Home Health Aide Training Part 10: Assisting with Ostomy Care

One of the issues that you may have to deal with when working with home health care patients is the problem of caring for an ostomy. An ostomy is a medical device which is installed in the person’s abdomen to replace the basic functions usually handled by the genitals or the anus to evacuate waste from the body. In other words, if someone is unable to urinate, they may have had an ostomy installed to allow them to urinate and or defecate. A part of your job will involve helping to care for the ostomy and helping your patient to adjust to living with one.

Why a Patient May Have an Ostomy

The most common reason for a patient to have an ostomy is that they have some kind of injury which has either resulted in the removal of their genitals or their colon. It is also possible for the genitals or colon to cease to function normally and as a result, an ostomy will need to be installed.

How an Ostomy Works

An ostomy is typically a kind of pouch which has been attached surgically to the patient’s body to allow them to remove fluids and other waste from the body. This pouch is typically located inside the body while a tube of some form is often attached to the appropriate part of the anatomy to allow the ostomy to be evacuated when it is full.

Types of Ostomies:

Colostomy: Typically installed as a result of the loss of all or a portion of the patient’s colon (large intestine).

Ileostomy: Similar to a colostomy, an ileostomy is connected to the small intestine and can also be temporary or permanent.

Urostomy: A common form of ostomy which is designed to divert urine from the genitals into a pouch for collection.

Precautions When Handling an Ostomy

Handling an ostomy means dealing with human waste and as a result, you must handle it carefully. Always wear latex gloves when handling the ostomy valve and be sure to clean the tube thoroughly after each evacuation. Pay close attention to the instructions included with the ostomy to ensure that you handle it correctly and that you replace the valve as needed.

Overfull Ostomy

One of the biggest problems that your patients may face is that their ostomy can become overfilled if they have a particularly large amount of waste which must be evacuated from the body. Because they must use an alternate method of evacuating such waste from the body, they often find that they have a great deal of difficulty in controlling the release of such waste. The key here is practice – your patients will eventually learn how to control their eating as well as when their ostomy must be emptied in order to ensure that problems don’t occur.

If and when they do however, it is very important to clean the affected area immediately to prevent infection from developing. If the pouch bursts, it may be necessary to contact emergency services as well to help deal with this problem.

Lifstyle Restrictions

Typically, those with an ostomy are able to eat all the foods they would normally eat, unless the doctor has specifically said that certain foods are not allowed to be eaten. It is also a good idea to help your clients to limit their intake of foods which can cause gas or cramps as these kinds of foods can be particularly difficult for patients with an ostomy to deal with.

As a general rule, an ostomy should not prevent the patient from doing all of the things he would normally have done, including walking, eating and participating in sporting activities. The key is only that the ostomy must be constantly monitored so that it can be evacuated as needed to prevent problems.

Emotional Considerations

As a home health care worker with a patient who has an ostomy, it’s important to ensure that you are able to support your client in his or her feelings about having to use an ostomy. Oftentimes, people feel less than adequate when they are forced to rely on an ostomy and as such, they need emotional support from their caregivers to help them realize that they can live a normal, productive life.

This means helping your home health care patients to minimize the disruptions that the ostomy will cause them and helping them to adjust to living with one. You should also be sure to involve the patient’s family as much as possible so that they can be made to understand the problems that your client is suffering from.

Stigma

You should tell your patient that he or she is not required to tell anyone about their ostomy if they choose not to do so. The only people who need to know are you and the immediate family who may need to help the patient to deal with the problems that the ostomy may cause.

Precautions

When working with patients with an ostomy, it’s important to be on the lookout for signs of infection. These may include swelling or redness of the area where the tube emerges from the body and or heat or particular skin sensitivity in the area of the ostomy. If such symptoms persist, it’s important to contact the attending physician to examine the area of the ostomy to ensure that the patient is being properly cared for.

Other problems which must be looked after regarding an ostomy involve quality of life issues. You will need to be prepared to clean up after an accident with evacuation of the ostomy as well as changing the clothing and or sheets of your patients who are wearing one whenever a problem occurs. Always wear latex gloves when handling the ostomy’s valve (tube) and be sure to clean it thoroughly according the manufacturer’s instructions.

Pay close attention to how the ostomy valve is opened. If you are not certain of how this is done, be sure to consult the attending physician or your supervisor to find out. Do not take it upon yourself to guess as to how the ostomy works. This can cause damage and or infection if it’s not done correctly. 

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