Charts can be returned to the team either by email or post:

Fluid diary guide

  • Please make sure you add the date at the top.
  • Please record any fluid (in or out) against the time it occurred.
  • In the 'Fluids in' column, we would like to know how much you have had to drink and when.
    There is also a guide on the diary page which gives you the amount average full cups and glasses hold. If you can measure your own cup /glass for accuracy it is even better.
  • In the 'Urine Out' column, we would like you tell us when you pass urine (wee) and how much if possible. Passing urine into an old measuring jug is one way to do this.
    If you go more than once in an hour, please tell us how many times.
  • In the 'W L or C' column. we would like you to tell us about any urinary leakage in between trips to the bathroom or any that occurs before you get to the bathroom. Please use the codes below - you can use more than one code:
    W = wet (leaking a lot)
    L = leaking smaller amounts
    C = pad or clothes had to be changed.

Bowel diary guide

  • Please complete the dates for your diary
  • Please put the time you had a bowel movement. If you go multiple times, then please list each time.
  • Any soiling of your clothes or pad due to bowel activity should be recorded in the 'Any soiling' column. 
  • If you take any medication for your bowels, please record the name of the medicine, how much you take and what time.
  • Please use one of the words small, medium, large to best describe the amount of stool (poo) you have passed.
  • The Bristol Stool guide helps you describe what your stool looks or feels like. Choose the appropriate number to describe your stool using the picture and description as a guide.
  • Use the 'other comment's column to tell us anything else about having your bowels open, such as tummy cramps etc. 

Food diary guide

  • Please tell us what you have eaten through the day. If you eat bread, rice or pasta please tell us if it is white or wholemeal.
  • Please note the times that you have your meals and snacks.
  • Please put the date of your food diary.
  • Please tell us about your portion sizes.

 

If you would like this information in another format, for example large print or easy read, or if you need help communicating with us:

First Community (Head Office)

Call: 01737 775450 Email:  fchc.enquiries@nhs.net   Text: 07814 639034

Address: First Community Health and Care, Consort House, 5-7 Queensway, Redhill, Surrey, RH1 1YB.

For office use only: PFD_LTC041 Assessment Charts Guide v1 Publication January 2025