Automatically translated version. The German original is authoritative; all amounts and legal references are unchanged. Zur deutschen Fassung.
Keeping a Care Diary: The Best Preparation for the Assessment
Whether it is a first application, an upgrade, or an appeal: with the Pflegegrad (care level), everything hinges on how convincingly the actual need for assistance is documented. The strongest tool for this costs nothing — a consistently kept Pflegetagebuch (care diary).
Why the Diary Carries So Much Weight
The assessment is required by law to take place in the home of the person in need of care, and the Medizinischer Dienst (medical review board) is explicitly required to interview family caregivers as well (§ 18a SGB XI). This is exactly where the opportunity — and the trap — lies:
- Many people in need of care summon all their strength during the visit (a "good day") and appear more independent than everyday life actually is.
- Relying on memory, relatives systematically underestimate their own effort — the 2-a.m. interventions get forgotten in conversation, but not in the diary.
- A documented period shows the frequency and regularity of the assistance — which is exactly what the assessment procedure evaluates.
What Belongs in It: Along the Six Modules
The Pflegegrad is calculated from six areas of life (§ 15 SGB XI). Keep your diary along these modules — that way it matches the assessor's methodology exactly:
| Module (weight) | What you should record |
|---|---|
| 1. Mobility (10 %) | Help getting up, stairs, falls/near-falls, walking distance |
| 2./3. Cognition & behavior (15 %) | Orientation problems, forgetfulness, nighttime restlessness, wandering tendency, mood |
| 4. Self-care (40 %!) | Washing, dressing, toilet visits, eating/drinking — with time of day and duration. The heaviest module! |
| 5. Coping with illness/therapy (20 %) | Preparing/administering medication, changing dressings, doctor visits, measuring blood sugar/blood pressure |
| 6. Everyday life & contacts (15 %) | Providing daily structure, keeping occupied, accompanying, enabling social contacts |
How to Keep It Correctly
- Briefly every day instead of at length once a week — 3 minutes in the evening are enough.
- Be specific: "7:10 a.m. helped with showering (20 min., not possible without assistance)" instead of "helped in the morning".
- Always record nighttime interventions — they are forgotten most often and carry great weight.
- Stay honest: document the good days too. A credible diary with ups and downs is more convincing than constant drama.
- Everyone writes: each person involved adds their own contributions — that is how the complete picture emerges.
After the Decision: The Diary as Evidence
If the Pflegegrad comes out too low, you have one month to appeal (§ 84 SGG) — informally, and the reasoning may be submitted later. Now the diary pays off twice: it proves in black and white where the assessment report deviates from everyday reality. It is also the best foundation for upgrade applications and for handing over to doctors or the care service.
Organize care together — with Liova
In Liova, the whole family keeps the care diary together — encrypted, from any device, and exportable at the push of a button as a PDF report for the assessment or an appeal.
Try free for 14 daysFrequently Asked Questions
How long before the assessment should I keep the care diary?
At least one to two weeks are recommended, ideally four. The longer the documented period, the more reliable the picture — especially with a fluctuating condition (good and bad days), it is the average that counts, not the snapshot on the day of the assessment.
The assessment is already tomorrow — is the diary still worth it?
Yes. Today, jot down a typical daily routine in bullet points with all assistance provided, and make a list of notable incidents from recent weeks (falls, nighttime interventions, forgotten medication). Even brief notes are better than relying on memory under pressure.
Does the care diary have to be handwritten?
No. There are no formal requirements — paper, spreadsheet, or app are all equally acceptable. What matters are the date, concrete situations, and the time spent. Digital has the advantage that several caregivers can document together and nothing gets lost.
Does the care diary also help with an appeal?
It is often the most important piece of evidence there. You can appeal against the Pflegegrad decision within one month — a diary kept without gaps proves the actual need for assistance and refutes an overly optimistic assessment report.
Who is allowed to write in the care diary?
Everyone involved in the care — relatives, friends, professional caregivers. The Medizinischer Dienst is explicitly required to take the caregivers' statements into account; the more complete the picture from everyone involved, the better.