In plain English
Many people with dementia continue to live at home with support throughout their illness. For some, residential care becomes the right option. This page sets out the choices, funding and how to choose a good provider.
The options
Home with support
Most people prefer to remain at home as long as possible, with support from family carers, paid carers (homecare visits), telecare, and adaptations. Many live at home throughout their dementia.
Extra-care housing
Self-contained flats with communal facilities and on-site staff. A middle option between independent living and a care home. Suitable for early to moderate dementia. Tenure varies (rented, leasehold, shared ownership).
Sheltered housing
Independent flats with a warden or alarm system. Less suitable as dementia progresses but useful in mild dementia.
Residential care home
24-hour care for personal care needs (washing, dressing, eating, medication). Many specialise in dementia. Suitable when home support is no longer sufficient.
Nursing home
Residential care plus 24-hour qualified nursing care. Suitable when nursing needs (complex medication, pressure care, end-of-life care) require qualified nurses on site.
Specialist dementia care
Within residential and nursing home sectors, many providers specialise in dementia. CQC inspection reports indicate quality and specialism.
When is it time?
Common triggers for considering residential care:
- Night-time wandering creating safety risk;
- Severe agitation or aggression that home support cannot contain safely;
- Frequent falls;
- Incontinence requiring more support than family can provide;
- Carer burnout or illness;
- Lack of a co-resident carer;
- Person with dementia themselves expressing preference.
The decision is rarely sudden; planning ahead, before crisis, gives better outcomes than emergency placement.
How to choose
CQC ratings
Care Quality Commission inspects and rates all care homes in England (similar bodies in Scotland, Wales and Northern Ireland). Ratings:
- Outstanding;
- Good;
- Requires Improvement;
- Inadequate.
Read the inspection report, not just the rating. Look for specific dementia care comments, staffing levels, and any safeguarding concerns.
Visiting
Visit multiple homes, ideally including a meal time. Look for:
- Welcome and attitude of staff to your visit;
- How residents look (engaged, content, occupied);
- Cleanliness and tidiness, but not over-clinical;
- Activity programme - meaningful and varied;
- Outdoor space;
- Mealtimes - sociable, choice, relaxed pace;
- Staff: regular team, dementia training, ratio appropriate;
- Family involvement: open visiting, family events;
- End-of-life care arrangements.
Questions to ask
- What is the staff turnover?
- What is the staff to resident ratio at different times of day?
- How many staff have completed dementia care training?
- How are behavioural symptoms managed?
- What is the antipsychotic prescribing policy?
- What involvement do families have in care planning?
- What happens at end of life?
- What are the cancellation and complaints procedures?
- What does the fee cover and what is extra?
How care is funded
Self-funded
People with savings or assets above the local authority threshold pay their own care fees. England threshold is currently £23,250 (savings and assets). Most care homes accept self-funded residents directly.
Local authority funded
Where savings and assets are below the threshold, the local authority contributes based on a means-tested financial assessment. The home must accept the local authority rate, which may be lower than the self-funded rate (a "top-up" may be required from family for some homes).
NHS Continuing Healthcare (CHC)
Where care needs are primarily health-related (not social care), NHS Continuing Healthcare may fund the placement in full. Eligibility is assessed by a multidisciplinary team. Many dementia cases are not eligible, but those with complex behavioural needs or end-of-life care may qualify. Worth applying.
NHS Funded Nursing Care
A weekly contribution towards the nursing element of care in a nursing home, paid regardless of means.
Property
The value of a property is excluded from financial assessment if a spouse, partner or dependant continues to live there. Otherwise, the property may be sold or used through a Deferred Payment Agreement to fund care.
Disability benefits
Some benefits (Attendance Allowance, the daily living component of PIP) may continue in care, though others stop.
Cost
UK average self-funded weekly fees in 2025:
- Residential care: £900 to £1,400;
- Nursing home: £1,100 to £1,800;
- Specialist dementia care: £1,200 to £2,000;
- London and South-East: 20 to 50 per cent higher.
The move
Plan ahead. Practical steps:
- Take familiar items: photographs, ornaments, a favourite chair;
- Provide a Life Story Book for staff;
- Visit before and after the move;
- Allow weeks for settling;
- Maintain family routines as far as possible.
Where to get help
- Local authority adult social services for assessment;
- Care Quality Commission reports;
- Age UK and Alzheimer's Society Dementia Connect for general advice;
- Independent care advisers (paid service) for personalised support;
- Carer's Allowance and benefit checks at this transition.
Frequently asked questions
When is residential care the right choice?
There is no universal answer. Common triggers are night-time wandering, severe aggression, recurrent falls, incontinence, or carer burnout. Planning ahead before crisis gives better outcomes.
Can my parent be moved against their will?
Where capacity is impaired, a best-interests decision under the Mental Capacity Act may include residential care. Deprivation of Liberty Safeguards apply if the placement amounts to deprivation of liberty.
What does NHS Continuing Healthcare cover?
Full funding of placement and care where care needs are primarily health-related. Eligibility is assessed by a multidisciplinary team. Many dementia cases are not eligible but assessment is worth requesting.
How can I tell a good care home?
Read CQC reports. Visit multiple homes, including at mealtimes. Look at engaged residents, regular staff, meaningful activity, and family involvement. Ask about dementia training and antipsychotic prescribing.
What happens to my parent's property?
If a spouse or dependant remains in the property, its value is excluded from financial assessment. Otherwise the property may be used (sold, rented, or via a Deferred Payment Agreement) to fund care.
References
- Care Quality Commission. https://www.cqc.org.uk
- Care Act 2014.
- NICE NG43: Transition between inpatient hospital settings and community.
- Alzheimer's Society. Care home guide.