe purpose of NetCE is to provide challenging cur-ricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication.

4 The publisher dis-claims any liability, loss or damage incurred as a conse-quence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into TO RECEIVE CREDIT Read the enclosed course. Complete the questions at the end of the course. Return your completed Answer Sheet/Evaluation to NetCE by mail or fax, or complete online at Your postmark or facsimile date will be used as your completion date. Receive your Certificate(s) of Completion by mail, fax, or email.

5 #69201 Geriatric Failure to thrive : A Multidimensional problem _____2 NetCE October 7, 2015 Disclosure StatementIt is the policy of NetCE not to accept commercial sup-port. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to ObjectiveThe purpose of this course is to educate psychologists regarding Geriatric Failure to thrive and to promote evi-dence-based clinical practice when caring for patients with this condition. Learning ObjectivesUpon completion of this course, you should be able to: 1. Define the various conditions responsible for unintended weight loss in Geriatric patients, including Geriatric Failure to thrive .

6 2. Analyze various ethical and legal issues that can arise when treating Geriatric Failure to thrive patients and the role of advance directives in ameliorating some of these issues. 3. Outline necessary components of the physical assessment and differential diagnosis of Geriatric Failure to thrive . 4. Evaluate the role of polypharmacy in unintended weight loss in elderly patients. 5. Describe the role of mental health screening in Geriatric Failure to thrive patients. 6. Create a treatment plan for a Geriatric Failure to thrive patients, including possible pharmacotherapy approaches and areas for monitoring and follow-up.

7 7. Identify Geriatric Failure to thrive patients for whom hospice referral should be marked with this symbol include evidence-based practice recommen dations. The level of evidence and/or strength of recommendation, as provided by the evidence-based source, are also included so you may determine the validity or relevance of the information. These sections may be used in conjunc-tion with the course material for better application to your daily #69201 Geriatric Failure to thrive : A Multidimensional ProblemNetCE Sacramento, California Phone: 800 / 232-4238 FAX: 916 / 783-6067 3 INTRODUCTIONU ndesired weight loss in the elderly causes a reduced quality of life and contributes to serious illness.

8 Elderly residents of nursing facilities who lose 5% of their body weight in one month are times more likely to die within a year [1]. Poor prognosis is also associated with low prealbumin and cholesterol levels. Malnutrition in the elderly can result in pressure sores, functional decline, longer rehabilitation, and multiple medical baby boomers will account for a substantial increase in the elderly population beginning in 2010 (Figure 1). By 2060, persons older than 65 years of age are projected to make up of the population [2]. There will also be an increase in the oldest old, those 85 years of age and older.

9 More elderly persons will be dependent on others for their survival, with increasing numbers living in skilled nursing and assisted living facilities. Healthcare providers should become prepared for the projected growth of the elderly population and be prepared to treat the various conditions unique to this TO THRIVEThe term Failure to thrive was originally used to identify abnormal growth and development pat-terns in children. The term was borrowed from pediatrics in the 1970s to describe a similar syn-drome that affected Geriatric patients. Failure to thrive is now commonly used in geriatrics and has become a diagnosis for hospice care.

10 It is defined by the Institute of Medicine as weight loss of more than 5%, decreased appetite, poor nutrition, and physical inactivity, often associated with dehydra-tion, depression, immune dysfunction, and low cholesterol [4]. It is not a single disease or medical condition. Rather, it is a Multidimensional problem that requires a multidisciplinary approach for its treatment. The four chief characteristics of geriat-ric Failure to thrive are impaired physical function, malnutrition, depression, and cognitive impair-ment [5]. Failure to thrive is commonly used as a nonspecific diagnosis when a patient loses weight due to an unknown cause.