Is dementia care free in the UK? A comprehensive guide to funding

According to the Alzheimer's Society, people with dementia and their families currently cover around two-thirds of the total cost of their care. This guide addresses the critical question, is dementia care free in the UK?, by outlining the various funding pathways and eligibility criteria.

Quick Summary

Dementia care is not automatically free in the UK; funding eligibility depends on complex health needs and financial assessments. The NHS fully funds care for those with a primary health need, while local authorities provide means-tested support for social care needs.

Key Points

• Dementia Care is Not Free: In the UK, long-term dementia care is classified as social care and is not automatically covered by the NHS, unlike medical treatment.

• NHS Continuing Healthcare (CHC): Full funding is available via CHC for those with a 'primary health need' (complex, intense, or unpredictable health needs), regardless of wealth, but a dementia diagnosis alone is not enough.

• Local Authority Funding is Means-Tested: Financial support from local councils for social care is based on an assessment of income and capital. Above a certain threshold, people must self-fund.

• Needs Assessment is the First Step: All funding routes begin with a free needs assessment from the local council to determine the level of care required.

• Benefits Can Help: Non-means-tested benefits like Attendance Allowance and PIP can provide additional income to help cover care costs.

• Varying Costs: The cost of care varies significantly across the UK depending on location, the type of care (residential, nursing, home), and the level of support needed.

The Short Answer: Is Dementia Care Free?

No, dementia care is generally not free in the UK. Unlike standard NHS medical treatment, the long-term support required for dementia is typically classed as 'social care'. This crucial distinction means that funding responsibility is often shared between the individual, the local authority, and sometimes the NHS, depending on the person's specific circumstances. A diagnosis of dementia alone does not guarantee free care.

Understanding the Different Funding Pathways

Navigating the funding landscape can be complex, but there are three main routes for paying for dementia care.

NHS Continuing Healthcare (CHC)

NHS Continuing Healthcare (CHC) is a comprehensive package of care that is fully funded by the NHS for individuals who have a 'primary health need'. This means the majority of a person's care needs are a result of complex, intense, or unpredictable health issues, rather than social care needs.

To be considered for CHC funding, an assessment must be undertaken, which does not consider the person's income or savings. Eligibility is based solely on health needs. If successful, CHC covers all care costs, whether at home or in a care home, including accommodation fees.

Local Authority Means-Tested Funding

For those not eligible for CHC, their local authority may provide funding for social care needs. This is a means-tested process, meaning a financial assessment of the person's income and capital (savings and assets) is carried out.

• Thresholds in England: As of the latest updates, there are capital thresholds that determine eligibility for financial support. If a person's capital is above the upper limit (currently £23,250 in England), they are generally expected to pay for their care in full (self-funding). If capital falls between the lower (£14,250) and upper limits, the council will contribute, but the person must also contribute.
• Property and the Means Test: The value of a person's home may be included in the financial assessment if they are moving permanently into a care home. However, it is disregarded in certain circumstances, such as if a partner or dependent relative still lives there. The property value is not included in the means test for care received in the person's own home.

Self-Funding

If a person's capital is above the local authority threshold, or if they prefer to arrange their care privately, they will be responsible for paying the full cost themselves. This is known as 'self-funding'. In some cases, the local authority may still be able to arrange care for a fee. Self-funders have more choice and control over their care providers but must bear all associated costs, which can be significant.

Key Factors Affecting Your Funding

The path to securing funding for dementia care involves several critical steps.

Needs Assessment

This is the first and most vital step, provided free of charge by the local authority. A social worker assesses the person's care and support needs, determining what help is required in their daily life. The outcome of this assessment dictates whether care is needed and, subsequently, whether a financial assessment is necessary.

Financial Assessment (Means Test)

Following a needs assessment, if it's determined that care is required, the local authority will conduct a financial assessment to calculate how much the person can afford to contribute. This looks at all income and capital, as described above. Local authorities can investigate 'deprivation of assets' if they believe a person intentionally gave away assets to avoid paying for care.

Financial Assistance and Benefits

Even if full funding isn't available, several non-means-tested benefits can help with the costs of dementia care.

• Attendance Allowance: For those over State Pension age who need help with personal care or supervision.
• Personal Independence Payment (PIP): For those under State Pension age who need help with daily living or mobility.
• NHS-Funded Nursing Care: If a person requires care from a registered nurse in a care home but doesn't qualify for CHC, the NHS will pay a flat rate contribution towards the nursing costs.

A Comparison of Funding Routes

Here is a quick overview of the main funding options for dementia care.

Feature	NHS Continuing Healthcare (CHC)	Local Authority Funding	Self-Funding
Eligibility	'Primary health need' (complex, intense, unpredictable care needs), not dementia diagnosis alone.	Means-tested based on income and capital; below local authority threshold.	Assets exceed local authority threshold; individual chooses to pay.
Means-Tested	No.	Yes.	N/A (pays full cost).
Coverage	100% of assessed care needs, including accommodation fees in a care home.	Contribution towards social care costs, based on assessment.	100% of care costs.
Inclusion of Property	N/A.	Yes, for residential care (with exceptions).	N/A (pays full cost).
Key Assessment	Multi-Disciplinary Team (MDT) based on health needs.	Needs Assessment & Financial Assessment based on social needs.	N/A (person or family arranges privately).

Conclusion: Navigating the Complexities and Finding Support

While dementia care in the UK is not free, substantial financial support is available, though eligibility is often complex. The first step is always to request a free needs assessment from the local council, which sets the wheels in motion for exploring funding options. It is essential to understand the difference between NHS-funded healthcare and means-tested social care.

For families, seeking professional advice and support from organisations like the Alzheimer's Society is highly recommended to navigate the assessment processes effectively and ensure they receive all the financial assistance they are entitled to. Early planning can help alleviate stress and secure the best possible care.

For more detailed information and support, the Alzheimer's Society offers extensive resources on paying for care.

Frequently Asked Questions

Does a dementia diagnosis mean you get free care from the NHS?

No, a dementia diagnosis does not automatically qualify you for free care. The NHS only fully funds care through Continuing Healthcare (CHC) if you are assessed as having a 'primary health need', which is based on the severity and complexity of your needs, not the diagnosis itself.

What is the capital limit for getting help with care costs from the local authority?

In England, the upper capital limit for means-tested local authority funding is currently £23,250. If your capital is above this amount, you are expected to self-fund your care. There are different thresholds and rules in Scotland, Wales, and Northern Ireland.

Will I have to sell my house to pay for dementia care?

The value of your home may be included in the financial assessment if you are moving into residential care permanently. However, it is disregarded in certain cases, such as if a partner still lives there. If you receive care at home, the value of your property is not counted.

What is NHS-Funded Nursing Care?

NHS-Funded Nursing Care (FNC) is a non-means-tested, flat-rate contribution from the NHS paid towards the cost of nursing care for those living in a nursing home who do not qualify for full NHS Continuing Healthcare. It is paid directly to the care home.

What happens if I give away my money or assets to avoid paying care fees?

Local authorities have rules to prevent 'deprivation of assets'. If they believe you intentionally gave away money or assets to avoid care fees, they can act as if you still own that capital during their financial assessment.

What benefits can help with dementia care costs?

Attendance Allowance (for those over State Pension age) and Personal Independence Payment (PIP) for those younger) can help with care costs. They are based on needs, not means, and are not taxable.

How do I start the process of getting funding for care?

You should start by requesting a free needs assessment from your local council's social services department. This will determine the level of care you or your loved one needs, leading to further assessments for funding eligibility.