Keeping a monitoring diary
Noticing and recording difficulties during eating and drinking is an important part of keeping people safe. It can sometimes be difficult to know what information is helpful or how to record it clearly. Keeping a diary can support early identification of difficulties and strategies or adjustments that can be made.
You do not need to write long, detailed notes, brief, meaningful observations are enough.
Why keep a diary?
A monitoring form helps you to:
- spot patterns over time
- identify foods, drinks or situations that make coughing worse
- notice whether choking risk may be increasing
- support safe decisions before considering referral (for care home staff)
- provide accurate information for a speech therapy assessment
What to look for
When observing the person, think about:
- When doo the difficulties happen?
- At the start of the meal?
- Mid‑meal?
- After eating or drinking?
- Is it happening at a particular meal/time of day?
- What were they eating or drinking?
- Specific foods and how they were prepared (for example, softly boiled potatoes or roasted potatoes)
- Thin or thick drinks
- Snacks as well as main meals
- What was concerning?
- A single cough
- Repeated coughing
- Throat clearing
- Wet or gurgly voice
- Signs of discomfort
- Any other signs
- Did anything help?
- Smaller pieces
- Slower pace
- Moistened food
- Change in posture
- Trying a different cup
- Anything else affecting swallowing?
- Tiredness
- Positioning
- Dentures
- Recent illness
- Reflux
- Distraction or agitation
These observations help build a clear picture without requiring clinical knowledge.
How to use the diary
Below is a simple text‑based structure you can use. This can be handwritten, typed or added into care records.
Monitoring form template
Date and time of day.
Food and drink type (note specific food or drink this happened with).
Difficulties noticed.
Any relevant environmental or behavioural factors.
Example entries
Date: 9 April 2026
Time: 1pm, lunchtime
Food and drink type: Ham sandwich with lettuce, crusts removed. Cup of tea
Did they have any difficulties? Took a long time to chew. Lots of coughing and face went red after 2nd bite which included large piece of lettuce.
Throat clearing a few times whilst drinking.
Any relevant environmental or behavioural factors? Took large bites of sandwich, watching television and talking at the same time.
Drank from open cup, took a few big sips at a time.
Date: 15 April 2026
Time: 7pm
Food and drink type: Ham sandwich with lettuce, crusts removed. Cup of tea
Did they have any difficulties? Took a long time to chew. Lots of coughing and face went red after 2nd bite which included large piece of lettuce.
Throat clearing a few times whilst drinking
Any relevant environmental or behavioural factors? Took large bites of sandwich, watching television and talking at the same time.
Drank from open cup, took a few big sips at a time.
What to do if you notice specific patterns?
If you notice there are specific times of day or specific foods that tend to be worse, then consider avoiding these foods or adapting the environment. This may be enough to manage the individuals difficulties. Use our resources (link to ‘I need more information with swallowing problems’) to help.
If there are still significant difficulties then a referral to us may be appropriate.
