Living with an Ostomy: Navigating Care and Quality of Life for Seniors

Caring for an older adult with an ostomy can be challenging, but it is also an opportunity to enhance their quality of life and provide vital emotional support. With over 750,000 people in the U.S. living with an ostomy, many of whom are older adults, understanding how to manage this condition is essential.

An ostomy—a surgically created opening in the abdomen that allows waste to exit the body—can be lifesaving for individuals with chronic illnesses or conditions like colorectal cancer, inflammatory bowel disease, or diverticulitis.

For seniors, an ostomy introduces a significant adjustment to daily life, often complicated by aging-related physical and emotional challenges. Proper care and support can help them navigate this transition and maintain dignity, independence, and well-being.

What Is an Ostomy, and When Is It Needed?

An ostomy is a medical procedure that creates a stoma, or an artificial opening in the abdomen, through which waste exits into a pouch or bag. Ostomies may be temporary or permanent, depending on the underlying medical condition.

Common reasons for an ostomy include:

• Chronic illnesses: Conditions such as Crohn's disease, ulcerative colitis, or diverticulitis often require surgical intervention when other treatments fail.
• Cancer: Colorectal or bladder cancer patients may need an ostomy if surgery involves removing part of the bowel or bladder.
• Injury or trauma: Severe abdominal injuries may necessitate an ostomy to allow the body to heal.

For older adults, these conditions are often compounded by aging-related health concerns, making recovery and adaptation more difficult.

The Emotional and Physical Impact of an Ostomy on Seniors

Seniors living with an ostomy face unique challenges:

• Emotional Challenges: Many seniors struggle with the psychological impact of an ostomy. Feelings of embarrassment, anxiety, or depression are common as they adjust to their new reality. Body image issues and social stigma can exacerbate these feelings, leaving them feeling isolated.
• Physical Limitations: Mobility may be affected, making it harder for seniors to manage daily activities or care for their ostomy independently.
• Nutritional Concerns: Some ostomy types, like ileostomies, can make nutrient absorption more difficult, increasing the risk of deficiencies.
• Social Isolation: Concerns about odor or leakage may cause seniors to avoid social situations, further impacting their mental health and quality of life.

Caring for Seniors with an Ostomy: Tips and Strategies

Providing care and support to a senior with an ostomy involves addressing both their physical needs and emotional well-being. Here are practical tips to ensure they remain healthy and confident.

1. Create a Care Checklist

Managing an ostomy requires a consistent daily routine. A checklist can help caregivers stay organized and ensure nothing is overlooked. Tasks may include:

• Emptying or replacing the ostomy pouch.
• Cleaning the skin around the stoma with warm water and mild, unscented soap.
• Inspecting the stoma and surrounding skin for irritation or infection.
• Ensuring the appliance fits securely to prevent leaks.

If the senior is unable to manage these tasks independently, hiring a professional caregiver can ease the burden.

2. Stock Essential Supplies

Always have extra ostomy supplies on hand to manage emergencies or unforeseen situations. Common supplies include:

• Ostomy pouches (disposable or reusable).
• Skin barrier wipes or sprays.
• Stoma powder to prevent irritation.
• Scissors for trimming pouches to fit.
• Disposable wipes to maintain hygiene.

Investing in high-quality products from trusted sources can improve comfort and reduce the risk of complications.

3. Provide Emotional Support

The emotional toll of living with an ostomy can be significant. Engage in open conversations to help your loved one process their feelings and overcome embarrassment or anxiety. Support groups can also be a valuable resource, offering opportunities to connect with others facing similar challenges.

4. Focus on Nutrition and Hydration

Seniors with an ostomy need a balanced diet to maintain health and manage symptoms. Avoid foods that are difficult to digest, such as fibrous vegetables, nuts, or seeds, and monitor their reaction to certain foods that may cause gas or discomfort.

Hydration is crucial, especially for those with an ileostomy, as fluid loss can lead to dehydration. The goal should be 8-10 glasses of water per day, adjusted for individual health needs.

5. Encourage Physical Activity

Maintaining mobility and light physical activity is important for overall health. Activities like walking, gentle yoga, or tai chi can help improve strength, flexibility, and mental well-being. Be mindful of the senior's comfort level and avoid activities that could strain the stoma area.

6. Ensure Proper Skin Care

The skin around the stoma is sensitive and prone to irritation. Regularly check for redness, swelling, or signs of infection, and consult a healthcare provider if issues arise. Using skin-friendly products can help maintain skin integrity.

7. Hire Professional Caregivers

If caregiving becomes overwhelming, professional home health aides or nursing staff trained in ostomy care can provide valuable support. They can also offer companionship and help seniors feel less isolated.

8. Schedule Regular Medical Checkups

Routine visits to a healthcare provider are essential for monitoring the stoma's health, ensuring the appliance fits correctly, and addressing any complications. Regular checkups also provide an opportunity to discuss concerns and adjust care plans as needed.

9. Ostomy Products at Home

For daily maintenance, you or your loved one will need various supplies. Always keep extras to ensure availability during emergencies. Buy these products from a trusted and reliable source. Here are the common ostomy products you will need:

• Ostomy pouches
• Stoma powder
• Skin wipes and sprays
• Ostomy Scissors
• Gentle soap and water 
• Disposable wipes to keep the environment clean, etc. 

Some Assisted Living Facilities Have Refused Potential Residents with an Ostomy

Some older adults are being denied admission to assisted living facilities (ALFs) solely because they have an ostomy. According to the United Ostomy Associations of America (UOAA), managing an ostomy is a routine activity of daily living, akin to the basic process of toileting. Individuals with an ostomy deserve equal access to care and should be welcomed and treated with dignity and respect, just like anyone else.

The UOAA has published an FAQ to help care recipients and their families with issues with getting admitted to an assisted living facility because of their ostomy. The last thing anyone wants is to have a loved one go to a nursing home when they don't need one.

If the loved one with an ostomy has Long-Term Care Insurance the benefits will pay for assisted living (or even in-home care) in most situations.

• Assisted Living Facilities FAQ l United Ostomy Associations of America

You can find quality assisted living facilities, in-home caregivers, home health agencies, and even memory care and nursing homes by using the LTC News Caregiver Directory. The directory is the largest database of long-term care providers in the United States and is free to use.

How Living with an Ostomy Impacts Seniors in Long-Term Care

Managing an ostomy adds another layer of complexity to caregiving for seniors in long-term care facilities. Staff must be trained to provide specialized care, including proper hygiene, equipment maintenance, and monitoring for complications.

Challenges in long-term care settings may include:

• Staffing shortages: Limited staff can make it difficult to provide the personalized attention ostomy patients require.
• Emotional barriers: Seniors in communal living environments may feel self-conscious about their condition.
• Compounded health issues: Seniors with chronic illnesses may face additional complications, making ostomy care more demanding.

Facilities that prioritize staff training and create supportive environments can significantly enhance the quality of life for residents with an ostomy.

Helping Seniors Thrive with an Ostomy

Living with an ostomy can be a challenging adjustment for seniors, but with the right care and support, it doesn't have to define their quality of life. By addressing their physical needs, providing emotional encouragement, and fostering social connections, you can help them navigate this transition with confidence and dignity.

Whether at home or in a long-term care facility, the goal is to empower seniors to live as comfortably and independently as possible. With regular checkups, a strong support system, and thoughtful caregiving, seniors with an ostomy can continue to enjoy meaningful and fulfilling lives.