What are advanced dementia (EMI) care homes?

If you or your relative develops advanced dementia or cognitive decline, you could consider a move to an EMI care home. But what is an EMI unit in a care home and is there an EMI care home near me? In this guide, we also look at EMI nursing homes and the cost.

At a glance

• EMI care refers to people who have major needs, as a result of advanced dementia.   
• EMD care refers to support for anyone living with dementia.
• EMI is defined as ‘Elderly, Mentally Infirm’ but this is no longer considered to be an appropriate term to use. 
• An EMI unit is a separate dementia unit in a nursing home or a care home, specifically tailored to the needs of people with advanced dementia.

What does EMI mean?

EMI is defined as ‘Elderly, Mentally Infirm’ but this is not considered to be an appropriate term to use today. 

Widely-accepted terms for care homes are ‘dementia residential care’, care homes described as having a ‘dementia unit’ or supporting ‘advanced dementia’. 

EMI care refers to people living with advanced dementia. 

Someone requiring EMI care may be confused, struggle with daily tasks, experience mood swings and wandering which could put them at risk.     

A EMI care home can support people with complex mental and cognitive health needs including advanced dementia.

What is an EMI unit in a care home?

An EMI unit is a separate dementia unit in a nursing home or a care home, specifically tailored to the needs of people with advanced dementia.

• Staff are trained to support people with advanced dementia in an EMI care home or EMI nursing homes. This means they can handle dealing with the behavioural difficulties that someone with advanced dementia may exhibit.
• EMI units are secure, to keep residents safe and prevent them from wandering off.
• While they come with higher fees, an EMI unit in a care home offers specialised care, safety, and an environment aimed at meeting these complex needs.

One woman posting on Alzheimer’s Society’s Dementia Support Forum posted:

My own Mum is in a fairly large home which provides residential care on the ground floor, and nursing care upstairs.

“There is also a small EMI unit upstairs, which can care for more challenging dementia cases.

“The residential care part of the home accepts people with dementia if their behaviour is not too difficult to manage, and does not cause distress to other residents.

“My mum is fine living in the residential care section of the home at the moment & hopefully will be for some time yet, but I have the reassurance of knowing that she could move to the EMI unit if it becomes necessary in the future.”

What is EMD care?

• EMD care stands for Elderly Mental Dementia care and refers to support for people living with dementia.  
• EMI care takes place in a dementia care home or nursing home. 

What is the difference between EMI and EMD care?

EMD care refers to support for anyone living with dementia.

If you need this type of care, you may not need support from a dedicated EMI unit because it supports people with advanced dementia needs.   

EMI	EMD
Elderly Mentally Infirm	Elderly Mental Dementia
Higher dementia care required such as nursing to support advanced dementia.	Some support needed e.g. personal care, to help someone diagnosed with dementia.
Specialist dementia units in care homes.	Care homes, home care etc.

How much does EMI Care cost?

EMI care tends to cost more than standard residential care due to specialised staffing, facility requirements, security, therapeutic activities, etc.

Costs vary significantly by region. London and the South East of England are often much more expensive than rural or less expensive parts of the country.

Region	Residential care	Nursing care	Residential dementia care	Dementia nursing care
East Midlands	£1,197	£1,380	£1,243	£1,415
East of England	£1,359	£1,606	£1,394	£1,573
London	£1,548	£1,759	£1,599	£1,767
North East England	£1,112	£1,264	£1,147	£1,296
North West England	£1,143	£1,422	£1,184	£1,470
Scotland	£1,539	£1,646	£1,603	£1,656
South East England	£1,446	£1,706	£1,515	£1,721
South West England	£1,339	£1,595	£1,387	£1,627
Wales	£1,156	£1,394	£1,217	£1,440
West Midlands	£1,202	£1,426	£1,243	£1,453
Yorkshire & The Humber	£1,170	£1,422	£1,201	£1,462
UK average fee	£1,298	£1,535	£1,343	£1,564

According to data from carehome.co.uk (see below), the average fee in the UK for self-funded residential dementia care is £1,343 and for dementia nursing care it is £1,564.   

