Free care diary for a DLA or PIP claim
For 1 to 2 weeks before you fill in the form, write down what really happens each day and night. Most refusals happen because parents describe too little: you get used to the help you give and stop noticing it. The diary makes the form easier and accurate.
- Write it on the day, not from memory at the end of the week.
- Include bad days and nights, not only usual days.
- Count minutes and how many times, and write what would happen if you did not help.
- Compare with a child of the same age without a disability.
Be honest. Write only what really happens. The form is a legal declaration: exaggerating can mean repaying money and prosecution. Leaving things out is the most common reason for a refusal.
| Activity | What happened | What I did to help | How long / how many times | What would happen without help |
|---|---|---|---|---|
| Getting up and dressed | ||||
| Washing, bathing, teeth | ||||
| Toilet and continence | ||||
| Eating, drinking, medicine | ||||
| Moving around, walking outside | ||||
| Communicating and understanding | ||||
| Behaviour, safety and supervision | ||||
| School, going out | ||||
| Evening and going to bed | ||||
| Night: times woken, how long, what you did |
A child of the same age without a disability would: ______________________________
| Activity | What happened | What I did to help | How long / how many times | What would happen without help |
|---|---|---|---|---|
| Getting up and dressed | ||||
| Washing, bathing, teeth | ||||
| Toilet and continence | ||||
| Eating, drinking, medicine | ||||
| Moving around, walking outside | ||||
| Communicating and understanding | ||||
| Behaviour, safety and supervision | ||||
| School, going out | ||||
| Evening and going to bed | ||||
| Night: times woken, how long, what you did |
A child of the same age without a disability would: ______________________________
| Activity | What happened | What I did to help | How long / how many times | What would happen without help |
|---|---|---|---|---|
| Getting up and dressed | ||||
| Washing, bathing, teeth | ||||
| Toilet and continence | ||||
| Eating, drinking, medicine | ||||
| Moving around, walking outside | ||||
| Communicating and understanding | ||||
| Behaviour, safety and supervision | ||||
| School, going out | ||||
| Evening and going to bed | ||||
| Night: times woken, how long, what you did |
A child of the same age without a disability would: ______________________________
| Activity | What happened | What I did to help | How long / how many times | What would happen without help |
|---|---|---|---|---|
| Getting up and dressed | ||||
| Washing, bathing, teeth | ||||
| Toilet and continence | ||||
| Eating, drinking, medicine | ||||
| Moving around, walking outside | ||||
| Communicating and understanding | ||||
| Behaviour, safety and supervision | ||||
| School, going out | ||||
| Evening and going to bed | ||||
| Night: times woken, how long, what you did |
A child of the same age without a disability would: ______________________________
| Activity | What happened | What I did to help | How long / how many times | What would happen without help |
|---|---|---|---|---|
| Getting up and dressed | ||||
| Washing, bathing, teeth | ||||
| Toilet and continence | ||||
| Eating, drinking, medicine | ||||
| Moving around, walking outside | ||||
| Communicating and understanding | ||||
| Behaviour, safety and supervision | ||||
| School, going out | ||||
| Evening and going to bed | ||||
| Night: times woken, how long, what you did |
A child of the same age without a disability would: ______________________________
| Activity | What happened | What I did to help | How long / how many times | What would happen without help |
|---|---|---|---|---|
| Getting up and dressed | ||||
| Washing, bathing, teeth | ||||
| Toilet and continence | ||||
| Eating, drinking, medicine | ||||
| Moving around, walking outside | ||||
| Communicating and understanding | ||||
| Behaviour, safety and supervision | ||||
| School, going out | ||||
| Evening and going to bed | ||||
| Night: times woken, how long, what you did |
A child of the same age without a disability would: ______________________________
| Activity | What happened | What I did to help | How long / how many times | What would happen without help |
|---|---|---|---|---|
| Getting up and dressed | ||||
| Washing, bathing, teeth | ||||
| Toilet and continence | ||||
| Eating, drinking, medicine | ||||
| Moving around, walking outside | ||||
| Communicating and understanding | ||||
| Behaviour, safety and supervision | ||||
| School, going out | ||||
| Evening and going to bed | ||||
| Night: times woken, how long, what you did |
A child of the same age without a disability would: ______________________________
Add up the week. Use these numbers when you answer the questions on the form.
| Help needed during the day (times per day, minutes) | |
| Help or supervision at night (times per night, minutes) | |
| Worst days this week and why | |
| Things I do that I no longer notice (count them) | |
| Evidence I can attach (GP, school, SENCo, therapist, EHCP) |
Everything in this diary is true to the best of my knowledge. Signed ____________