History of F.R.A.I.L.

The first meeting of F.R.A.I.L was in April, 1999 at the Advanced Wound Care Symposium in Anaheim, California. The origins of the group evolved from a vision expressed by Dr. Oscar Alvarez during a brainstorming session with some key personnel at Healthpoint, Ltd., a pharmaceutical company located in Fort Worth, Texas. The idea for the group was simple: there exists a void in healthcare for the recognition of the needs and complications associated with frail elderly patients who suffer the consequences of immobility. Clinicians in long-term care are routinely faced with caring for patients who present with complicated histories that include multiple debilitating diseases, non-optimal nutritional profiles, and, for some, longstanding chronic wounds that have failed to respond to any treatment. These patients are often subjected to rigorous efforts to close and/or manage their wounds – with little success – but these efforts still take a significant toll on their stamina and quality of life. Only through a concentrated and focused analysis of these issues could better support measures begin to emerge. After conceptualizing the basic elements of F.R.A.I.L.'s mission, a multi-disciplinary group of healthcare professionals was convened to facilitate completion of F.R.A.I.L's goals. This group included physicians, nurses, researchers, and healthcare finance experts, all of whom had years of experience, in some capacity, dealing with chronic non-healing wounds, a key indicator of frail elderly. Once formed, the group readily took to the tasks of defining and estimating the number of affected elderly, identification of palliative management needs, and bringing attention to unanswered questions surrounding the diagnosis, assessment, and prognosis for complications of immobility among the frail elderly. In order to establish the basis for extending palliative care services to this non-traditional group, the F.R.A.I.L. Board completed a white paper that presents the current status, citing an extensive review of available literature on accepted treatment options used with frail elderly having chronic illnesses. These options, while appropriate for the majority of patients, do not accommodate the unique needs of this subset of the elderly population. F.R.A.I.L. hopes to bring recognition, dignity, and palliative options to elderly patients who suffer the consequences of chronic illnesses and immobility.