Choosing a Care Home for Someone with Dementia

Choosing a care home for someone with dementia is one of the most emotional and practical decisions a family can face. It often comes after months or years of caring, worrying, adapting the home, arranging visits, managing medication, and trying to keep a loved one safe.

For many families, the decision is not simple. You may feel guilty, relieved, anxious, overwhelmed, or unsure whether now is the right time. You may be comparing care homes while also dealing with hospital discharge, falls, wandering, night-time confusion, carer burnout, or rising care needs at home.

The right care home should do more than keep someone safe. It should understand dementia, support the person’s dignity, preserve as much independence as possible, involve family, and feel like a place where the person can be known as an individual.

This guide explains when a care home may be needed, what makes a good dementia care home, what to ask when visiting, how to compare homes, and how to plan the move with care.

When might someone with dementia need a care home?

Many people with dementia live well at home for a long time, especially with family support, home care visits, routines, memory aids, adaptations and community services. A care home may become necessary when needs become too difficult or unsafe to manage at home.

There is rarely one single sign. More often, families notice a pattern of increasing risk, exhaustion or unmet needs.

A care home may need to be considered if the person:

• is no longer safe at home, even with support
• is wandering, leaving the house at night, or getting lost
• has repeated falls or injuries
• forgets to eat, drink or take medication
• needs help during the night as well as the day
• has distress, agitation or behaviour that is difficult to manage safely
• is becoming isolated, frightened or neglected at home
• needs more personal care than family or home carers can provide
• has complex health needs alongside dementia
• has a family carer who is becoming exhausted, unwell or unable to continue

Choosing a care home does not mean you have failed. Dementia changes over time, and care needs can grow beyond what one person or one family can safely provide.

If you are still weighing up support at home, our guide to home care: types of support, funding and how to choose may help you compare options.

Residential care, nursing care and dementia care: what is the difference?

Before choosing a home, it helps to understand the type of care needed.

A residential care home provides accommodation, meals, personal care and support with daily living. This may be suitable for someone with dementia who needs help with washing, dressing, meals, medication prompts, supervision and daily routines, but does not need regular nursing care.

A nursing home provides care from registered nurses as well as care staff. This may be needed if the person has more complex health needs, such as wound care, feeding difficulties, complex medication, severe mobility problems, advanced frailty or other medical needs.

A dementia care home or dementia unit should have staff trained in dementia care, a suitable environment, and routines designed for people with memory, communication, behavioural or orientation difficulties.

Some homes provide residential dementia care, some provide nursing dementia care, and some provide both. Ask clearly what type of dementia care the home is registered and staffed to provide.

For a broader overview of care home types, costs and inspections, see our guide to care homes in the UK: types, costs and ratings.

Start with the person, not the vacancy

When families are under pressure, it is easy to start with the question, “Which home has a bed?” Sometimes that is unavoidable, especially after a hospital admission or crisis. But the best starting point is the person’s needs, personality and routines.

Think about what matters to them:

• Do they prefer quiet spaces or company?
• Do they enjoy music, gardening, faith activities, pets, cooking, television, reading or walking?
• Do they become distressed by noise, crowds or unfamiliar people?
• Do they need help with eating, drinking or swallowing?
• Do they walk around a lot or try to leave?
• Do they need support with continence?
• Do they become anxious during personal care?
• Do they communicate pain, hunger or fear clearly?
• Do they have cultural, language, religious or dietary needs?

A care home that looks attractive may not be the right fit if it cannot support the person’s behaviour, communication, mobility or emotional needs. A less polished home may sometimes provide warmer, more personalised care. Look beyond décor and marketing.

Check the CQC report, but do not stop there

In England, care homes are regulated by the Care Quality Commission, or CQC. The NHS advises checking the most recent CQC report when choosing a care home, because inspection reports can show how well a home is doing and highlight areas of concern. You can read the NHS guide to dementia and care homes.

CQC ratings are useful, but they are not the whole picture. Reports can become out of date, homes can improve or decline, and a rating may not tell you whether a home is right for your relative’s specific dementia needs.

When reading a CQC report, look at:

• the overall rating
• the ratings for safe, effective, caring, responsive and well-led
• whether staffing levels or medicine management were concerns
• whether dementia care was mentioned
• how the home responds to complaints or incidents
• whether previous problems have been addressed

CQC also explains what people should expect from a good care home, including safety, enough skilled staff, respectful care, involvement in decisions and responsive support. You can read CQC’s guide to what to expect from a good care home.

Visit more than once if possible

A planned visit can show you what a home wants you to see. A second visit, at a different time of day, may tell you more. If possible, visit during mealtimes, late afternoon, or a busier part of the day. Dementia symptoms often fluctuate, and a home’s atmosphere can change depending on staffing, routines and activities.

