When Should Someone With Dementia Go Into a Care Home?

 If you’re reading this, you’re probably facing one of the hardest decisions imaginable. You’re not alone, and there’s no shame in considering all your options.

The Reality Check: You’re Already Doing So Much

Before we discuss care homes, let’s acknowledge something important: if you’re caring for someone with dementia, you’re already going above and beyond. The sleepless nights, the constant worry, the heartbreak of watching someone you love change – none of this is easy.

This isn’t about giving up. It’s about making sure everyone gets the best possible care.

The Hard Truth: When Home Care Isn’t Enough Anymore

You Know It’s Time When…

The signs aren’t always dramatic. Sometimes they build up gradually until you realise that what once felt manageable has become overwhelming. Many families find themselves in a constant state of worry, checking on their loved one multiple times a day or lying awake at night wondering if they’re safe. Here are the key indicators that suggest professional care might be needed:

Your loved one’s safety is at constant risk:

• They’re wandering outside in the middle of the night
• They’re forgetting to turn off the hob or leaving taps running
• They don’t recognise dangerous situations (like walking into traffic)
• They’re having frequent falls or accidents

You can’t meet their care needs anymore:

• They need help with everything: washing, dressing, eating, using the toilet
• They require supervision 24 hours a day, 7 days a week
• They have medical needs that need professional nursing care
• Their behaviour has become aggressive or unpredictable in ways you can’t manage

The impact on you and your family is becoming unsustainable:

• Your own physical or mental health is suffering
• You’re isolated from friends and other family members
• Your work or relationships are being severely affected
• You feel angry, resentful, or constantly exhausted
• Other family members (including children) are being affected

“But I Promised I’d Never Put Them in a Home”

This is one of the most painful thoughts families face. Here’s the truth: putting someone in professional care when they need it is keeping your promise to look after them.

You’re not abandoning them, you’re ensuring they get the specialist care they need whilst preserving your own wellbeing so you can continue to be a loving presence in their life.

What Does “The Right Time” Actually Look Like?

Early Stage Dementia

Most people can remain at home with some additional support:

• Home care visits for help with personal care
• Day centres for social interaction and stimulation
• Family support for shopping, appointments, and companionship
• Attend local, free events such at care homes like Newgate Lodge

Moderate Stage Dementia

This is when many families start seriously considering care homes:

• Daily tasks become increasingly difficult
• Safety concerns arise more frequently
• Behavioural changes become more challenging
• 24-hour supervision becomes necessary

Advanced Stage Dementia

Professional care often becomes essential:

• Total assistance required for all personal care
• Complex medical needs develop
• Communication becomes very limited
• End-of-life care considerations

Remember: These are guidelines, not rules. Every person’s journey with dementia is different.

The Guilt Factor: Let’s Talk About It

“I feel like I’m failing them.” You’re not failing anyone. Recognising when professional care is needed shows wisdom and love, not failure.

“What will people think?” People who matter will understand. Those who don’t understand haven’t walked in your shoes.

“They wouldn’t want this.” The wishes and values of your loved one can help guide what’s best for them now.

“I should be able to cope.” Dementia care often requires specialist training, equipment and 24-hour staffing. It’s not about being strong enough, it’s about recognising when professional help is needed.

Choosing the Right Type of Care Home

Residential Care Homes

These are designed for people who need help with daily living but don’t require constant medical supervision. The atmosphere is typically more relaxed and home-like, with care staff who focus on personal care and maintaining independence wherever possible. Most residents have their own rooms and participate in communal meals and activities.

Best for: People who need help with daily tasks but don’t have complex medical needs

• Assistance with washing, dressing and meals
• Medication management
• Social activities and companionship
• 24-hour care staff (not necessarily nurses)

Nursing Homes

These facilities provide a higher level of medical care and are equipped to handle complex health conditions alongside dementia. You’ll typically find qualified nurses on duty around the clock, along with access to healthcare professionals like physiotherapists and occupational therapists. The environment is more medically focused while still maintaining comfort and dignity.

