“I’m just the guy who takes care of myself,” stated a male participant in his 80s with heart disease, diabetes and urinary dysfunction. Although he was found on several occasions naked, covered in feces, having collapsed trying to manage ostomy care on his own, he denied needing help with ostomy care. His caregiver was a non-child relative who provided extensive assistance with shopping, medications and finances, but who did not see her role as a personal care provider. The caregiver never entered his bathroom and hired a personal care attendant for bathing assistance, but the attendant proved unreliable and did not alert the caregiver to any problems. The survivor did not report his peristomal skin problems, and these problems remained undetected for over a year until his placement in an adult care foster home. “How many people would you ask to clean up your mess?” asked a woman in her 80s who was living with her son and daughter-in-law. She could not see her ostomy due to a large hernia, struggled to secure the skin barrier to her skin properly and had to change the skin barrier frequently because it leaked or fell off completely. The caregiving daughter-in-law was frustrated by the frequent accidents, bad smells, and laundry that resulted from her mother-in-law's inability to secure her skin barrier. Neither woman suggested collaborating in ostomy care. Eventually, a paid caregiver was hired to help with daily tasks, including ostomy care. The first time the new caregiver helped her patient take a shower and then change the skin barrier the patient began crying, and said ‘Thank the Lord. You have been brought to help me.’ The paid caregiver said this was when she realized the extent to which the patient had felt unable to ask for help with her ostomy.
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