Care-Partner Support Needs During Recovery After Fecal Ostomy Surgery in Older Adults: A Qualitative Study

BACKGROUND: Older adults recovering after fecal ostomy surgery may require substantial care-partner support, yet the activities requiring assistance and barriers to obtaining support are poorly understood. We sought to identify care-partner contributions to recovery and opportunities to improve care-partner involvement. STUDY DESIGN: We conducted semi-structured interviews 30-90 days after planned fecal ostomy surgery among adults aged ≥65 years at a tertiary academic medical center. Purposive sampling captured experiences across the aging spectrum and benign and malignant indications. Interviews were analyzed using hybrid inductive-deductive coding and a modified Framework method until thematic saturation was reached. RESULTS: Twenty-one participants completed interviews; median age was 73 years (IQR 68-77), 13 (61.9%) were female, 11 (52.4%) underwent surgery for benign disease, and 10 (47.6%) for colorectal malignancy. Preoperative vulnerabilities included cane/walker use in 5 (23.8%), wheelchair use in 4 (19.0%), >5% weight loss in 10 (47.6%), and polypharmacy in 14 (66.7%). Care-partners provided emotional and psychological support, ostomy-specific assistance, shopping and cooking, transportation and mobility assistance, and cleaning and housework. Participants frequently described variable care-partner availability and unanticipated support needs. Physical distance, reluctance to request assistance, and financial costs to care-partners further constrained support. Most participants supported an intervention to identify care-partners and organize anticipated recovery tasks. CONCLUSIONS: Older adults recovering from fecal ostomy surgery require care-partner support across multiple domains, but support may be unavailable or unanticipated. Explicit preoperative identification of anticipated tasks and available care-partners may improve preparation for postdischarge recovery.