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

Abstract

Objectives: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. Design: Observational study. Setting: Residential care homes in Norfolk, UK. Participants: 22 elderly people (18 women, mean age 86.6 years SD 8.6, 12 with MMSE scores <27). Measurements: 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).

Water intake: validity of population assessment and recommendations

“…The approaches may include using deuterium dilution as a measure of total hydration or by using as a measure of hydration such as plasma osmolality. An alternative is the direct observation of intake as used by Jimoh et al [30]. They recently reported the development of a drinks diary for use in the elderly.…”

ESPEN guideline on clinical nutrition and hydration in geriatrics

“…There is little evidence of the accuracy of assessment of fluid intake by informal carers, but it may be better than for care staff as informal carers may be more aware of the full drinks intake of the older adult. We have evidence that when older adults record their own drinks intake it is more accurate than that assessed by care staff [352]. Older adults and their informal carers may like to use a tool like the Drinks Diary (which explicitly assesses amount consumed, rather than amount provided [352]) to record fluid intake, but we suggest that they also ask their health care providers to check serum or plasma osmolality.…”

“…We have evidence that when older adults record their own drinks intake it is more accurate than that assessed by care staff [352]. Older adults and their informal carers may like to use a tool like the Drinks Diary (which explicitly assesses amount consumed, rather than amount provided [352]) to record fluid intake, but we suggest that they also ask their health care providers to check serum or plasma osmolality. Within health and social care settings fluid intake or fluid balance should only be assessed in specialist medical units with specifically trained personnel.…”

Reducing urinary tract infections in care homes by improving hydration

“…In a small study, drinks diaries were completed by patients to track fluid intake over a 24-hour period 18. Residents were typically asked to record the name of the drink, type of mug, cup or glass used, and tick the appropriate picture indicating how much they drank (a little, half, a lot or all).…”