Dementia care
Dementia care at home, at every stage
Familiar surroundings and the same carer each day are the two things that help most with dementia, and both are easier at home. This page maps what changes at each stage to the care that fits it.
3,500+ vetted carers, experience with dementia shown on every profile
Not sure which stage they are at? See the stage map or call 0203 369 3624
The stage map
What changes, what a carer does, and which care fits
Clinicians describe seven stages. Most families find it easier to think in three: early, middle and late. Each one needs a different kind of help, and the help usually needs to change a few months before the family feels ready for it.
Early stage · Stages 1 to 3
Forgetful, and frightened of what it means
What is changing
- Repeating questions, losing words, misplacing things
- Trouble planning: bills, appointments, recipes they have made for years
- Withdrawing from friends and hobbies
- Low mood or irritability, often before anyone says the word dementia
When it is moving on
Getting lost on a familiar route, a kitchen near-miss, or a fall are the usual signs the next stage has started.
What a carer does at this stage
At this stage a carer is company and a safety net rather than personal care: a walk, a game of cards, help with the diary and the post, a second pair of eyes on medication. The aim is to keep life as it was for as long as it can be.
Companionship visits
£15–£20 an hour
Do this now
Do the paperwork while your relative can still sign it: Lasting Power of Attorney for finances and for health, and a conversation with them about what they would want later on.
Read
Middle stage · Stages 4 and 5
Needs help with the day, and the evenings get hard
What is changing
- Cannot manage washing, dressing or meals reliably alone
- Confuses time and place; may not recognise the house
- Sundowning: agitation, pacing and confusion as the light goes
- Wandering, especially at night; repetitive behaviour; suspicion of family
When it is moving on
Falls, weight loss, a hospital admission, or a family carer who is no longer sleeping mean the arrangement needs to grow.
What a carer does at this stage
Daily visits with the same carer, built around a fixed routine: up, wash, dress, breakfast and medication at the same time each day. A carer who knows the person can head off agitation before it starts, redirect rather than argue, and keep the day calm. Nights often need cover too.
Daily visits, then nights
£18–£25 an hour; nights from £130
Do this now
Simplify the house: a dementia clock, labels on cupboards, lights on sensors, the front door alarmed at night. Small changes like these can keep somebody safe at home for months longer.
Read
Late stage · Stages 6 and 7
Needs someone there all the time
What is changing
- Full help with personal care; incontinence is usual
- Little speech, but still responds to touch, music and familiar voices
- Difficulty walking, then sitting, then swallowing
- More infections, more hospital visits, and a care home is being suggested
When it is moving on
If comfort becomes the main aim, palliative care at home is the same carers with a different emphasis, and the GP and district nurses alongside.
What a carer does at this stage
Round-the-clock care, usually a live-in carer with dementia experience, sometimes two in rotation, with a waking-night carer if nights are disturbed. The work is skilled and physical: hoisting, repositioning, mouth care, spotting infections early, and keeping the person comfortable and known. Nurses come in for what carers cannot do.
Live-in dementia care
from £1,260 a week, typically £1,340
Do this now
Ask for an NHS Continuing Healthcare assessment. At this stage the need is health as much as social care, and the NHS can fund the whole package at home.
Read
What dementia care looks like
Eight things a good dementia carer does without being asked
The care is mostly ordinary tasks, done in a particular way, and that way of doing them is where the skill lies.
- 01
Same face, same time
A familiar carer arriving at the same hour each day helps somebody know where they are.
- 02
Prompt, do not take over
The clothes are laid out in order, and the toothbrush is put into their hand. If a carer does it all for them, the skill is lost sooner than it needs to be.
- 03
Redirect, never argue
If it is 1985 and they are waiting for the school bus, the carer asks about the children rather than correcting the year.
- 04
Meals that get eaten
Finger food, one thing on the plate at a time, and somebody sitting down to eat with them. Weight loss is easy to miss in the middle stage, and it matters a great deal.
- 05
Medication, watched
The carer prompts each dose, sees it swallowed and writes it down. A blister pack on its own usually stops being enough around stage four.
- 06
The evening plan
Curtains drawn before dusk, the lights on, the television off, and something to occupy the hands. Sundowning is much easier to prevent than it is to settle once it has begun.
- 07
Out, safely
A walk, a trip to the shops, or time in the garden. Staying indoors all the time tends to make everything harder. A dementia assistance card in the pocket helps if you get separated.
- 08
Notes for the family
A note of what was eaten, what was said and what changed. If you are not there every day, this is how you keep a picture of the week.
What to look for in the carer
Dementia experience, named
Ask how many people with dementia they have cared for and at what stage. On PrimeCarers it is on the profile.
Calm under repetition
The fortieth "when are we going home?" needs the same warmth as the first, and not everybody is able to manage that.
Physically able
In the middle and late stages a carer often needs to help somebody move. Ask about hoist training if that applies.
Available for the long run
Consistency does a great deal of the work here. A carer who can commit for a year is usually worth more than somebody who seems ideal but can only stay a few months.
Likes the person
Interview them together. Watch how they speak to your relative, not to you.
Every profile on PrimeCarers lists conditions the carer has experience with, and you interview them for free before booking. Questions to ask at interview.
Home or a care home?
With dementia, familiar is a treatment
There are good care homes, and there is a point where one may be right. But most families reach for it earlier than they need to, because nobody told them what care at home can do. Live-in dementia care from £1,260 a week is about the same as a specialist care home place, and it is one-to-one.
The house is the memory
Where the kettle is, which chair is theirs, and the route to the bathroom in the dark are all held in the house itself. A move takes that away in a single day, and confusion usually gets noticeably worse.
One carer, not a rota
Recognising a face is one of the last things to go. On a care home floor there may be twenty different faces in a week, where a carer at home is one.
