How to determine if a self toileting dementia resident is constipated?

[DPRN]

I manage a dementia care unit where most of our residents are high functioning. We need to document when a resident moves their bowels, but many residents self toilet and forget to tell us that they moved their bowels. Therefore, how do we know if they have moved their bowels in the past 3 days?? We already have signs posted on the bathroom doors to remind the residents to tell the nurse if they move their bowels. The signs have worked for some, but we still have an issue with others. The resident's will all say "yes" if you question them about moving their bowels, but who knows if that is true or not.

[CapeCodMermaid, RN]

Do they have bowel sounds? Do their abdomens look distended? Are they eating? It's not easy with demented residents.

[NurseLoveJoy88, ASN, RN]

Sometimes they may c/o stomach pain. Then I may assess more for bowel sounds and distention. Most of my demented residents are incontinent but I have had the same question as the op for my higher functioning residents.

[flashpoint]

We have this problem with one resident...the others leave some sort of sign for us...LOL. We ended up disconnecting the chain from the handle in the tank of the toilet...she can't flush. It's a bit of a pain to have to take the lid off the tank and reach into the water every time we need to flush, but at least we know what she is doing.

[mamamerlee, LPN]

Remove the tank lid. Get a large paper clip and hook it onto the rim of the tank. Slip the end of chain onto the paper clip. No more hands in the water!

[flashpoint]

Oh! Brilliant idea!

Thanks!

[carbaminohemoglobin]

Bowel sounds present? S/sx of abd pain? Abd distension? PCP may order a DRE.