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One of the most challenging responsibilities for family caregivers is to ensure wound and ostomy care. It is mainly due to the unpleasant feelings related to the task involving the ostomy bag removal, cleansing of the stoma and the skin around it, and the body image issues that could arise in some patients.

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The good thing, according to a survey, is that family caregivers have received more help with ostomy care than with any other nursing task, probably due to a higher level of complexity associated with this type of care. Still, family caregivers need more training in ostomy and peristomal skincare.

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Patient and family engagement

The surgical process of creating an ostomy may affect the gastrointestinal or urinary system. The majority of people use the words ostomy and stoma interchangeably, but the meanings of both differ slightly. An ostomy is an internal diversion that allows stool or urine to pass out through the opening (stoma) made in the abdomen. Ostomy surgery alters the physical appearance and bodily functions of a patient, and it might affect the patient’s self-imaging. The nurse must engage with both the patient and caregiver to make them cooperative with each other. Many of the patients experience peristomal skin complications after they get back home. A lack of knowledge can make things worse here. Therefore, caregivers should understand how to prevent and treat these skin complications.

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Stoma and peristomal skin assessment

An important part of post-surgery education is to show patients and caregivers how to assess both the stoma and the peristomal skin during every pouch change. A normal stoma is pink, moist, slightly above raised above the skin level and functioning properly. In some people, however, the stoma’s top may level with the skin. It’s called a flush stoma.

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Abnormalities that may result in a stoma requiring medical attention include changes in the color or length and separation of the stoma from the peristomal skin. Problems or complications with the peristomal skin include black or dark maroon spots and damage or rash in the area. Normal peristomal skin is similar to the skin elsewhere on the abdomen. If there are abnormalities, you shouldn’t ignore them.

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It is understandable for both patients and caregivers to be a bit anxious about their ability to detect and respond in case complications arise. Nurses should talk to them and give them necessary information about signs and symptoms, when those complications might arise, and how to prevent them. Nurses should also teach them the way to irrigate the stoma in case there is a sigmoid or descending colostomy.