This topic is about managing a colostomy for someone who is 89 years old and has low vision, living in North Carolina's Triangle area. They are looking for practical ways to handle their colostomy care and to guide caregivers effectively. Here are some helpful tips and resources:

1. Visual aids for self-care:
- Consider using a stand-up or wall-mounted magnifying mirror, preferably one with lights to improve contrast.
- Explore low-vision devices like high-power magnifiers, telescopic lenses, or glasses designed for macular degeneration.

2. Making the pouch/barrier safer for the stoma:
- After cutting a custom opening, soften the inner rim by wrapping a damp washcloth around your finger and rubbing the cut edge before applying. This helps prevent abrasion and bleeding.
- If possible, ask your surgeon for a stoma size that allows you to buy pre-cut appliances, eliminating the need for cutting.

3. Appliance and accessory choices:
- Consider using the pre-cut SenSura Mio one-piece system from Coloplast.
- Use Coloplast barrier wipes for skin protection.
- Reinforce the flange with Medipore cloth tape (3M) in high humidity or perspiration.
- For irritated or broken skin under the wafer, apply Anacept wound gel sparingly, let it dry, and then use a barrier wipe.
- Use a few drops of essential oils or baby oil inside the pouch for odor control and lubrication as an alternative to commercial deodorants.

4. Bathing/Showering options:
- Shower with the pouch off to thoroughly clean the stoma area, but be prepared for output, which may increase supply use.
- If showering with the pouch on, reinforce edges with waterproof tape or Medipore, cover the pouch with plastic wrap, or dry the outside with a hair dryer on low.

5. Application technique reminders:
- Center the wafer and press gently but firmly around the stoma opening and along the flange edge to ensure it sticks well.
- You can order free samples of almost every appliance and accessory from manufacturers’ websites or by phone to find what works best for you.

6. Obtaining hands-on help:
- Ask the surgeon’s clinic or Duke’s ostomy nurses for a referral to a visiting ostomy nurse; insurance might cover short-term teaching visits.
- If private-pay help is needed, inquire about rates from local home-health agencies, as costs vary by region and service length.
- Clearly explain your needs to helpers, describing each step and desired outcome in detail.

7. Community support:
- Search online forums for discussions about "blind" or "low vision" ostomy experiences, where several members share long-term strategies.