Seniors and diabetes

In the past few months, I have noticed that seniors are experiencing a difficult time managing their diabetes due to lack of funds for diabetes supplies.  I have also noticed that community programs seem to be decreasing their involvement for seniors and diabetes.

As the baby boomers age, more and more people will find themselves trying to manage diabetes and may become very frustrated and sad with their living situation, lack of funds and resources. I hope this blog will assist or lessen the frustration and identify resources that may come in handy.

The Canadian Diabetes Association has reported that 57% of Canadians with diabetes do not comply with their prescribed diabetes management due to lack of funds for medication, devices and supplies. Therefore these individuals compromise themselves and their well-being.

For seniors, once they retire, their medical coverage may change from private to public, leaving them without the coverage they once had. As a result, more personal funds are being used to provide their necessary medical care. Worse, supplies are sometimes not being bought because all available personal funds are needed to purchase food, pay for rent and other necessities.  For example, I met a 72-year-old woman who needs needles to inject insulin. Her government coverage does not cover these needles. She is using just one needle for more than 3 injections, which causes her incredible pain when she injects. It was very surprising to learn about her situation.

Another situation involved an 87-year-old legally-blind woman. She had a community agency nurse come into her home every morning to administer her insulin shots and arrange the dinner time injection, which the woman would administer herself. The agency wished to change this arrangement and teach the woman to do this on her own through the use of the clicking of the insulin pen. I connected with this agency who informed me that in other situations they have done this and the person became very pleased that he/she was able to do it on their own and did not need to wait for the nurse. The agency agreed that each situation needs to be assessed and they would consider the anxiety and safety concerns of the person.

Coverage for diabetes supplies varies across Canada. An individual’s location will determine the coverage received for their diabetes medication, devices, supplies, and physical and emotional support from provincial or territorial governments.

The Canadian Diabetes Association has compiled information about medical coverage provided by provinces, Nunavut, and territorial drug plans.

The provinces that seem to present the programs, based on income levels, best suited for people with diabetes are: British Columbia, Alberta, Ontario, Quebec, and Nova Scotia.  Nunavut and the two territories provide the most extensive coverage for diabetes devices and supplies. Their coverage is monitored by the Non-Insured Health Benefit (NIHB) and is based on income levels. This coverage also covers dilated eye exams and mental health counselling or depression screening.

Health Canada covers diabetic supplies and medications for: First Nation, Inuit population, Veterans and military personnel.

Other financial resources which may be accessed are:

1. Pharmaceutical manufacturers which have compassionate programs. These are based on income levels. Compassionate application forms can be obtained from diabetes education centres or from the manufacturer.
   1. Sanofi-Aventis
   2. Lilly Canada Cares Insulin Assistance Program
   3. Levemir Patient Assistance program
   4. Pump companies – discounts on pump supplies
2. Your diabetes education centre may be able to provide insulin samples and diabetic supplies, as long as the endocrinologist supports this direction.
3. Community Pharmacy Outreach programs (CPOP) partnered with the Canadian Diabetes Association
   1. These programs provide a variety of diabetic supplies.
   2. CPOP can be located through your regional Canadian Diabetes Association office.
4. Registered Disability Savings Plan RDSP
5. Disability tax credit: http//www.cra-arc.gc.ca/E/pbg/tft2201/
6. Revenue Canada: declaring medical costs on tax form
7. Check with different drug stores for their prices on diabetic supplies. There are definitely price differences in these stores. Also make sure when seniors days are in certain drug stores to avail yourself of discounts. This will help as well.
8. Each drug store has different dispensing fees. Some may not have dispensing fees for seniors.
9. You may be able to order diabetic supplies online at a reduced cost. Make sure the supplier is secure.

For a person, who has no private health care, the following check list may help:

1. Check with the Canadian Diabetes Association for the provincial, Nunavut and territory programs
2. Diabetes Education Centre: request to see the centre’s social worker, who will assist with your financial needs
3. If on a pump, contact the pump company
4. If receiving insulin and the above has not provided financial assistance, contact the pharmaceutical manufacturer for their compassionate programs.

Besides the financial resources there are community programs that can assist as well.

1. Most communities have community care access programs (CCAC) which may provide nursing, personal support workers, occupational therapists, physiotherapists, and social worker personnel to come into the home to help. This agency can be accessed through your family doctor. If you are at the hospital, a CCAC representative is usually available to assess your needs. However, it’s important to note that this agency has restricted guidelines, which may not always fit with needs.
2. Canada Mortgage and Housing Corporation: Home Adaptations for Seniors Independence program (HASI). This program helps homeowners and landlords pay for minor home adaptation to extend the length of time that low-income seniors can live in their own homes independently. 
3. Considering diabetes complications such as retinopathy (eye problems due to diabetes) and neuropathy (pain/numbness in feet), home adaptations may be needed. The amount that can be obtained is a $3500.00 forgivable loan with conditions. Please check out the criteria by calling 1-800-481-7718. In some areas of Canada funding for these or similar programs is provided jointly by the government of Canada and the provincial or territorial housing agency.

As stated previously, financing diabetic medication and supplies can be overwhelming, burdensome, and very anxiety provoking.  There are resources in your community to access, especially the Canadian Diabetes Association. To identify which financial and community support programs are in your region to help, phone: 1-800 BANTING (226-8464) or Email: info@diabetes.ca.