We will implement a bowel movement record for any individual who has a history or diagnosis of chronic constipation. The use of this system requires the staff to supervise toileting, and at a minimum, visually note the toileting outcome in order to document that outcome on the record. For each such individual, all assigned staff are further trained in bowel movement expectations of that individual and the strict rules regarding communication of any deviation from what is expected (e.g., not having a successful outcome in more than a day). Our staff are well trained to call our nursing staff in such event, and out nursing staff will proceed accordingly…usually taking the individual for a physical examination or even to a minor emergency clinic, if necessary.

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