Digital rectal examination (DRE) is frequently performed in nursing home patients and may be associated with pain, discomfort and electrocardiographic disturbances. In view of the high number of demented residents in long-term care, and the communication difficulties due to their condition, we performed ECG monitoring during rectal examination in order to detect any changes. In the great majority (85%) of the 28 patients in the study no ECG changes were recorded. Four patients had tachycardia not directly related to the rectal examination and two female patients had bradycardia with no hemodynamic consequences. Our study suggests that DRE in demented patients is not associated with significant ECG disturbances.