Best for: People with complex medical needs or advanced dementia

• Qualified nurses available 24/7
• Medical care and monitoring
• Specialist equipment if needed
• End-of-life care

Specialist Dementia Care Units

These facilities are specifically designed for people whose dementia symptoms require specialist understanding and care approaches. The staff receive additional training in dementia care and understand how to communicate effectively with people at different stages of the condition. The environment is carefully planned to reduce confusion and provide appropriate stimulation.

Best for: People whose dementia symptoms require specialist understanding

• Staff trained specifically in dementia care
• Secure environments to prevent wandering
• Activities designed for different stages of dementia
• Better understanding of behavioural changes

Red Flags: Care Homes to Avoid

Trust your instincts when visiting care homes. If something feels wrong, it probably is. You’re not being overly critical, you’re being protective of someone you love. A good care home will welcome your questions and scrutiny because they’re proud of what they offer.

When visiting potential care homes, be wary if you notice:

• Strong unpleasant smells that linger
• Residents looking unkempt or distressed
• Staff who seem rushed, stressed, or dismissive
• Lack of activities or stimulation for residents
• Reluctance to show you around or answer questions
• Recent poor inspection reports
• High staff turnover rates

Green Flags: Signs of a Good Care Home

A quality care home should feel welcoming and homely from the moment you walk in. The staff should be  genuinely pleased to see residents and take pride in showing you around. You should get a sense that this is a place where your loved one would be treated with respect and kindness, not just treated as another person.

Look for these positive indicators:

• Clean, welcoming environment that feels like home
• Residents who are content and well-cared for
• Staff who engage warmly with residents and know them well
• Varied activities and programmes tailored to different abilities
• Good recent inspection reports
• Willingness to involve family in care planning
• Clear communication about costs and care plans

The Practical Steps: Making It Happen

1. Get a Professional Assessment

Contact your local council’s social services department for a care needs assessment. This is free and will help determine:

• What level of care your loved one needs
• Whether you might qualify for financial help
• What options are available in your area

2. Research Your Options

• Use the CQC (Care Quality Commission) website to check inspection reports
• Ask for recommendations from GP, social workers or local dementia charities
• Visit multiple homes to compare
• Read reviews on sites like carehome.co.uk and Google, but remember every situation is different
• Consider the different types of care homes available in your area

3. Plan Your Visits

When visiting care homes:

• Go at different times of day to get a full picture
• Bring your loved one if possible, but don’t force it if they’re distressed
• Ask to speak to the manager and some care staff
• Request to see the room your loved one would have
• Ask about their activities programme and meal times

4. Ask the Important Questions

Don’t be afraid to ask detailed questions. Any reputable care home will expect this and be happy to provide comprehensive answers. If they seem evasive or impatient with your questions, that’s a red flag in itself. Write your questions down beforehand so you don’t forget anything important in what can be an emotionally charged situation. You might find our guide on questions to ask when choosing a care home helpful for preparation.

• “How do you handle challenging behaviour?”
• “What happens if someone’s needs change or worsen?”
• “How do you involve families in care decisions?”
• “What’s your policy on visiting hours?”
• “Can you accommodate their personal preferences and routines?”
• “What training do your staff have in dementia care?”

Managing the Transition: Making It Easier for Everyone

Before the Move

The preparation phase is crucial for helping your loved one feel as comfortable as possible with the transition. Even if they don’t fully understand what’s happening, familiar objects and routines can provide comfort and security. Take time with this process as rushing can create additional stress for everyone involved.

• Involve your loved one in the decision as much as possible
• Visit the home together several times if they’re able
• Bring familiar items: photos, favourite chair, bedding
• Create a memory box with meaningful objects
• Inform the care home about their preferences, routines, and history

Moving Day

• Keep it calm and positive
• Don’t make the goodbye lengthy if they’re distressed
• Leave some familiar items in view immediately
• Ensure care staff know key information about them

The First Few Weeks

• Visit regularly but give them time to settle
• Be patient, adjustment takes time and there may be setbacks
• Build relationships with the care staff
• Bring in photos of family events to keep them connected
• Don’t take any anger or distress personally. It’s the dementia, not them

What If It’s Not Working Out?

