Quick answer: In most cases, yes — dementia is generally treated as a social care need rather than a medical one in England, so families typically pay for care home fees. But there are important exceptions. If dementia care needs become severe and complex enough to qualify as a “primary health need,” the NHS may fund care 100% through NHS Continuing Healthcare (CHC) — regardless of savings. Means-tested council support also applies when savings fall below £23,250 in England (2026 threshold).
Understanding dementia care costs is essential for families across England. One of the most common and urgent questions people ask is: Do dementia sufferers have to pay care home fees?
In most cases, the answer is yes — but it depends on financial circumstances, the type of care required, and whether the person qualifies for NHS or local authority funding.
This guide explains how dementia care fees work in England, including financial assessments, capital thresholds, NHS Continuing Healthcare, and the options available if someone cannot afford care.
An Overview of Dementia Care Costs
Dementia care costs vary depending on the level of support required and where care is provided. As dementia progresses, care needs often increase, which can significantly affect overall costs.
- In-Home Care
Many people with dementia begin with care at home. Professional carers assist with personal care, medication, meal preparation, and daily routines. Typical costs range from £20 to £30 per hour, depending on location and complexity of care. Live-in care arrangements may cost more but can be a cost-effective alternative to residential care in some situations. - Day Care Centres
Day centres provide structured activities, supervision, and social interaction for people living with dementia. These services generally cost between £40 and £100 per day. - Residential Care Homes
Residential care homes provide 24-hour personal care and supervision. In England, fees typically range from £600 to £1,600 per week, depending on the region and level of support required. - Nursing Homes
For individuals with advanced dementia and complex medical needs, nursing homes provide round-the-clock nursing care. Costs usually range from £800 to £2,000 per week, sometimes higher in certain areas.
Given these figures, it is understandable why families worry about whether dementia sufferers have to pay care home fees and how long savings may last.
Financial Assessments for Dementia Care in England
In England, local authorities carry out a means test (financial assessment) to determine whether a person must pay for their own care. Here’s how the process works:
| Assessment Area | Category | Description |
|---|---|---|
| Assessment Process | Income Evaluation | Local authorities assess an individual’s income to determine their ability to pay for dementia care. |
| Savings Evaluation | Savings and overall financial situation are also evaluated as part of the assessment process. | |
| Self-Funder vs. Local Authority Support | Self-Funder | Individuals with sufficient income or assets may pay for their own dementia care. |
| Local Authority Support | Those with limited means may qualify for financial assistance from local authorities. | |
| Thresholds | Financial Thresholds | Specific thresholds determine eligibility for funding. |
| Assistance Eligibility | Individuals with assets below a certain limit may receive assistance, relevant for ongoing dementia care. |
Understanding this assessment process is important for families as they plan the financial implications of dementia care and plan for their loved ones’ needs.
Who Pays for Dementia Care in England?
In England, who pays for dementia care can depend on each person’s situation.
Here’s a straightforward look at the four main sources of funding:
1. Self-Funding
If a person’s savings and assets exceed the upper capital threshold, they must pay for their own care. This applies to residential care, nursing care, and care at home.
2. Local Authority Funding
If savings fall below the upper threshold, the local authority may help pay for care following both:
- A care needs assessment
- A financial assessment
However, the council may only fund care up to its usual rate, meaning families sometimes choose to pay a “top-up fee” for a preferred home.
3. NHS Continuing Healthcare (CHC)
This is often misunderstood.
Dementia does not automatically qualify for free NHS care. However, if a person’s needs are primarily medical – meaning they have complex, intense, or unpredictable health needs — they may qualify for NHS Continuing Healthcare.
If approved, the NHS covers the full cost of care, regardless of savings or property ownership.
This is one of the few situations where dementia sufferers do not have to pay care home fees.
4. A Combination of Funding
Some families move from self-funding to local authority support once savings fall below the threshold. Others receive partial NHS-funded nursing care payments if living in a nursing home.
Understanding these categories helps families plan realistically and avoid unexpected financial pressure.
What to Do if You Cannot Afford Dementia Care Fees
If paying for care feels overwhelming, there are options available.
- Apply for Local Authority Funding. Request a financial assessment from your local authority. If you meet specific criteria, they may cover some or all of your dementia care costs.
- Look Into Attendance Allowance or Personal Independence Payment (PIP). These government benefits can provide additional financial support. Attendance Allowance is for those over 65, while PIP is available for individuals under 65 who need assistance due to a long-term health condition.
- Consider Deferred Payment Agreements. Some local authorities offer deferred payment agreements, allowing you to use your home as collateral to cover care costs, which can be repaid later when the property is sold.
- Seek Charitable Support. Many charities, like Age UK and the Alzheimer’s Society, offer financial advice and may provide grants or support for dementia care costs.
- Consult a Financial Adviser. A qualified financial adviser with experience in care planning can help you explore additional funding options, including equity release, annuities, and savings plans.
