Mrs Rebecca Howson1
1Alfred Health, Bayswater, Australia
Australia’s aging population presents unique hurdles when planning, providing care and educating new ostomate’s; and these variations to care differ greatly depending on the individual. Whilst there are many predictors to flag potential issues, and well planned out pathways for the stoma’s physical journey; this is aimed at highlighting the often overlooked and under documented complexities encountered as we navigate patients in the transition to home. This is an example of how not all complications and barriers to discharge are due to the stoma, the output, or any medical issue. It is about the patient’s ability to self-manage. This follows the journey of a non-English speaking background patient transferred from the acute setting to Rehabilitation. She was struggling to manage her colostomy appliance, which could put her and her husband with dementia into residential care. The ability to self-manage a stoma is often the defining factor to an aged person’s ability to return to their lives at home or placed into formal care. Her motivation to prevent placement was demonstrated by her readiness to learn. As a Stomal Therapy Nurse, it is our responsibility to identify the barriers to self-care, adapt product selection and implement the most achievable goals. The patient’s specific goals and the interventions produced to achieve these; were individualized so that she is able to return home to continue to live her life; and not dictated by her new stoma. This idea meant that the concept of self-care had to be as simple as 1, 2, 3.
A registered Nurse since 2011 working in the Colorectal ward at the Alfred and Enrolled Nurse since 2007, in aged care; I have always had an affiliation with working with the older person and patients with Stomas. This history meant when i was looking to continue with my Studies that Stomal Therapy seemed like an appropriate choice.
Since completing The Graduate Certificate in Stomal Therapy in 2016, I have been working as the Stomal Therapy C.N.C in Caulfield Hospital, a Sub-acute Rehabilitation center which includes: slow stream(Aged Care), Fast stream, aged psychiatry and a specialized Acquired Brain Injury unit.