Feasibility study of an intervention to provide nutritional care for people living with dementia at home
Study Code / Acronym
TOMATOAward Number
NIHR203110Programme
Research for Patient BenefitStatus / Stage
CompletedDates
1 November 2022 -3 May 2024
Duration (calculated)
01 years 06 monthsFunder(s)
NIHRFunding Amount
£247,950.00Funder/Grant study page
NIHRContracted Centre
Dorset Healthcare University NHS Foundation TrustContracted Centre Webpage
Principal Investigator
Professor Jane MurphyPI Contact
jmurphy@bournemouth.ac.ukPI ORCID
0000-0003-3531-5566WHO Catergories
Methodologies and approaches for risk reduction researchModels across the continuum of care
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 206 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Study Code / Acronym | TOMATO |
|---|---|
| Award Number | NIHR203110 |
| Status / Stage | Completed |
| Start Date | 20221101 |
| End Date | 20240503 |
| Duration (calculated) | 01 years 06 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | Dorset Healthcare University NHS Foundation Trust |
| Contracted Centre Webpage | |
| Funding Amount | £247,950.00 |
Abstract
What is the feasibility and acceptability of a new nutritional intervention for home-dwelling people with dementia (pwD), delivered by home care staff and family carers? Background In the UK, two-thirds of people with dementia (pwD) live at home relying on family/friends to support eating and drinking as dementia progresses. Many are at risk of undernourishment due to reduced appetite, eating and swallowing problems, leading to reduced health and quality of life and increased health care use, costing around £23.5 billion in terms of health and social care expenditure. Home care workers (HCWs) provide care for pwD more frequently and for longer than Healthcare Professionals (HCPs). Existing research and our engagement work indicate HCWs are well positioned to assess nutritional status and intervene early, but currently lack training, access to resources and support from NHS services. A more pro-active and wide-ranging approach to nutritional assessment and management is needed targeting interventions at HCWs and family carer dyads, with input from appropriate HCPs. Aims and objectives To refine and assess the acceptability and feasibility of an existing nutrition intervention applied to pwD receiving home care. Objectives 1. Understand more about the current provision of nutritional care for pwD at home (in receipt of home care), via semi-structured interviews. 2. Tailor a multi-component home-based nutrition intervention, (developed for pwD in care homes) to improve nutritional care and outcomes for pwD in receipt of home care. 3. Refine a logic model for the nutritional intervention for this population. 4. Collect data associated with costs to deliver the intervention. 5. Evaluate the acceptability and feasibility of the intervention including fidelity and barriers and facilitators to using the intervention. Methods A mixed-methods study comprising two phases across 2 areas (Dorset and West Yorkshire). Phase 1: Intervention refinement. We will refine our established care home nutritional intervention so it is tailored to home care for pwD. Interviews will be undertaken with family carer dyads (n= 6) and HCWs (n=6). We will review the revised intervention with carers, nutritional clinical experts and senior HCWs. Phase 2: Intervention feasibility testing. We will train HCWs to deliver the intervention. We will recruit 32 dyads (comprising a pwD, at risk or currently experiencing malnutrition and their carer). Data collection: Recruitment and attrition rates, outcome measures (quality of life, nutritional status, carer burden (baseline and 4 months), and costs) and interviews with pwD-carer dyads (n=12), HCWs (n=12), managers (n=2) at 4 months and intervention fidelity. Data analysis – a process evaluation will be undertaken based on the logic model, intervention fidelity measures, quantitative outcome measures, and themes from the qualitative data. Timelines for delivery-18 months Anticipated impact and dissemination Dissemination will be via 3 academic/professional publications, social media, a website, newsletter and conferences and working with social care stakeholders. A group of family carers and HCWs will support the project (project design, delivery and analysis, engagement and dissemination plans). If findings suggest the intervention is feasible and acceptable, we plan to seek NIHR funding for further effectiveness and implementation work.
Aims
The aim of this project is to work together with home care staff, people with dementia and family carers to provide nutritional care for people living with dementia at home.