LIVING WITH A STOMA - TEMPORARILY OR PERMANENTLY
A stoma is a surgically created body orifice, for example an artificial intestinal exit in the abdominal wall, through which the bowel is evacuated, if a lesion or a surgical resection makes the natural evacuation impossible. A stoma can be created temporarily or definitely. The understanding of the terms “urostomy” and “colostomy” is important for the patient. They stand for artificial bladder exit and artificial intestine exit.
An operation which requires the creation of a stoma is generally a complex and burdensome intervention. The patients who undergo such a surgery need time to recover. Rehabilitation is then crucial to help them learn to cope with the new situation and recover physically. Although a stoma may be a temporary measure, the affected persons need assistance and advice for the proper care of the artificial body orifice in order to be able to cope well with everyday live as in the past. Furthermore, facing such a drastic physical alteration is a serious psychological challenge.
Apart from the optimisation of the stoma care and the treatment of stoma-related complications, we are concerned about teaching the patient in the appropriate and autonomous stoma care. Furthermore, with our therapies and complementary services we want to help our patients learn to cope well with the psychological and psycho-social strains arising from the profound changes in their lives. Our holistic treatment is aimed at enabling the patients to manage practical problems in everyday life and maintain the highest possible level of performance and quality of life.
- Evaluation of the basic health condition and primary care
- Assessment of the knowledge about stoma care: we will discuss with you the stoma systems used in the past and potential problems that might have occurred previously, such as instability or skin irritations
- Individual attitude (acceptance or rejection) towards the stoma; other psychological problems relating to the stoma (marital problems, etc.)
FIRST STOMA CONSULTATION
- is the stoma device fixed? How does the patient handle the stoma device? If possible, the patient should to demonstrate the removal and fixing of the stoma bag.
- Written report on the results, documentary images; measuring of the stoma, explanation of previous mistakes or causes of problems
- Assessment of the existing stoma device; decision on potential improvements
- Clarification of the involvement of the family or the partner in the stoma care, if there is need
- Definition of the rehabilitation goal
- Regular stoma care assistance
- Weekly stoma care consultation (individual talk)
- If problems occur regarding the used stoma system, we provide alternative systems for testing
- Training for stoma care problems; if necessary, supply of auxiliary material; for example a cutting device to adjust the perforation in the base plate
- Assessment of an irrigation of the colostomy and discussion with the patient (acceptance of such a measure)
- Training of the patient and start of a supervised irrigation
- ADDITIONAL SERVICES ACCOMPANYING THE THERAPY
- “Discussion in a group of stoma patients” guided by a psychologist
- Possibility of participating in “Cancer Group Talks”
SERVICES UPON DISCHARGE
- Prescription of an abdominal bandage (stoma bandage)
- Planning or suggestions regarding further therapies (for example, surgical revision or prescription of an abdominal bandage by the general practitioner at home)
- Arrangement of a stoma care service or support for the stoma care by an outpatient service at home, if there is need
- Information document for the provider of further stoma care
- Stoma care pass
- Information material
- PREPARATION FOR THE LIFE AFTER THE REHABILITION
- Information on providers of support and assistance, in the event problems with the stoma care should occur at home
- Information of the treating doctor, if the patient needs stoma-related psychotherapeutic assistance
- Arrangement of career counselling, if particular problems at work due to the stoma are foreseeable