Are Dementia Patients Entitled to Free Care?

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In this guide, we’ll discuss whether there’s free care for dementia patients in the UK, and how you might be able to get support.

Contents:

Have you recently been diagnosed with dementia? Or maybe someone you support has just received a diagnosis. If so, you may be wondering what sort of costs are involved when it comes to arranging care – and is there any free care for dementia patients in the UK? 

Many families end up providing unpaid care for someone with dementia – often reducing their work hours so they can be there for their loved one.

However, as the condition progresses, you may need to look for more specialist care. That could be home care for a few hours each day, a live-in care assistant, or even dementia care homes for round-the-clock support. 

In this article, we’ll look at how needs are assessed, whether there’s free care for dementia patients in the UK, and what your funding and care options are. 

Dementia Caregivers Guide
Carer’s Allowance for Dementia Carers

Health Needs vs Social Needs

When someone’s care needs are assessed, they will either be categorised as health needs, or social needs.

There is a huge difference in the amount of support and funding available in those two categories. 

Let’s look at them in more detail.

Primary health needs

If you’re looking for free care for dementia patients in the UK, their care needs must be established as a primary health need. 

Health needs may include medical care, the treatment and management of an illness or injury, or the support needed to manage a long-term health condition or disability. 

If the person’s needs are considered to be health needs, the NHS are responsible for paying for their care, through NHS continuing healthcare funding (sometimes known as CHC). CHC is a care package available to adults in England, Wales and Northern Ireland with long-term, complex health needs.

CHC is not means-tested, so care will be covered regardless of your financial circumstances.

The person you support might be eligible for CHC if:

CHC can cover care in settings outside of the hospital, including your own home or a care facility. 

Social Needs

Social needs include any support someone might need with the usual activities of daily living. 

This might include:

Social needs are covered by the local authority, and they are means-tested. This means that the local authority will establish whether the individual can pay for their own care, or whether a contribution is required towards care costs.

Do all dementia patients qualify for CHC?

So, do all dementia patients qualify for CHC?

Unfortunately, people with dementia aren’t automatically eligible for NHS continuing healthcare funding. 

Some people living with dementia are eligible for CHC. However, many people are assessed as having social needs rather than health needs – and therefore they aren’t eligible for NHS funding. This means that there isn’t always free care for dementia patients in the UK.

Other Funding Options For Dementia Care

There may be other ways to fund dementia care, depending on the person’s circumstances. 

These include:

NHS-funded nursing care

Some people aren’t eligible for CHC but still need nursing care. In these cases, they might be eligible for NHS-funded nursing care. This is where the NHS pays part of the nursing home fees for a patient. 

To qualify for NHS-funded nursing care, the person must:

The NHS will not pay the full fees for the person’s nursing home, but will pay the home directly for the nursing costs. 

Joint packages of care

If the person has mostly social needs but also some health needs, the NHS may pay for part of their support package. This means they won’t receive all of their care for free, but the NHS will fund some of their support. This is known as a joint package of care. 

Direct payments 

Direct payments are when a personal care budget is paid to the person (or a nominated family member) directly to pay for their care needs. This gives them a greater flexibility when arranging care.

Direct payments come from the local authority, not the NHS. 

Lots of people choose to employ a care assistant with their direct payments. They can also be used for short stays in a care home. 

You can’t usually pay for care from a partner or relative who lives with you, and the local authority might put some conditions on your direct payments. 

If you are the carer or family member of someone with dementia and they no longer have the capacity to arrange their own care with direct payments, you can be appointed as the ‘suitable person/nominated contact’ to arrange this on their behalf.

Make sure you understand what insurance you’ll need for direct payment arranged care.

Arranged care

You can ask your local council to arrange care on your behalf (or for the person you care for who has dementia). This type of care will usually be from a care agency, so you won’t have to handle hiring a carer or any of the other admin that comes with it.

The only downside is that you may not receive consistent care from the same person, as the agency will assign carers to you based on their shift pattern.

Self-funding

If the person isn’t eligible for any funding from the NHS or local authority, they may be able to pay for their own care from their own income or savings. 

As with direct payments, this means there’s a greater flexibility. You and your family member can choose the option that works best for them.  

Assessing The Needs Of Someone With Dementia

If the person you look after needs extra care, you’ll need to arrange an assessment to see whether they’re eligible for CHC or any other support. 

What should I do to be assessed for NHS continuing healthcare?

If you think someone may be eligible for CHC, you should contact the GP to ask to be referred for a healthcare assessment. Alternatively, if the person lives in a care home, you can discuss this with the staff team.

It’s a two-stage process, starting with a checklist. If the checklist suggests that the person might be eligible for CHC, it will be followed by a full assessment.

The person will be assessed by a team of healthcare professionals. They’ll look at what help the person needs, how complex their needs are, and whether they’re predictable or changing. They’ll also ask what would happen if they don’t receive the right care at the right time. 

They will look at the following needs:

Each of these will be given a weighting, with priority and severe being the highest, and no needs being the lowest. People who have priority or severe needs will often be eligible for CHC.

The person with dementia and their family will be fully involved in the assessment process, and will be given the chance to give their views.

Once the assessment has taken place, a decision should be made within 28 days and the local Integrated Care Board (ICB) will contact you. However, if the person is terminally ill, the process can be fast-tracked and support put in place within 48 hours.

The person’s needs will usually be reviewed every three months. If their needs change or their health improves, they may no longer be eligible for CHC.

If the person doesn’t qualify for CHC, the NHS may decide that they’re eligible for NHS-funded nursing care instead. They shouldn’t need a separate assessment for this. 

If you want to appeal the decision, you can talk to the ICB.

How do I get a needs assessment from the local authority?

If the person doesn’t qualify for CHC, you can still arrange a needs assessment with your local authority. This will let you know if they are eligible for any council funding – this may be given in the form of direct payments or arranged care. 

Your first step is to arrange a needs assessment from your local council. You can apply online to do this. 

A needs assessment will be conducted by a social worker or occupational therapist, and might happen face to face or over the phone. You can be with the person you support during the assessment.

The results will recommend what support could help the person with dementia. This may include home care, equipment such as personal alarms, or moving to a care home.

After the needs assessment, you can request a financial assessment. Someone from the council will ask questions about the person’s income, savings, benefits and property. 

If the person with dementia has savings of less than £23,250, the local authority will usually help to pay for care costs – although, depending on the person’s income, they may need to pay towards the cost of their care as well. 

If you want to appeal a decision from the local authority, you can contact them directly. There should be a complaints procedure on their website. 

Your Care Options

Now you know about the funding options available to you or the person you support, and whether they’re eligible for free care for dementia patients in the UK, you can make some decisions about the type of care that’s most appropriate. The needs assessment will also usually make recommendations.

Care options available may include:

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