The routine survives
Tea at four, the news at six, and the same walk each day. Routine is what holds a day together when memory no longer can.
Couples stay together
A partner who cannot lift or manage the nights can still be there. A live-in carer for a couple is one rate, not two care home fees.
Paying for it
A dementia diagnosis opens up help with money that most families never claim
There are four things worth applying for in the first month. The first of them is not means-tested, and the form takes an afternoon.
The full picture, including what dementia care costs at each stage: the cost of care for dementia and how to fund care at home.
How it works
From “something has to change” to a carer at the door
No assessment visits, no waiting list. Some families are talking to a carer the same day.
Search your postcode
See the carers who cover it, with photos, rates, experience and reviews. Filter by hourly, live-in or overnight.
Talk to the ones you like
Message them directly, or tell us what you need and we can suggest some carers to look at. The choice is always yours.
Meet before deciding
A call, a video chat or a visit, free and before anything is booked. A lot of families have a good idea within the first ten minutes.
Book, and change it as needs change
Contract, insurance and payment run through us. You can add visits, add nights, or move to live-in care as things change, and you only pay for care that happens.
Safety first
Someone coming into their home? We take that seriously.
Letting a carer into the home of someone you love takes trust. We've built every layer of protection so that trust is earned, not assumed.
Vetting before a carer appears
Enhanced DBS, ID and right-to-work checks and an online interview before a carer appears, with renewal or rechecks depending on the accepted route. We check that a carer is caring; their skills and training are for you to check with them.
Insured and above board
Every visit is insured, contracted and paid securely online after care happens. There is no cash and no informal arrangement to manage.
A real person who knows you
Your own account manager and a UK support team who know you, your carer and your situation, not a call centre script.
Help when plans change
If your carer is unwell or away, our team will always do their best to find you vetted cover at short notice.
What clients say
Our Latest Carer Reviews
Margaret N
"Excellent - Lovely lady. My mother is so pleased with the work she does in helping her."
Read the full review
Julia S
"Julia is a highly skilled and companionate carer who is able to give so much of herself and adapt to any situation."
Read the full review
Andres Felipe C
"My son who he is caring for automatically welcomed Andres and can be heard laughing & having fun with Andres."
Read the full reviewQuestions families ask
Dementia care, answered
Clinicians use seven: no impairment, very mild, mild, moderate, moderately severe, severe and very severe decline. Families find three bands more useful: early (stages 1 to 3), middle (4 and 5) and late (6 and 7), because the kind of help changes at each. The seven stages in detail and the stage map.
Attendance Allowance (not means-tested), a council needs assessment for them and a carer’s assessment for you, an NHS Continuing Healthcare assessment if needs are high, a council tax discount, and Carer’s Allowance if you care for 35 hours a week. And a carer as well: a few hours of cover each week is often what keeps a husband or wife going. What to apply for.
The ordinary tasks of the day, done in a particular way: the same carer at the same time, prompting rather than taking over, redirecting rather than arguing, meals that get eaten, medication seen swallowed, an evening plan for sundowning, safe trips out, and notes for the family. Eight things a good dementia carer does.
Early on, companionship visits at £15 to £20 an hour. Daily visits are £18 to £25 an hour, overnight care from £130 a night. Live-in dementia care starts from £1,260 a week, typically £1,340, with our fee included. The cost of care for dementia.
When they cannot be kept safe or comfortable at home with the care that is available, or when what they need is nursing rather than care. Most families reach that point later than they expect once they know what live-in care can do. Wanting to stay at home is a good reason to try. The full answer.
Sometimes. NHS Continuing Healthcare funds the whole package, including live-in care at home, where the primary need is health rather than social care. Late-stage dementia with complex needs can qualify; early stages usually do not. It is worth asking for an assessment. Free live-in care with dementia?
Increased confusion, agitation and restlessness in the late afternoon and evening. Curtains drawn before dusk, lights on, a calm routine, something to do with the hands, and a familiar carer who does not argue. Overnight care helps where it spills into the night. What is sundowning?
Introduce the carer as help for you rather than for them, start with something they would accept from anyone (a lift to the shops, a hand in the garden), keep the same person, and let them choose from two or three profiles. Refusal is usually about dignity, not the help. How to get someone to accept care.
Carers on PrimeCarers are self-employed and list the conditions they have experience with on their profile, alongside reviews from families. You choose the carer and interview them for free, so you can ask directly about dementia experience and at what stage. How we vet carers.
With the right care, through every stage. Live-in carers, waking-night carers, district nurses and the GP together cover what a nursing home does, in the person’s own bed. Dementia life span and end-of-life care at home.
Guides
Everything we have written about dementia
Fourteen guides on dementia itself, and the pages families read alongside them.
Day to day
- 37 activities for people with dementia
- Admiral Nurses and free dementia support
- Eating and swallowing in later dementia
- How do you make someone with dementia happy?
- Making the home dementia-friendly
- What is a dementia clock?
- What are dementia assistance cards?
- What are dementia cafes?
- Horses and Alzheimer’s symptoms
- Does a lack of social contact cause dementia?
- When someone with dementia refuses care
- Wandering and leaving the house
- Aggression and agitation
- Hospital stays with dementia
- My husband has dementia: what help can I get?
- When a parent refuses to wash
- Live-in care for dementia
Decisions and money
- At what point should someone with dementia go into care?
- Dementia and driving
- The cost of care for dementia
- What dementia training a carer should have
- Free live-in care with dementia?
- Is live-in care cheaper than a care home?
- Can someone be forced into a care home?
- Dealing with irrational elderly parents
- Lasting power of attorney and dementia
A familiar face, every day, at home
See the carers near you with dementia experience, and talk to the ones you like before deciding anything.