Financial Constraints & Health: A Case Study of a Retired Patient

This case study examines the health and socioeconomic challenges faced by a retired IT worker in Australia in his mid-70s living with hypertension, T2DM, TIAs, arthritis, and psoriasis. The study highlights the patient's interaction with healthcare providers, including his GP, colorectal specialist, pathology services, and pharmacy, emphasizing the accessibility of healthcare due to his proximity to services and government support schemes like Medicare, NDSS, and PBS. The patient has made significant lifestyle changes, such as quitting smoking and alcohol, losing weight, and adopting a healthy diet and exercise routine. However, he still experiences anxiety related to his conditions and fears of hypoglycemic episodes and recurrent TIAs. His primary concern is financial limitations, hindering his ability to travel and visit family. The case study contextualizes these financial worries within the broader issue of pension adequacy in Australia, referencing ASFA guidelines and Sydney Morning Herald articles that discuss the challenges pensioners face in affording a modest lifestyle while managing chronic illnesses, highlighting the social and political impacts on his overall health.

Patient in the
Community
Georgia and Sumana

Who is our
patient?
Male
Retired IT worker (highly stressful job)
Mid 70’s
Conditions
 Hypertension
 T2DM
 2 TIA’s (Transient Ischaemic Attack)
 Arthritis
 Psoriassis
In 2015 the National Health Survey data reflected that 3
out of 5 Australians over 65 had two or chronic conditions.1

Impacts of
chronic
disease:
Interaction
with the
Health
Care
System
Due to living with an array of conditions, our patient
has close relationships with the health care providers in
his community.
 GP: Monthly visits and is able to contact his doctor at
any time he feels it is necessary.
 Colorectal Specialist: Annual check-up
 Pathology: Regular blood tests
 Pharmacy: Has been filling his prescriptions at the
same pharmacy for over 20 years and is known as a
familiar face in the vicinity and knows the staff by
first name basis.

Impact of
chronic
disease:
Access to
Health Care Health care is highly
accessible for the patient General Practitioner sees
his promptly Lives in close vicinity to his
GP Drives himself to distal
appointments Medicare National Diabetes Services
Scheme (NDDS) Pharmaceutical Benefits
Scheme (PBS)
2
3
4

Daily Life Constantly aware of his medication timing Fear of hypoglycemic state (previous episodes) Daily insulin injections Restricted diet and mindful eating Daily skin care routine Tiredness towards early afternoon. Arthritic pain flare ups regularly, unable to use his
hands properly, relies on his wife for assistance Usually at home

Lifestyle
changes
due to
diagnosis Quit smoking Gave up alcohol Lost 30kg Gave up fast food for home cooked meals Walks daily

Limited by
Fear T2DM Previous hypoglycemic episodes Headaches, sweats, ringing in the ears, difficulty
speaking Common colds and infections worry him because of
their detrimental effects upon his condition
Due to stress hormones increasing in a state of
sickness, blood glucose levels can rise without the
patient realizing.5 Overall, a constant feeling of anxiety TRANSIENT ISCAHEMIC ATTACK Fearful for recurrence Fear for his wife having to call the ambulance for him

Main Issue
for our
patient:
Limited by
finances
additional
to his health
conditions According to our patient, the biggest thing that stops
him from doing what he desires are his finances. Dreams of travelling around Australia Would like to visit his adult children more often - Unable to afford the costs - Diabetes medication is required to be kept
refrigerated. Not convenient in a long durations of
travel How can somebody on a pension live a lifestyle
of comfort? Does the pension really allow for a
modest lifestyle?

Money
Worries for
a Nation of
Pensioners The main concern for our patient are his finances His medications have to come first Everything else in his life comes second Can’t afford extra health cover to enable him travel
Relevant Australia Wide….
A recent article in the Sydney Morning Herald discussed these issues. “A single retiree who
qualifies for a full government pension can expect to receive $22,700 a year, including a so-
called pension supplement and an energy supplement. A couple can expect to receive
$34,300 a year.”6
Association of Superannuation Funds of Australia (ASFA) claim that the pension provides a
“modest” lifestyle.6
“ASFA estimates that a single person between the age of 65 and 85 would need an
income of $23,800 to achieve a modest lifestyle. The catch is that this requires
spending nothing on items such as gifts, music, home improvements or overseas
holidays.”6
A pension incomes allows for (guidelines by ASFA)
-$980 a year for domestic holidays
 $23 month for entertainment
 $7.40 a month at chemists ( keep in mind one script costs $6.40)
 $77 a week on food6
Is this really sufficient for our pensioners in Greater Western Sydney who may be
living with chronic illness?

SOCIAL IMPACTS ON
HEALTH Teenage life
 Smoking was very popular
amongst his friends
 Drinking alcohol also
popular among his friends.
Was a social drinker then
progressed to solitary
drinking.
Retirement village
- Patient is now more aware
of the health of others and
looks out for his neighbors
POLITICAL IMPACTS
ON HEALTH
Education – patient was not
educated about healthy food
options, consequences of
stress and the real dangers of
smoking in his teenage years.
Processed “fast-food” in
abundance in Greater Western
Sydney is a contributing factor
Patient has fine access to
health care. He is able to
manage his conditions and
seek medical treatment and
services.

What now
for our
patient? Continue to live a quiet lifestyle in his retirement Volunteering at local Rotary events Healthy lifestyle habits Long distance relationship with his children Maintaining his health as best he can

Reference List:
1. Chronic Conditions [Internet]. The department of Health. 2017 [cited 5 September 2018]. Available from:
http://www.health.gov.au/internet/main/publishing.nsf/content/chronic-disease
2. Medicare [Internet]. Australian Government Department of Human Services. 2018 [cited 5 September 2018].
Available from: https://www.humanservices.gov.au/individuals/medicare
3. Eyes on diabetes [Internet]. Diabetes Australia. 2015 [cited 5 September 2018]. Available from:
https://www.diabetesaustralia.com.au/
4. Pharmaceutical Benefits Scheme [Internet]. PBS. 2018 [cited 5 September 2018]. Available from:
http://pbs.gov.au/pbs/home;jsessionid=ctrkoo2wovzwpunwwvieq
5. Illness and complementary medicine [Internet]. Diabetes in Australia. 2015 [cited 5 September 2018]. Available
from: https://www.diabetesaustralia.com.au/illness-and-complementary-medicine
6. Patten S. What life is really like on the age pension [Internet]. The Sydney Morning Herald. 2016 [cited 7
September 2018]. Available from: https://www.smh.com.au/money/what-life-is-really-like-on-the-age-pension-
20160426-gofbs8.html