Prevention and early support can help people stay independent for longer. When more help is needed, a clear plan makes the choice between care at home and a care home easier, and much less stressful.
The best care plan starts years before care is needed
Many of the factors linked to dementia can be changed, including blood pressure, blood sugar, hearing, activity, smoking and social isolation.1 The World Health Organization’s 2026 guideline recommends tackling several of these together.2
Even after a diagnosis, early support can help people cope better, keep doing what matters to them and give families more time to plan.3 Every extra month of independence matters, both for quality of life and, as the costs below show, for the family’s finances.
Care works best when it is based on a clear assessment of the person’s strengths and difficulties, not a one-size-fits-all approach.3
01
Cognitive assessment
Understanding current memory and thinking, with objective data.
02
Cognitive stimulation
Structured activities and training to keep the mind engaged.
03
Daily routines
Practical strategies that support independence day to day.
04
Family guidance
Helping families understand changes and respond with confidence.
05
Ongoing monitoring
Tracking changes over time so support can be adjusted.
Your options
Staying at home, or moving to a care home
Most people want to stay at home for as long as it’s safe. The right choice depends on needs, safety, family support and money, and it often changes over time.
Option 1
Staying at home with support
Care can be built up step by step as needs change:
Visiting carers for personal care, medicines, meals or company, from a few hours a week to several visits a day
Live-in care, with a carer living in the home
Day centres and respite to give family carers a regular break
Home adaptations and technology, such as grab rails, sensors, reminders and alarms
Self-directed Support from your council, so you can choose how your care is arranged13
Benefits
Familiar surroundings, which can reduce confusion and distress
Stay close to partner, pets, neighbours and routines
One-to-one attention, and more control over care
Things to weigh up
Night-time needs and wandering can be hard to cover
Heavy reliance on family carers, who risk burnout
Can cost more than a care home once needs are round the clock
Option 2
Moving to a care home
There are different types of home:
Residential care homes provide accommodation, meals and personal care, with staff on hand 24 hours a day
Nursing homes also have qualified nurses for complex health needs
Specialist dementia homes or units have staff trained in dementia care and secure, dementia-friendly design
Benefits
Round-the-clock supervision and safety
Company, activities and regular meals
Family can return to being partner or child, not full-time carer
Things to weigh up
A move can be unsettling, especially in later stages
Less one-to-one attention
Quality varies, so visit and check inspection reports
Signs it may be time to review the plan
Safety worries: falls, wandering, leaving the cooker on
Needs at night that family can’t cover
The main carer’s own health is suffering
Care at home now costs as much as a care home
Costs
What care costs, and what help is available
Typical prices for those paying privately. Actual costs vary widely by provider, location and level of need, so always get written quotes.
Needs most of the day, and a spare room for the carer
Day centre or respite
Varies by provider and council
Often part of a council support package
Giving family carers a regular break
Residential care home
Scotland average £1,539 a week; dementia care £1,6039
Edinburgh often £1,800 to £1,900 a week{c(10)} ≈ £94,000 to £99,000 a year
24-hour supervision without nursing needs
Nursing care home
Scotland average £1,646 a week; dementia nursing £1,6599
≈ £86,000 a year at the Scottish average
Complex health needs requiring a qualified nurse
Estimate the cost of care at home
Home care per week£693
Home care per year£36,036
Care home per year£96,200
An illustration only, before any free personal care or benefits. The default rate is based on the UK median of £33.15 an hour11 and the care home fee on typical Edinburgh prices.10
In Scotland
Free personal care
If a council needs assessment shows you need it, personal care at home is free, whatever your age, income or savings.4,5 This covers help such as washing, dressing, eating and taking medicines. You may still pay for housework, shopping or social activities.
In a care home, the council pays £260.30 a week towards personal care, and £117.10 a week for nursing care if needed.4 You pay the rest of the fee, for accommodation and living costs.
Care home fees
The means test
Over £36,750 in capital: you pay your own fees, apart from the free personal and nursing care6
Between £22,750 and £36,750: the council helps, and you contribute £1 a week for every £250 above the lower limit6
Under £22,750: the council pays towards fees at its standard rate, £930.45 a week residential or £1,074.13 nursing; you contribute from income such as your pension6,7
Your home is not counted for the first 12 weeks, or at all while a partner or certain relatives still live there8
Benefits
Money you may be entitled to
Pension Age Disability Payment: £76.70 or £114.60 a week, not means-tested14,15
Carer Support Payment: £86.45 a week for eligible carers16
Council Tax discount or exemption for someone with significant cognitive difficulties17
Fees in England vary widely by region. These are average weekly fees for people paying privately, from Q2 (April to June) 2026.20
Area
Residential care
Nursing care
Dementia nursing care
Residential, per year
National average
£1,428
£1,638
£1,669
≈ £74,000
London
£1,681
£1,878
£1,927
≈ £87,000
South East
£1,566
–
–
≈ £81,000
East Midlands
£1,243
–
–
≈ £65,000
North East
£1,206
–
–
≈ £63,000
For comparison: Scotland
£1,575
–
–
≈ £82,000
Source: Lottie Care Home Index, Q2 2026.20 The national figure is Lottie’s platform-wide average. “–” means no regional figure was published.
Key difference
No free personal care
Unlike Scotland, England has no free personal care, at home or in a care home. Care is means-tested, so many people pay the full cost themselves.19
If you need nursing care in a nursing home, the National Health Service (NHS) pays £267.68 a week directly to the home towards it (NHS-funded nursing care), whoever pays the rest.21
Between £14,250 and £23,250: the council helps, and you contribute from your capital and income19
Council-funded residents keep at least £31.80 a week for personal expenses19
Your home isn’t counted if a partner, relative over 60 or dependent child lives there23
A deferred payment agreement lets you use your home’s value to pay fees later, without selling it straight away23
Other help
NHS funding and benefits
NHS continuing healthcare fully funds care, at home or in a care home, for people whose needs are mainly health needs. It is based on an assessment, not a diagnosis22
Will we have to sell the house to pay for a care home?
Not necessarily. In Scotland the home isn’t counted for the first 12 weeks, or at all while a partner or certain relatives live there.8 In England it isn’t counted if a partner or certain relatives live there, and a deferred payment agreement can delay any sale.23 Ask your council about the options before making decisions.
Is care at home always cheaper than a care home?
Not always. A few hours a day is usually cheaper, but live-in or round-the-clock care can cost as much as, or more than, a care home.10,12
Is personal care really free in Scotland?
Yes, if a council assessment shows you need it. It is free regardless of age, income or savings, although other costs such as housework or care home accommodation are not covered.4,5
When should we start planning?
As early as possible, ideally before a diagnosis. That gives time for prevention, Power of Attorney and decisions everyone has had a say in.
Can CogMission help us decide?
We can’t arrange care or give financial advice, but we can help you understand the condition, what to expect and how best to support your loved one at home.
World Health Organization. Risk reduction of cognitive decline and dementia: WHO guidelines, second edition. 15 July 2026. who.int/publications/i/item/9789240123557
Figures checked 2 October 2026. Rates usually change each April.
Clinically reviewed by Charmaine Shepherd, Functional Medicine Practitioner, and Jean Dow, Medical Herbalist. Last reviewed: October 2026. This page is for information and does not replace advice from your GP.
The earlier you plan, the more choice you have
Book a free 20-minute call to talk about prevention, early changes or supporting a loved one.