When you visit, use your senses. Dementia UK recommends looking for a warm welcome and a homely atmosphere, and using your senses — including whether the home smells pleasant and feels warm enough. Their guide to considering a care home for a person with dementia is a helpful resource for families.

Notice:

• Are residents spoken to kindly?
• Do staff seem rushed or calm?
• Are residents sitting alone without engagement for long periods?
• Are people supported to move, eat and communicate?
• Does the home feel clean without feeling clinical?
• Are there quiet spaces as well as social areas?
• Do staff know residents by name?
• Does the manager welcome questions?

A care home does not need to be perfect. But it should feel safe, respectful and honest.

Look closely at dementia training and staffing

Dementia care is skilled work. It is not just about being kind, although kindness matters deeply. Staff need to understand memory loss, communication changes, distress, behaviour, personal care, nutrition, falls risk, medication, safeguarding, capacity and end-of-life care.

Ask the manager:

• What dementia training do staff receive?
• How often is training refreshed?
• Do night staff receive the same dementia training?
• How do staff support people who become distressed, agitated or aggressive?
• How do staff learn about each resident’s life history and preferences?
• How many staff are on duty during the day and night?
• How do staffing levels change if residents’ needs increase?
• What is staff turnover like?

High staff turnover can make dementia care harder because familiarity matters. People with dementia often feel safer when supported by staff who know their routines, fears, preferences and communication style.

Person-centred care: what it should look like

Good dementia care should be person-centred. This means the person is not treated as “a dementia resident”, but as someone with a life story, personality, relationships, habits and preferences.

In practice, person-centred dementia care may include:

• knowing how the person likes to be addressed
• understanding their previous work, family roles and routines
• respecting food, faith, culture, language and identity
• offering choices rather than doing everything for them
• adapting communication to the person’s ability
• supporting hobbies and familiar activities
• recognising pain, fear or distress behind behaviour
• involving family in care planning

Ask to see an example of a care plan, with personal details removed. Does it feel individual, or generic? A good care plan should explain the person’s needs, risks, preferences, routines and what helps when they are distressed.

The environment: is it dementia-friendly?

The physical environment can make a big difference for someone with dementia. A confusing layout, poor lighting, noisy corridors or identical doors can increase anxiety and disorientation.

Look for:

• clear signs and visual cues
• good lighting without harsh glare
• safe walking routes
• secure outdoor space
• quiet areas for rest
• homely rather than institutional décor
• contrasting colours to help people find toilets, doors and furniture
• personalised bedroom doors or memory boxes
• safe access to familiar activities, such as folding laundry, gardening or music

Secure does not have to mean restrictive. The best homes balance safety with freedom, movement and dignity.

Safety, falls and wandering

Safety is often one of the main reasons families consider a care home. For someone with dementia, risks may include falls, leaving the building, forgetting hazards, not recognising danger, choking, medication mistakes or becoming distressed during personal care.

Ask:

• How do you assess falls risk?
• How do you support someone who walks constantly or tries to leave?
• Are doors secured in a way that is safe but not frightening?
• How do you prevent pressure sores?
• How do you manage choking or swallowing risk?
• How do you keep residents safe at night?
• How are incidents recorded and shared with family?

If the person has frequent falls, mobility problems or complex nursing needs, ask whether the home can continue supporting them if these needs worsen. A home that is suitable now may not be suitable in six months if it cannot provide nursing care or higher staffing support.

Food, drink and mealtimes

Mealtimes are a useful window into a care home’s culture. Dementia can affect appetite, swallowing, food recognition, concentration, coordination and the ability to use cutlery. Some people need encouragement, adapted plates, finger foods, texture-modified diets or one-to-one support.

During a visit, ask whether you can observe a mealtime. Look for whether staff sit with residents, offer calm support, notice when someone is struggling, and treat people respectfully.

Ask:

• How do you support residents who forget to eat?
• Can residents eat at different times if they prefer?
• Do you provide finger foods?
• How do you monitor weight loss?
• How do you support hydration?
• Can you manage special diets, cultural diets or swallowing recommendations?
• How are families told if eating or drinking becomes a concern?

If dehydration or poor fluid intake has already been a concern, our guide to dehydration symptoms in adults and children may be useful.

Medication and healthcare support

People with dementia may have several medicines, and medication needs often change. Mistakes can happen if systems are weak, so ask how the home manages prescriptions, reviews, side effects and missed doses.

Ask:

• Who administers medication?
• How are medicines stored and recorded?
• How often are medicines reviewed?
• How do you monitor side effects such as drowsiness, falls or confusion?
• Which GP practice supports the home?
• How often do GPs, nurses, dentists, opticians or chiropodists visit?
• How are families updated after health changes?

If the person has complex health needs, ask whether the home can support them safely or whether nursing care is more appropriate.

