The journal of nutrition, health & aging

, Volume 19, Issue 5, pp 491–496 | Cite as

Assessment of a self-reported drinks diary for the estimation of drinks intake by care home residents: Fluid intake study in the elderly (FISE)

  • Florence O. JimohEmail author
  • D. Bunn
  • L. Hooper
Open Access



We evaluated the accuracy of a newly developed self-completed Drinks Diary in care home residents and compared it with direct observation and fluid intake charts.


Observational study. Setting: Residential care homes in Norfolk, UK.


22 elderly people (18 women, mean age 86.6 years SD 8.6, 12 with MMSE scores <27).


Participants recorded their own drinks intake over 24 hours using the Drinks Diary while care staff used the homes’ usual fluid intake chart to record drinks intake. These records were compared with drinks intake assessed by researcher direct observation (reference method), during waking hours (6am to 10pm), while drinks taken from 10pm to 6am were self-reported and checked with staff. Results: Drinks intake assessed by the Drinks Diary was highly correlated with researcher direct observation (Pearson correlation coefficient r=0.93, p<0.001, mean difference −163ml/day) while few staff-completed fluid charts were returned and correlation was low (r=0.122, p=0.818, mean difference 702ml/day). The Drinks Diary classified 19 of 22 participants correctly as drinking enough or not using both the European Food Safety Authority and US recommendations.


The Drinks Diary estimate of drinks intake was comparable with direct observation and more accurate (and reliably completed) than staff records. The Drinks Diary can provide a reliable estimate of drinks intake in elderly care home residents physically and cognitively able to complete it. It may be useful for researchers, care staff and practitioners needing to monitor drinks intake of elderly people, to help them avoid dehydration.

Key words

Nutrition surveys homes for the aged beverages dehydration aged 


  1. 1.
    Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. Journal of the American Geriatrics Society. 1999 Oct;47(10):1187–94.PubMedCrossRefGoogle Scholar
  2. 2.
    Thomas DR, Cote TR, Lawhorne L, Levenson SA, Rubenstein LZ, Smith DA, et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors Association. 2008 Jun;9(5):292–301.PubMedCrossRefGoogle Scholar
  3. 3.
    Stookey JD, Purser JL, Pieper CF, Cohen HJ. Plasma hypertonicity: another marker of frailty? Journal of the American Geriatrics Society. 2004 Aug;52(8):1313–20.PubMedCrossRefGoogle Scholar
  4. 4.
    DRIE — Dehydration Recognition in our Elders [Internet]. [cited 2013 Nov 7]. Available from: Accessed November 7, 2013
  5. 5.
    Siervo M, Bunn D, Prado C, Hooper L. Accuracy of prediction equations for serum osmolarity in frail older people with and without diabetes. Am J Clin Nutri. 2014;100(3):867–76.CrossRefGoogle Scholar
  6. 6.
    Mentes JC. A typology of oral hydration problems exhibited by frail nursing home residents. J Gerontol Nurs. 2006 Jan;32(1):13–9; quiz 20–1.PubMedCrossRefGoogle Scholar
  7. 7.
    Hooper L, Bunn D, Jimoh FO, Fairweather-Tait SJ. Water-loss dehydration and aging. Mech Ageing Dev. 2014 Dec 9;136(7):50–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Godfrey H, Cloete J, Dymond E, Long A. An exploration of the hydration care of older people: a qualitative study. Int J Nurs Stud. 2012 Oct;49(10):1200–11.PubMedCrossRefGoogle Scholar
  9. 9.
    Forsyth DM, Lapid MI, Ellenbecker SM, Smith L, O’Neil M, Low D, et al. Hydration status of geriatric patients in a psychiatric hospital. Issues Ment Health Nurs. Proquest; 2008 Aug 1;29(8):853–62.CrossRefGoogle Scholar
  10. 10.
    Pokrywka HS, Koffler KH, Remsburg R, Bennett R, Roth J, Tayback M, et al. Accuracy of patient care staff in estimating and documenting meal intake of nursing home residents. J Am Geriatr Soc. 1997;45:1223–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–98.PubMedCrossRefGoogle Scholar
  12. 12.
    Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.PubMedGoogle Scholar
  13. 13.
    EuroQol—a new facility for the measurement of health-related quality of life. Health policy (Amsterdam, Netherlands). 1990 Dec;16(3):199–208.CrossRefGoogle Scholar
  14. 14.
    Shapiro ASS, Wilk MB. Biometrika Trust An Analysis of Variance Test for Normality ( Complete Samples ). Biometrika. 1965;52(3):591–611.CrossRefGoogle Scholar
  15. 15.
    Comrie F, Masson LF, McNeill G. A novel online Food Recall Checklist for use in an undergraduate student population: a comparison with diet diaries. Nutri J. 2009 Jan;8:13.Google Scholar
  16. 16.
    Martin Bland J, Altman D. Statistical methods for assessing agreement between two methods of clinical measurement. The Lancet. 1986 Feb;327(8476):307–10.CrossRefGoogle Scholar
  17. 17.
    EFSA Panel on Dietetic Products N and A (NDA). Scientific Opinion on Dietary Reference Values for water. EFSA J 2010. 2010 Mar 25;8(3):1459.Google Scholar
  18. 18.
    Institute of Medicine. Panel on Dietary Reference Intakes for Electrolytes and Water. 769 Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC, USA.; 2004.Google Scholar
  19. 19.
    Thompson FE SA. Dietary assessment methodology. Second. Coulston A, Boushey C, Ferruzzi ME, editors. Nutrition in the prevention and treatment of Disease. Academic Press. San Diego; 2008.Google Scholar
  20. 20.
    Mentes JC, Culp K. Reducing hydration-linked events in nursing home residents. Clin Nurs Res. 2003;12(3):210–25.PubMedCrossRefGoogle Scholar
  21. 21.
    Gaspar PM. Water intake of nursing home residents. J Gerontol Nurs. 1999 Apr;25(4):23–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Simmons SF, Reuben D. Nutritional intake monitoring for nursing home residents: a comparison of staff documentation, direct observation, and photography methods. Journal of the American Geriatrics Society. 2000;48:209–13.PubMedCrossRefGoogle Scholar
  23. 23.
    Chidester JC, Spangler AA. Fluid intake in the institutionalized elderly. J Am Diet Assoc. 1997;97:23–28; quiz 29–30.PubMedCrossRefGoogle Scholar
  24. 24.
    Reid J, Robb E, Stone D, Bowen P, Baker R, Irving S, et al. Improving the monitoring and assessment of fluid balance. Nurs Times. 2004 May 18;100(20):36–9.PubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2015

Authors and Affiliations

  1. 1.Norwich Medical SchoolUniversity of East Anglia, Norwich Research ParkNorwichNorfolk, UK
  2. 2.NorwichUK

Personalised recommendations