Reviewing these options can help families identify valuable financial resources to make dementia care more manageable. Exploring local authority support, government benefits, deferred payment agreements, charitable assistance, and professional financial advice not only eases the financial burden but also provides peace of mind.
With the right planning, families can focus on ensuring their loved ones receive quality dementia care without being overwhelmed by costs.
FAQs About Dementia Care
Most people with dementia must pay care home fees if their savings and assets exceed £23,250. If assets fall below this threshold, the local authority may help fund care following a financial assessment.
In England, if a person has more than £23,250 in savings and assets, they are usually required to self-fund their care. If assets fall between £14,250 and £23,250, partial support may be available.
Dementia alone does not automatically qualify for free care. However, individuals with complex or primarily medical needs may qualify for NHS Continuing Healthcare, which covers full care costs regardless of savings.
A home may be included in the financial assessment if the person moves permanently into residential care. However, it is usually excluded if a spouse or dependent relative still lives there.
If savings fall below £23,250, the local authority may begin contributing towards care costs after reassessment. The individual may still need to contribute from their income.
The local authority must carry out a care needs assessment. If a person meets eligibility criteria and falls below financial thresholds, the council is required to arrange suitable care.
Benefits such as Attendance Allowance or Personal Independence Payment (PIP) can provide additional financial support, although they do not directly cover full care home fees.
There is currently no universal cap on total care home fees in England. Individuals may continue paying for care until their assets fall below the funding threshold.
Final Thoughts
Individuals with dementia generally have to pay care home fees, although the extent of these fees varies based on personal financial situations and eligibility for support. The question Do Dementia Sufferers Have to Pay Care Home Fees is central to many families, and understanding dementia care costs, financial assessments, and available options can significantly alleviate the financial burden associated with care. By being proactive and informed, families can ensure that their loved ones receive the necessary care while managing the costs effectively.
Considering Dementia Care at Home Instead?
Home-based dementia care can be a more affordable and comforting alternative to a care home. Oath Healthcare provides specialist, CQC-registered dementia carers across Cambridge and Suffolk.
Call us today: 01223 755 887 (Cambridge) or 01223 755887 (Suffolk)
Related Services:
Speak to your local Oath Healthcare team
CQC-regulated home care from local branches across England. Same-day call-back, free no-obligation assessment, care can start within 48 hours.
Ely · Huntingdon · Newmarket · St Neots
01223 755887 Suffolk
Bury St Edmunds · Ipswich · Sudbury · Mildenhall
01223 755887 Redbridge & East London
Ilford · Wanstead · Woodford · Romford
020 3949 4333 South Essex
Basildon · Southend · Canvey Island · Brentwood
01268 206550 Nottingham
West Bridgford · Beeston · Mansfield · Hucknall
0115 865 6333
Frequently asked questions
Do dementia sufferers have to pay care home fees?
In most cases, yes - dementia is generally classified as a social care need rather than a primary health need, so families typically pay for residential care home fees. However, there are two routes to NHS funding: NHS Continuing Healthcare (CHC) for those with a primary health need, and NHS-funded Nursing Care contribution. Means-tested council support also kicks in below GBP 23,250 of savings in England.
Does the NHS pay for dementia care?
The NHS can fund 100% of dementia care through NHS Continuing Healthcare (CHC) if the person's care needs are primarily about healthcare rather than social care. This applies in care homes, nursing homes, and at home. Approximately 30% of dementia sufferers may qualify, but uptake is low because many families don't realise they can apply.
At what stage of dementia does the NHS fund care?
There is no automatic stage trigger - funding depends on the complexity, intensity, and unpredictability of care needs, not the diagnosis alone. Late-stage dementia with severe behavioural challenges, complex medication regimes, mobility loss, and frequent unpredictable health changes often meets the NHS Continuing Healthcare threshold.
How are dementia care home fees calculated in England?
Care home fees in England are not means-tested for everyone, but local authority support is. If the person has more than GBP 23,250 in savings (England 2026 threshold), they pay full fees as a self-funder. Below that, the council contributes on a sliding scale. Property may be counted as an asset for residential care but not for home care.
What benefits are available for dementia care?
Key benefits include: Attendance Allowance (GBP 72-108/week, not means-tested, for over-65s needing care), Personal Independence Payment for under-65s, Carer's Allowance for unpaid family carers, Council Tax reductions, and NHS Continuing Healthcare for those who qualify. The blue badge scheme and free prescriptions may also apply.
Can dementia care be provided at home instead of a care home?
Yes. Many families now choose home care over residential care for dementia patients - it maintains familiar surroundings (which is therapeutic for dementia), provides 1-to-1 attention, and is often cheaper than a residential placement. Live-in dementia care typically costs GBP 1,200/week, compared to GBP 1,200-2,000/week for a residential care home.