Fluid and Nutrition Intake Record

Who this is for

A record of what was offered and what was taken. Each line holds the time, what was offered, whether it was food or drink, the amount taken in whatever units you were asked to use, and a note — and the sheet totals the amounts without saying anything about what they ought to be.

Carers asked by a nurse, dietitian or doctor to keep a record for a few days, families worried about how little somebody is eating or drinking and wanting a clear account to hand over, and anyone recording for somebody who cannot say themselves.

What this helps you track

• Everything offered through the day, with the time
• What was actually taken, in the units you were asked to use
• Where something was declined, marked so it is not missed
• Help given, texture, temperature, anything worth passing on
• The day's amounts added up, in your units, with nothing to compare them against

How to use it

1. Write the person's name, the date, the units you are using and who asked for the record at the top.
2. Add a line every time something is offered, whether or not it was taken.
3. Say what it was, mark it as food or drink, and write the amount taken in your own units — cups, part of a plate, whatever you were asked to count in.
4. Tick declined when it was offered and not taken, so a quiet refusal is on the page.
5. The browser and spreadsheet versions total the amounts and count the entries; on paper, add them at the foot.
6. Hand the completed sheets to whoever asked for them; the sheet has no view on the figures.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser
• Excel / Google Sheets workbook

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The workbook uses plain formulas only — SUM, IF, COUNTIF and the like — so it opens in Excel, LibreOffice and Google Sheets without anything breaking, and every calculated cell is grey so you can see which figures it worked out.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

What is the right amount for someone to eat or drink?

This sheet does not say and carries no target, no daily figure and no range. If you were given one by a nurse, dietitian or doctor, write it in the notes in their words and compare the totals yourself.

What units do I use?

Whatever you were asked to use, or whatever you can count consistently: cups, glasses, part of a plate, a number from a jug marked in your own way. Write the unit at the top and keep to it, or the total means nothing.

Why record what was declined?

Because a day of full cups on the table that were never drunk looks, on a sheet that only counts what was taken, like a day when nothing was offered. The tick keeps the two apart.

Does it work out whether they had enough?

No. It adds up what you wrote and counts the lines. Whether that is enough is a question for the person who asked you to keep the record.