I enjoyed your article "Ostomy Care at Home" (Supporting Family Caregivers: No Longer Home Alone, April). My mom had health issues and ended up with an ileostomy. After struggling with repeated surgeries and a prolonged recovery period due to wound dehiscence, she finally progressed to simply needing "the bag," as she called it, in her 60s. While initially depressed and discouraged, she eventually thrived and became a great educator to those in her life. She found a cartoon somewhere showing a character holding a bag with a big smile on his face, with the caption "Ask me about my bag." She hung this cartoon on her refrigerator and when asked about it would talk about her ostomy. Her grandchildren thought this was pretty neat and it helped them to understand Grandma.

My father struggled with the appearance of "the bag," and as a result intimacy was nonexistent, per a tearful discussion with Mom. My sisters and I all enjoyed sewing, and we came up with the idea to make Mom pretty nightgowns with matching ostomy pouch covers. They were both grateful, although embarrassed to talk of it.

We also developed an "emergency ostomy kit" that Mom carried. In a makeup tote, we put an extra pouch, a wafer, skin prep wipes, two pairs of gloves, a travel-size roll of toilet tissue, wet wipes (moisturizer free), a pair of underwear, a washcloth, and a small garbage bag. Having this readily available gave her confidence to travel again.

As nurses, we need to be alert to the impact of body image on patients and their significant others. Just as quality of life includes relationships and family roles as well as physical health, our education must include these factors too.

Roberta Dean, MSN, RN

Greenville, MI