Method: Two ET nurses and two nurses who work at out patient ostomy clinic organized and tabulated patients' basic information, problems, and types of supports they receive. The subjects were those patients who were 80 years and older and visited the clinic between April 2004 and September 2005.

Results: We had 18 subjects, average 83 years old. They visited the clinic 1-10 times during the 18 months period. Diagnoses that led to their ostomy surgeries included bladder tumor (8 pts), colon tumor (7 pts), and others. Local skin problems of the subjects were parastomal hernia (3 pts), skin excoriation (2 pts), mucosal transplantation (2 pts), and others. Two patients had problems with the leakage of pouches. Physical changes associated with aging that need to be addressed included decreased visual acuity (7 pts), decreased physical strength(5 pts), increased and /or deepening skin folds (4 pts), dry skin (4 pts), and others. It was found seven patients were completely independent with the care of their stomas, 2 patients with some assistance when changing pouch, and 2 patients with care givers changing pouches, and one patient completely dependent. Types of supports at the clinic included supporting patients' to be independent, assuring patients that there is no problems found, dealing with skin problems, discussing other health-related issues, and providing current knowledge.

Discussion: We observed physical changes associated with aging such as decreased physical strength, decreased visual acuity, poor manual dexterity, increase and/deepened skin folds, and dry skin. We need enough knowledge and skills to deal with the changes while assisting those patients. And our subjects were quite independent with the care of their stomas. It was suggested that it's possible for older patients to be independent and health care providers need to teach them patiently.