If you care for someone with dementia, there may come a point when you are unable to look after them at home anymore, or when moving into a care home is in their best interests. Here’s what you need to know about making this difficult decision.
There are two main types of care home:
Some homes offer both residential and nursing care. The needs of the person with dementia will influence the type of care home you choose.
Reasons for considering residential care might include:
When considering a move into a care home, try to involve the person with dementia, as far as possible, and other family members. Our dementia specialist Admiral Nurses can also offer advice: please see Sources of support for contact details.
Many people with dementia will eventually lose the mental capacity to make their own decisions about their care. For this reason, it is best to make plans for their future as early as possible so they can share their opinions and preferences in advance.
These plans should include:
An advance care plan (ACP): a document that sets out the person’s wishes for their future medical and personal care, including residential care.
Lasting power of attorney (LPA): a legal process where a person appoints someone trusted to make decisions on their behalf if they lack capacity. There are two types: health and welfare; and property and financial affairs.
If the person lacks capacity and does not have an ACP or LPA, you may need to make a decision about whether they should move into a care home on their behalf, in their best interests. You should involve other family members, especially those with caring responsibilities, as well as professionals involved in the person’s care.
There are certain assessments that can establish the care needs of the person with dementia and their eligibility for financial support.
Needs assessment: a Social Services assessment to identify the person’s support needs and make recommendations for their care, which may include moving into a care home. The assessor will not recommend a particular care home but can provide a list of options locally.
Financial assessment: a review of the person’s finances to establish whether they qualify for financial support with their care. If possible, this should take place before you start looking for care homes, as it might influence your decision – for example, some may be over your budget.
NHS continuing healthcare funding (CHC) assessment: an assessment of eligibility for care funding for adults with long-term, complex health needs, which may include dementia. Normal NHS healthcare – for example, from a GP, district nurse or in hospital – is free, but CHC covers other care costs, such as home carers or care home fees.
Applying for CHC can be stressful, so it is highly recommended that you have support from a dementia specialist. Our Helpline can advise you if there is an Admiral Nurse or other support service in your area that could help.
Choosing a care home can be challenging. Some might be too expensive, full, or unable to cater for the person’s individual needs. In some cases, there may not be a suitable care home in your area, and the person might be offered a placement that is some distance from you.
Finding a suitable care home for a person with young onset dementia (where symptoms develop before the age of 65) can be particularly difficult. Many are tailored to older people and cannot support the different needs of a younger person. You may like to read our information and advice on choosing a care home for a person with young onset dementia.
All care homes are inspected and rated by independent regulators:
You can find inspection reports online or ask the care home directly.
When you are looking at care homes, preparing a checklist of your requirements and wishes may be helpful. You can also ask friends, family, and other local people – such as members of carers’ support groups – if they have any recommendations.
When visiting care homes, look for a warm welcome and a homely atmosphere. Use your senses – how does it smell? Is it warm enough? If possible, talk to the other residents, relatives and staff about their experiences of the home.
Other questions to consider are:
Moving into a care home is a major transition. The person with dementia may feel the loss of their independence, home, attachment to their main carer and normal routines. But although the move can be distressing, it will often lead to improvements in health and quality of life, and more opportunities for socialising and meaningful activities.
To ease the process, find out if the person could have an overnight or short respite stay prior to moving in. Make sure they have comforting and familiar items around them, such as their own bedding, photos and ornaments. They may even be able to take in their favourite chair or other small pieces of furniture.
You can play an important part in helping the person settle into the care home and have a positive experience of living there.
When someone you care for moves into a care home, it is natural to feel mixed emotions, including feelings of guilt, grief, loneliness, relief and a sense of freedom. You may also worry that family, friends and professionals will judge you for not being able to continue in your caring role.
However, moving the person into residential care is often a positive step, allowing them to receive expert, specialist care and relieving you of some of the physical and mental strain. And when you are no longer absorbed in the daily duties of caring, you can focus on enjoying the time you spend together.
To speak to a dementia specialist Admiral Nurse about transition to a care home or any other aspect of dementia, please call our free Helpline on 0800 888 6678 (Monday-Friday 9am-9pm, Saturday and Sunday 9am-5pm, every day except 25th December) or email helpline@dementiauk.org.
Alternatively you can book a phone or video appointment in our virtual clinic.
Choosing a care home for a person with young onset dementia
Guide to NHS continuing healthcare funding
Looking after yourself as a carer
Mental capacity and decision-making
carehome.co.uk – care home reviews
Financial assessments for social care
Make, register or amend a lasting power of attorney
My Home Life – supporting quality of life in care homes
Our virtual clinics give you the chance to discuss any questions or concerns with a dementia specialist Admiral Nurse by phone or video call, at a time that suits you.
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