Region			Self-funded residential dementia care	Self-funded dementia nursing care
England			£1,346	£1,583
Scotland			£1,603	£1,656
Wales			£1,217	£1,440
UK average fee			£1,343	£1,564

Who pays for EMI care?

EMI care funding options include:

• Self-funding individuals (or their family) pay privately. In England, if your savings and assets are worth £23,250 or more, you must pay for the full cost of your care.
• Local authority funding. This is means-tested. If someone’s savings, income or assets are below certain thresholds, local authority support may be available. In England, if your savings and assets are worth between £14,250 and £23,250, you will be eligible for some support from your local authority. If they are  less than £14,250, you will be eligible for full support. You must ask your council for a care needs assessment.
• NHS-funded nursing care. You may find that you are eligible for NHS-funded nursing care which can help pay some of your care.  
• NHS Continuing Healthcare. You may be eligible for NHS Continuing Healthcare if your health need is complex and primarily health-related, you may be eligible for full funding.

What does EMI care involve? 

Knowing what distinguishes an EMI care home from other care homes can help you make informed decisions about the type of care you want for your family member or friend.

– Specialist staff training

Staff need skills in dementia care, managing behaviours, communication, end-of-life care. EMI homes typically require more advanced training

– Higher staff to resident ratio

Residents in EMI units have more complex care needs—physical, emotional, and mental, therefore residents benefit from more support and supervision.

– Safe, secure environment

The unit ensures safety with locks, security-conscious layout and design and restricted areas. This prevents wandering and limits risks for residents who are disoriented.

– Therapeutic activities and facilities

Residents are encouraged to take part in activities like music therapy, animal therapy, brain-stimulating games and memory activities like reminiscence therapy.

Residents can also enjoy quiet rooms and sensory gardens.

What is the difference between EMI care and nursing care? 

EMI care refers to dementia care that may not require a nurse.

Nursing care refers to daily medical care from a trained nurse and can support a wide range of different conditions including dementia care. 

How to choose the right EMI care home for you

Here are practical steps to help you choose an EMI care home:

1. Check reviews & ratings

Look for CQC inspection reports.

Read family and resident reviews on carehome.co.uk for real feedback.

2. Cost transparency

Get a detailed breakdown of care fees; what’s included and what may incur extra charges.

3. Visit in person

Observe how residents are treated, how staff interact and the atmosphere.

Check the care environment. This includes signage, layout, ease of navigation, lighting and safety features.

4. Ask about staff training & turnover

What staff training is given and how often does it take place?

Is there a high turnover of staff? This can result in inconsistent care.

5. Activities & mental stimulation

Are activities suited to dementia? What activities take place? For example, sensory, reminiscence.  

6. Safety & security features

Are there secure doors/exit points, outdoor spaces with safe access, alarm systems, etc?

7. Care plan flexibility

As care needs increase, how does the care home adapt to meet these needs?  E.g. nursing care or collaboration with external health services.

Is EMI care legal and regulated?

Yes. Care homes offering this type of care must be registered with the relevant care regulator in England, Wales, Scotland or Northern Ireland.

For example, the Care Quality Commission (CQC) in England. These care homes are subject to inspections and must meet standards.

Will the care home resident lose autonomy in an EMI care home?

No a care home resident should not lose autonomy in a EMI unit in a care home.

A good EMI home strives for a balance of safety, structure, and maintaining dignity, choice and autonomy of the individual, where possible.

For example, staff can offer individuals choice over their eating times, personal preferences and activities.

How can I find EMI care homes near me?

For families seeking care, carehome.co.uk can help you compare homes, read real reviews, check locations, facilities, cost and regulatory status.

This website has tens of thousands of listings of care homes and nursing homes and over 396,000 reviews of care homes.

You can read reviews of dementia care homes from relatives, see photographs, facilities, and contact details.

If you’re looking for some EMI care homes near you, you can find dementia residential care homes in your local area.

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