"Wrapping care around Mr. and Mrs. Deepoo has been a true team effort."
- Linna Tran, CCAC Care Coordinator
With help from the Central West CCAC, this Health Links patient and her spouse of 64 years are able to remain safe and independent in their own home.
In the summer of 2014 Mrs. Deepoo’s family doctor referred her to the Central West CCAC, citing concerns with her uncontrolled blood pressure, unmanaged diabetes, medication challenges, and overall decline in physical functioning. Mrs. Deepoo had also begun going to the hospital with abnormally high blood sugar, and her husband of 64 years – who had health concerns of his own – grew worried about her fluctuating health conditions.
While Mrs. Deepoo had been referred to professionals who could help, however, she found travelling difficult and often missed appointments due to miscommunication or forgetfulness. When she met CCAC Care Coordinator Linna Tran, Mrs. Deepoo was overwhelmed, uncertain, frustrated with the health care system, and had no clear sense of how to navigate it to address her complex needs. As Mrs. Deepoo explains: “When you don’t know things, what are you going to do?”
Linna began by developing a care plan designed to meet the couple’s requirements and circumstances. To help address their immediate needs first, Linna arranged for a visiting nurse and in-home pharmacist to work closely with Mrs. Deepoo’s doctor and endocrinologist to adjust her insulin levels and stabilize her critically high blood sugar.
Over the coming months, the team closely monitored and supported
Mrs. Deepoo while her medical needs continued to change; additional services included physiotherapy treatments to support Mrs. Deepoo’s functional goals, as well as a nurse to teach Mr. Deepoo to help manage and monitor her diabetic care. And when Mr. Deepoo ended up in the hospital with his own health issues, Linna followed up to ensure he accessed specialist care and joined him on an appointment with his family doctor, providing essential background information to support the physician’s assessment. As a result, Mr. Deepoo was referred to a pain clinic, is on new mediations and awaits his next specialist appointment.
“Wrapping care around Mr. and Mrs. Deepoo has been a true team effort,” Linna says of the collaboration. “Throughout this journey, there
has been constant communication between their doctors, specialists, nurse, pharmacist and myself – and the positive outcome is very
evident. Mrs. Deepoo has had no emergency room visits, is now attending all medical appointments, has remained medically stable,
and is more independent overall, while Mr.Deepoo is also getting the care and support he needs.”
Remarkably, the couple who once struggled to attend a doctor’s appointment recently travelled to Guyana to visit their children – a
dream two years in the making. With their newfound knowledge and improved health, they successfully managed their needs independently during the month-long visit.
Asked what she would tell others about her CCAC experience, Mrs. Deepoo’s answer is simple. “You can get help, and it helps you help
yourself,” she says. “Thank you very much for everything.”