TOMATO project logo

Project TOMATO (nuTritiOn and deMentia AT hOme) aims to work together with home care staff, people with dementia and family carers to provide nutritional care for people living with dementia at home.

The collaborative project is about adapting an intervention to support people living with dementia at home with eating and drinking.

Responding to an increasing need 

The number of people living with dementia is increasing at an unprecedented rate. In the UK, dementia affects over 850,000 people. Most people with dementia live at home and are supported mainly by family or friends.

As dementia progresses, ensuring people eat and drink well presents numerous challenges for all involved. Poor nutrition is a significant factor causing ill health. Many with dementia are at risk of being undernourished due to reduced appetite, eating and swallowing problems. Being undernourished leads to poorer health and quality of life for people with dementia (and their carers), more GP appointments and increased hospital admissions.

The significance of undertaking this study was further reinforced after initial discussions with people living with dementia, family carers, health care professionals and home care workers. They emphasised that eating and drinking are crucial issues of concern for them.

Home care workers are well-positioned to play a critical role in intervening early in the nutritional care for people with dementia at home. A more proactive and wide-ranging approach to nutritional assessment and management is needed targeting interventions at home care workers and family carer groups, with input from appropriate health care professionals.

How will the study be conducted? 

Project TOMATO will help develop an intervention for people with dementia living at home, which is crucial to achieving improved nutritional care and health outcomes while reducing carer burdens.

An older couple preparing fruit and vegetables in a kitchen

The study will take place in Dorset and West Yorkshire in two phases over 18 months: 

  • Phase 1 involves adapting an existing nutrition intervention by getting feedback from people with dementia, family carers, home care staff and nutrition experts.
  • Phase 2 will include training home care workers to deliver the adapted intervention to people with dementia and family carers in receipt of care at home.

Working in partnership 

This project is led by Bournemouth University, working in partnership with other universities and health care provider organisations: 

Patient and Public Involvement (PPI) and Project Steering Group

We will regularly draw on expert advice from the TOMATO Project Steering Group which includes dietitians, doctors, speech and language therapists, home care providers and home care workers throughout the study.

A Public Patient Involvement (PPI) group consisting of family carers, people with dementia and home care workers will continue to provide input to help influence and shape the research and development of the intervention. We will hold meetings throughout key stages of the study.

During the 18 years of caring for my wife I lost count of the number of times I provided details of her ever-changing care needs. The people who required these updates were providing help, guidance, services and support – in other words I was sharing my experience to help improve care. I am now honoured to be helping in this project.”

John Major,  former carer and TOMATO PPI lead 

Sharing our findings

We will work with our Project Steering Group and PPI Group to identify specific outlets and the best ways to share our findings. These would include website and patient and carer websites, academic journals, blogs and social media posts and conference presentations.

Making a difference 

Project TOMATO will help develop an intervention for people with dementia living at home, which is crucial to achieving improved nutritional care and health outcomes while reducing carer burdens.

In addition, the project will help support the development of the home care workforce by extending existing skills. The project will support the acquisition of new knowledge, approaches and attitudes via training. Consequently, this approach will strengthen the commitment and recognition of the critical role of nutritional care for people with dementia.

As a feasibility study, findings from TOMATO could inform the design of a larger trial to measure the effectiveness of the adapted and tested intervention.

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