Activities should be meaningful, not just busy

Activities in dementia care should not only be about filling time. They should support wellbeing, identity, movement, social connection and calm. For some people, a group quiz may be enjoyable. For others, it may be confusing or distressing.

Look for a variety of options:

• music and singing
• gentle exercise
• gardening
• baking or food preparation
• reminiscence activities
• crafts and sensory activities
• faith or cultural activities
• quiet one-to-one time
• safe access to outdoors

Ask how activities are adapted for people with advanced dementia, communication problems, visual impairment, hearing loss or limited mobility.

Visiting, family involvement and communication

Family involvement can make a major difference. Relatives often know what a person’s behaviour means, what calms them, what foods they enjoy, how they express pain, and what routines feel familiar.

Ask:

• What are the visiting arrangements?
• Can family visit at different times of day?
• How do you involve families in care reviews?
• Who should family contact with concerns?
• How quickly do you inform families after falls, infections or changes?
• Can family help personalise the room?
• How do you support video calls or phone contact?

A home that treats families as partners is often better placed to provide personalised dementia care.

Questions to ask when visiting a dementia care home

It can help to take a written list of questions. You may not ask them all, but having them with you can make visits less overwhelming.

• What type of dementia care do you provide?
• Can you support people as dementia progresses?
• Do you provide nursing care, or only residential care?
• What dementia training do staff receive?
• How many staff are on duty during the day and night?
• How do you support residents who are distressed, anxious or aggressive?
• How do you manage wandering or exit-seeking?
• How do you support eating, drinking and weight loss?
• How do you involve families in care planning?
• How often are care plans reviewed?
• How do you manage falls, infections and hospital transfers?
• What happens if care needs increase?
• What is included in the weekly fee?
• What costs extra?
• What notice period applies?
• How do you handle complaints?

Alzheimer’s Society offers a useful resource on choosing a care home for a person with dementia, including points families may want to consider before and during the move.

Understanding care home fees

Care home fees vary widely depending on location, care needs, room type, nursing requirements and whether the home is privately run, charitable or local authority linked. Dementia care and nursing dementia care may cost more than standard residential care because of staffing, training and complexity.

Ask for a written breakdown of fees and extras. Clarify:

• weekly fee
• what is included
• whether dementia care costs more
• whether nursing care costs more
• top-up fees
• personal expenses
• hairdressing, chiropody, outings or activities
• notice periods
• what happens if needs increase
• what happens if local authority funding begins later

For more detail, read our guides to care home fees and how social care funding works in the UK.

Local authority funding, top-up fees and assessments

If the person may need help paying for care, contact the local council for a care needs assessment and financial assessment. Local authority funding depends on eligible care needs and financial circumstances.

Be careful with top-up fees. A top-up is usually paid by a third party, often a family member, when someone chooses a care home that costs more than the local authority will pay. Top-ups can be expensive and long term, so get clear written advice before agreeing.

If the person has significant health needs, NHS Continuing Healthcare may also need to be considered. CHC is not means-tested and is based on whether someone has a primary health need. Our guide to NHS Continuing Healthcare: who qualifies and how to apply explains this in more detail.

Hospital discharge and urgent placements

Sometimes families are asked to choose a care home quickly because a relative is medically ready to leave hospital. This can feel rushed and stressful.

If this happens, ask:

• Is this placement temporary or permanent?
• Has a care needs assessment been completed?
• Has NHS Continuing Healthcare been considered?
• Who is paying during any interim period?
• Can the person move later if the home is not suitable?
• What support is available to compare homes?

Try not to be pressured into a permanent decision without understanding the funding, care needs and review process. A short-term placement may sometimes be used while longer-term needs become clearer.

Helping someone with dementia move into a care home

The move itself can be unsettling. Familiarity matters, and people with dementia may become more confused or distressed in a new environment. Planning can make the transition gentler.

Before the move, consider:

• visiting the home together if possible
• sharing a life story document with staff
• bringing familiar photos, bedding or ornaments
• labelling personal items
• keeping routines similar where possible
• telling staff what helps during distress
• explaining food preferences, sleep habits and personal care routines
• agreeing how family will be updated during the first few weeks

Some people settle quickly. Others take weeks or months. Increased confusion after a move does not always mean the home is wrong, but it should be monitored carefully. Good staff will help the person feel safe, learn their routines and involve family in settling-in plans.

What if the person does not want to move?

This is common and emotionally difficult. If the person has mental capacity to decide where they live, their decision must be respected, even if family disagree. If there are serious risks, professionals may need to discuss options and safeguards.

If the person lacks capacity to make the decision, a best interests process may be needed. This should consider the person’s wishes, feelings, beliefs, safety, wellbeing and the views of family and professionals.

