Are Dementia Patients Entitled to Free Care?

Surewise offers carers insurance:

  • Self-Employed Carers & PAs
  • Individual Employers
  • Carer & PA Businesses
  • Direct Payments Arranged Care

In this guide, we’ll cover if dementia patients are entitled to free care, and how you might be able to claim for this.

Contents:

If you or someone you care for have recently been diagnosed with dementia, you may be wondering what sort of costs are involved when it comes to arranging care. Many families end up providing unpaid care for someone with dementia – often reducing their work hours in order to do so.

However, at some point, you may be in need of more precise care. That may be in the form of a live-in care assistant, or you may be looking at care homes for dementia patients for round-the-clock support. 

Primary health needs vs social needs

When someone’s care needs are assessed (typically via a care assessment), their health needs will either be assessed as health needs, or social needs.

This may not sound very important, but there is a huge difference in the type of support and funding available in these two categories. Social needs are typically referred to as needs which can generally be provided within the community by a local authority.

These needs are means-tested, which means that the local authority will establish whether the individual in question has the financial means to pay for their own care, or whether a contribution is required towards care costs.

If someone’s care needs are established as a health need, however, then this means that the NHS are considered responsible for the payment of the individual’s care needs. Health needs are not means-tested, so care will be covered regardless of the individual’s financial situation.

Primary health needs

NHS Continuing Healthcare Funding

If you or someone you care for is currently living with dementia, you may be eligible for NHS continuing healthcare funding (CHC). CHC is a care package available to adults in England, Wales and Northern Ireland with long-term, complex health needs otherwise known as a primary health need.

People who qualify for CHC will receive social care for free, such as the costs for care or care home costs. NHS Continued Healthcare funding is not means-tested and is free of charge at the point of need, covering every care need you are deemed to have.

Do all dementia patients qualify for CHC?

Unfortunately, people with dementia are not automatically eligible for NHS continuing healthcare funding. Instead, the complexity and severity of your health needs will first be assessed. 

Unfortunately, many people living with dementia are assessed as having ‘social needs’ rather than ‘health needs’, and social care needs are not eligible for NHS funding.

What to do to be assessed for CHC?

If you think you or someone you care for may be eligible for NHS Continuing Healthcare Funding (CHC), you should contact your GP to ask to be referred for a healthcare assessment.

Alternatively, if you or someone you care for are in a care home and receiving treatment for dementia symptoms, you may be able to discuss this avenue with care home staff.

Social needs

If you are assessed as having social care needs as someone living with dementia, you may still be eligible to receive benefits to help you pay for the care you need.

Direct payments 

Direct payments are when a personal care budget is paid to you (or a nominated family member) directly to pay for your care needs. The main advantage of this benefit is that you have a greater flexibility over the care you receive.

Many people opt to employ a care assistant using their 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’ to arrange this on their behalf.

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

How to receive direct payments

If you haven’t had a care assessment yet, this is the first place to start. Contact your GP to discuss having an assessment of your care needs carried out to determine what benefits and personal care budget you may be eligible for.

Once you have been assessed as eligible for direct payments, you can apply via your local council. 

Arranged care

Alternatively, you may nominate for 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 agency-based, 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.