Objective:We compared changes in BMI as well as nutritional and fluid intake in older adult patients who died and survived while in special nursing care facilities, and examined whether trajectories in the death group were effective in predicting prognosis. Methods:We retrospectively extracted data from BMI, nutritional and fluid intake for all older adults admitted to a special nursing care facility between April 2007 and the end of July 2022, searching for changes in the monthly mean values. Results:Data were obtained for 646 patients in the death group and 498 in the survival group. In the death group, BMI, nutrition and fluid intake decreased significantly from 12 months before death compared with the survival group. In the death group, nutrient intake per kilogram of body weight decreased significantly and irreversibly as of 6 months before death, and fluid intake decreased significantly and irreversibly starting 3 months before death compared with the previous month. Discussion:The trajectories of BMI, nutrition and fluid intake decreased simultaneously from 12 months before death, and the significant irreversible decrease in fluid intake followed by nutritional intake per kilogram body weight was effective in predicting the prognosis of elderly patients dying in special care facilities.