Alzheimer’s Society advises gently raising the subject of moving to a care home and trying to understand the person’s concerns. Their page on who makes the decision to move a person with dementia into a care home explains this in more detail.

Warning signs a care home may not be suitable

No home is perfect, but some signs should make you pause. Be cautious if:

• staff seem dismissive or impatient with residents
• the manager avoids questions about staffing or fees
• residents appear distressed without support
• the home feels chaotic, unsafe or poorly supervised
• there are strong unpleasant smells without explanation
• care plans seem generic or out of date
• staff cannot explain how they support dementia-related distress
• families are discouraged from visiting or asking questions
• inspection reports show serious issues that have not been addressed
• the home says it can meet all needs without properly assessing the person

Trust your instincts, but also ask for evidence. If something feels wrong, ask directly how the home manages that issue.

After the move: what to review

The first few weeks are important. Arrange a review with the home after the person has settled, often within four to six weeks, or sooner if there are concerns.

Discuss:

• how the person is settling
• eating and drinking
• sleep
• falls or incidents
• mood, distress or behaviour
• personal care
• medication changes
• family contact
• activities and social engagement
• whether the care plan needs updating

If the person seems distressed, losing weight, falling, becoming withdrawn or not receiving agreed support, raise concerns early. Put important concerns in writing and ask for a clear plan.

Choosing between two good homes

Sometimes the decision is not between a good home and a poor one, but between two reasonable options. In that case, think about the person’s quality of life, not only practical convenience.

Ask yourself:

• Which home seemed to know its residents best?
• Where did staff speak most respectfully?
• Which environment would feel calmer for this person?
• Which home can manage likely future needs?
• Which home communicates best with families?
• Which location makes regular visiting realistic?
• Which home felt honest about challenges?

The best home is not always the closest, newest or most expensive. It is the one most likely to understand the person and meet their needs safely and kindly.

Final thoughts

Choosing a care home for someone with dementia is not just a practical task. It is a deeply personal decision about safety, dignity, identity and trust. Take time to understand the person’s needs, visit homes where possible, ask direct questions, read inspection reports, and involve the person as much as they are able.

Look for a home that understands dementia, communicates well, involves families, supports meaningful activity, manages risk calmly, and treats residents as individuals. A good dementia care home should help the person feel safe, known and respected.

For official and specialist advice, see the NHS guide to dementia and care homes, CQC guidance on what to expect from a good care home, Dementia UK’s guide to considering a care home for a person with dementia, and Alzheimer’s Society’s resource on choosing a care home for a person with dementia.

This article is for general information only and should not replace medical, legal, financial or social care advice. If you are making care decisions, speak to the person’s GP, local adult social care team, care providers, and appropriate advisers.

Frequently asked questions

When is it time for someone with dementia to move into a care home?

It may be time to consider a care home if the person is no longer safe at home, needs support day and night, has repeated falls, wanders, forgets food or medication, becomes very distressed, or if family carers can no longer cope safely. The decision should be based on needs, risks, wellbeing and available support.

What type of care home is best for dementia?

The best type depends on the person’s needs. Some people need residential dementia care, while others need nursing dementia care because of complex health needs. Look for dementia-trained staff, a safe and calm environment, personalised care plans, meaningful activities and good family communication.

How do I know if a care home is dementia-friendly?

A dementia-friendly care home should have trained staff, clear signage, good lighting, safe walking areas, calm routines, personalised rooms, meaningful activities and a strong understanding of behaviour, communication and distress in dementia. Staff should speak respectfully and know residents as individuals.

What questions should I ask a dementia care home?

Ask about dementia training, staffing levels, night-time support, falls, wandering, eating and drinking, medication, behaviour, family involvement, activities, fees, what happens if needs increase, and how complaints are handled. Ask to see an example care plan if possible.

Should I choose the care home with the best CQC rating?

CQC ratings are important, but they should not be your only guide. Read the full report, visit the home, observe staff and residents, ask dementia-specific questions, and consider whether the home can meet your relative’s current and future needs.

Can someone with dementia be forced into a care home?

If the person has mental capacity to decide where they live, their decision should be respected. If they lack capacity and there are serious risks, a best interests decision may be needed involving family and professionals. Legal safeguards may apply if the person is deprived of their liberty for their own safety.

How can I help someone settle into a care home?

Bring familiar items, photos, bedding and music. Share a life story document with staff, explain routines and preferences, visit regularly if possible, and agree how the home will update you. It can take time for someone with dementia to adjust to a new environment.

What if the care home is not meeting my relative’s needs?

Raise concerns with the nurse, senior carer or manager as soon as possible. Be specific and put important concerns in writing. Ask for a care plan review. If problems continue, follow the home’s complaints process and consider contacting the local authority, CQC or safeguarding team if there are safety concerns.