Sometimes, despite your best efforts, a care home isn’t the right fit. Signs might include:

• Significant deterioration in their wellbeing
• Frequent unexplained injuries or incidents
• Consistent medication errors
• Staff who don’t seem to understand their needs
• Your concerns aren’t being addressed

You have the right to move them to another care home. Don’t feel stuck with your first choice if it’s not working. Our article on how to leave a care home provides guidance on this process if needed.

The Financial Reality: What It Actually Costs

Average costs (2024):

• Residential care: £600-£1,000+ per week
• Nursing home care: £800-£1,500+ per week
• Specialist dementia care: Often 20-30% more

Potential funding sources:

• Personal savings and assets
• Council funding (if assets are below £23,250 in England)
• NHS Continuing Healthcare (for complex health needs)
• Attendance Allowance (continues in care homes)

Important: Get financial advice early. There are legitimate ways to plan for care costs, but any asset disposal needs professional guidance to avoid complications later. You can learn more about who pays for elderly care and the funding options available.

Your New Role: From Carer to Advocate

Once your loved one is in a care home, your role changes but doesn’t end:

Stay Involved

• Regular visits (but don’t feel guilty if you need breaks)
• Attend care plan reviews
• Advocate for their needs and preferences
• Maintain their connections with friends and family

Look After Yourself

• You’re still important, don’t disappear into guilt
• Use this time to rebuild your own health and relationships
• Consider counselling if you’re struggling with the transition
• Connect with other families in similar situations

When Care at Home Might Still Work

Before considering a care home, you might explore:

• Increased home care support: More frequent visits or live-in care
• Adult day services: Regular respite and social interaction
• Respite care: Short-term care home stays to give you a break
• Home adaptations: Making the environment safer
• Technology solutions: Monitoring systems, medication dispensers

These options work best when:

• Your loved one is in early to moderate stages of dementia
• Their behaviour isn’t putting them or others at risk
• You have good family support networks
• You can afford the additional costs (learn more about how much home care costs)
• Your own health and wellbeing aren’t seriously compromised

The Bottom Line: There’s No Perfect Answer

Every family’s situation is different. What works for your neighbour might not work for you. What worked for your family last year might not work now.

The “right” decision is the one that:

• Keeps your loved one safe and well-cared for
• Preserves their dignity and quality of life
• Doesn’t destroy your own physical and mental health
• Allows you to remain a loving presence in their life

Finding Support Through This Journey

Professional support:

• Dementia UK Admiral Nurses (specialist dementia nurses)
• Alzheimer’s Society local groups and helpline
• Age UK advice services
• Local carers’ centres

Peer support:

• Online forums for dementia carers
• Local carers’ support groups
• Faith communities (if relevant to you)
• Friends and family who understand

Emotional support:

• Counselling services (many specifically for carers)
• GP for mental health support
• Employee assistance programmes (if available through work)

A Personal Message

If you’ve read this far, you’re clearly someone who cares deeply about making the right decision. That alone tells us that whatever choice you make will be made with love.

There is no shame in needing help. There is no failure in choosing professional care. There is no weakness in admitting you can’t do everything.

What there is, is courage. The courage to make difficult decisions, to put your loved one’s needs first, and to preserve your own wellbeing so you can continue to be there for them in whatever way works best.

At Lidder Care, we understand that choosing a care home is never easy. We’re here to support both you and your loved one through this transition, providing not just professional care, but genuine compassion and understanding.

Your journey with dementia doesn’t end when someone moves into care, it just takes on a different shape. And that’s perfectly okay.

Need to talk to someone? Our team is here to listen and help, without pressure or judgment. Contact us to discuss your situation and explore how we might support your family.