I am writing in response to "Ostomy Care at Home" (Supporting Family Caregivers: No Longer Home Alone, April). As a home health certified wound and ostomy nurse, I appreciate the authors' emphasis on supporting caregivers of patients with a new ostomy. Patients and caregivers can be inundated with a large amount of postsurgery information, so it is important to have easy-to-follow instructions and reference material on hand. The article's informational tearsheet, "Information for Family Caregivers," is an asset.

Concerns related to diet, hydration, and nutrition are commonly discussed at length by patients and caregivers. I would like to suggest a clarification to the "How to prevent dehydration" section of the article, which recommends that ileostomy patients' diets include foods that are high in sodium and fiber. Fiber is an important part of the diet; however, for ileostomy patients, high-fiber food is generally not advised for the first few weeks after surgery. Osgood and Handschuh state, "For the first six to eight weeks after surgery, avoid high-fiber foods that absorb water such as oats, citrus fruits, apples and beans" in order to reduce the risk of blockage from foods that are not easily digested.1

Therefore, I propose revision of the information in the article's tearsheet that endorses high fiber. This clarification would benefit caregivers and patients in reducing the risk of further complications during the adaptive phase of a new ostomy.

Robin McGlade, BSN, RN, CWON, CWCA

Brandon, MS

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