The Disability Handbook on Anaemia

Introduction.

1. Anaemia is a very common condition and may be defined as an abnormally low level of haemoglobin in the blood. The oxygen carrying capacity of the blood depends on the presence of haemoglobin which is contained in red blood cells. When the haemoglobin level in the blood is reduced, the various parts of the body are deprived of oxygen, which is vital to their needs, resulting in all the symptoms attributable to anaemia. Insofar as chronic heart and lung diseases [Chapter 11] also deprive the body of oxygen, they give rise to some of the same symptoms as anaemia and will be more disabling in the presence of anaemia.
2. Anaemia may be due to excessive blood loss; inadequate production of normal red blood cells; excessive destruction of red blood cells, or to various combinations of these factors.
3. Whilst it is often possible to treat both the cause of severe anaemia and the anaemia itself, sometimes such an anaemia is a complication of a serious underlying disease (e.g. leukaemia,) which may give rise to significant disablement in its own right.

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Care Needs.

Anaemia may be slight and symptomless and is common in young women of child-bearing age, as a result of blood loss during menstrual periods. When the anaemia is much more severe the individual becomes progressively weaker and more breathless. Only in its advanced stages is anaemia likely to give rise to a need for attention or supervision in its own right, by which time breathlessness will occur at rest, or on the slightest exertion. With this degree of anaemia everyday activities may be impossible, or take an inordinate length of time to execute.

Mobility Considerations.

Severe cases of anaemia may result in limited walking ability, due to breathlessness and this is likely to precede attention and supervisory needs. Any angina or intermittent claudication [see Chapters 11 & 13] will be rendered more disabling by the presence of significant anaemia. The presence of anaemia in the vast majority of people is unlikely to be of a severity which would result in a degree of weakness and/or breathlessness sufficient to impair walking to a significant degree.

Duration of Need.

This is very largely determined by the cause. Whilst the anaemia resulting from blood loss can be corrected, if necessary, by transfusion, anaemia secondary to malignant disease, or renal failure, is likely to be chronic. Thus the duration of need is likely to be determined by such underlying conditions and their responses to treatment, rather than by the anaemia itself.