Hemophilia used to be considered “the royal disease,” as many of Europe’s male heirs suffered from frequent bouts of uncontrollable bleeding during the late 19th century. Luckily, this bleeding disorder is better understood nowadays, and those with the disorder are living longer and more fulfilling lives. To wit, there are studies confirming that U.S. patients over 65 years of age make up 10% of the overall hemophiliac population. This is up from 2% in early studies, and higher than the 6% reported abroad.
While congenital sufferers are born with the disease and are almost exclusively male, there are also instances of acquired hemophilia in older men and women. Both types are manageable, but require a great deal of preventive and emergency care.
Congenital hemophilia is inherited from the mother and presents in male babies when normal bleeding does not result in a scab, or when bruising leads to painful, subcutaneous bleeds. This type of hemophilia is more common, and is treated with both preventive injections of a coagulative medication as well as on-demand, hormone-based inhibitors to stop sudden bleeds.
Alternatively, older adults can acquire hemophilia if their natural clotting inhibitors fail. This is most common with a serious surgery, but can also present when one experiences several instances when a nosebleed refuses to stop, bleeding from wounds lasts a long time, gums refuse to stop bleeding after brushing, skin bruises for no apparent reason and extreme stiffness occurs around elbows, knees and ankles after a minor bump.
Congenital hemophilia limits an older adult’s ability to play contact sports, take certain medications, including aspirin, and may require extra care when undergoing dental treatment.
What used to be minor spills or falls also have the potential to result in more serious bleeds in the brain or joints as we age. To wit, older adult patients who bump their heads could now experience sudden paralysis, a loss of balance, vision trouble, confusion, difficulty speaking and severe head and neck pain.
Additionally, minor sprains can morph into more serious joint problems, especially around knees, ankles and elbows. Osteoporosis can even lead to flare-ups and cause sufferers to take pain medication, which may lead to opioid addiction in older sufferers.
Muscle pain could also signify graver issues such as changes in bleeding patterns as we age, cirrhosis, portal hypertension and upper-gastrointestinal bleeds, all of which we cannot see with the untrained eye.
For those with acquired hemophilia, many of the same ailments persist, but it is important to try to find the root cause of the condition so as to better manage treatment. Preventive and emergent shots could still be necessary, but less so if an underlying malignancy were to be identified and treated accordingly.
Those experiencing either congenital or acquired hemophilia may experience the following impairments:
Medical alert devices are a great investment for those who continue to experience congenital hemophiliac symptoms, as well as those recently diagnosed with acquired hemophilia. These devices are especially important given that falls in older adults have the potential result in life-threatening bleeding.
Fall detection is critical for those ages 65 and over suffering from this disorder since one slight bump to the head could lead to confusion, dizziness or worse. That said, monitoring services that provide check-in services might be best in the event the older adult is unable to reach an in-home help button, or cannot press their pendant for help given joint stiffness in the elbows, ankles or knees.
Not only will such services and options give the hemophiliac peace of mind, but the system could boost their confidence and encourage them to venture outdoors knowing they are covered by GPS tracking or mobile alerts.
Acquired and inherited hemophiliac symptoms:
Many long-term patients with hemophilia may elect to forgo medical alert devices and systems, as they already have a strong network of care. Those who have recently acquired the disease may also choose to manage their symptoms without medical alerts, assuming they know the root cause behind their uncontrollable bleeding.
Hemophilia is no longer a misunderstood or deadly disease for those past the age of 30. That said, long-term care is still critically important. What used to be a minor fall or bruise could quickly become a joint issue requiring surgery. These unanticipated complications are easily mitigated, however, with a 24/7 medical alert or monitoring system. At the first sign of trouble, an older adult with either acquired or congenital hemophilia can get in touch with a primary care provider and receive assistance to not only prevent unnecessary pain, but avoid comorbidities that may abound with just a minor fall.
Even without round-the-clock monitoring, having a personal network of care around the hemophiliac is critical, since one minor cut or gum bleed could have very painful consequences.