Specialist dementia care homes: What they offer and how to choose

A specialist dementia care home provides dedicated care and support for people living with dementia, including those with more complex needs.

Alzheimer’s Society estimates that around 70% of people living in care homes in England have dementia. While many care homes support people with the condition, some specialise in dementia care and have environments, staff and activities tailored to residents’ needs.

But what makes a care home a specialist dementia care home, and how can you tell whether it is right for your loved one?

This guide explains what specialist dementia care homes offer, how they differ from other care homes and what to look for when choosing one.

What is a specialist dementia care home?

A specialist dementia care home is a residential or nursing care setting where the environment, staff and approach to care are tailored to the needs of people living with dementia.

Unlike some general residential care homes, which may only be able to support people with mild dementia, specialist homes can often provide care for people with more advanced or complex needs.

Depending on the services available, they may support people who:

• Experience significant memory loss or confusion.
• Need help with everyday activities such as washing, dressing and eating.
• Become distressed, anxious or restless.
• Have difficulty communicating their needs.
• Are at risk of becoming lost or leaving a safe environment.
• Have advanced dementia or additional physical health conditions.

Good specialist dementia care goes beyond managing symptoms. It means understanding the person behind the diagnosis, including their life story, personality, relationships, preferences and routines.

The aim is to help residents maintain their independence, dignity and quality of life for as long as possible.

However, not every specialist dementia care home can support every stage of dementia. Some provide residential care, while others offer nursing care for people with more complex medical needs.

It is important to check that a home can meet your loved one’s current needs and continue supporting them if their condition changes.

What is the difference between a dementia care home and a specialist dementia care home?

Many residential care homes accept people living with dementia, but the level of support they provide can vary.

A general residential care home may be suitable for someone in the early stages of dementia who needs help with everyday activities but does not require more complex support.

A specialist dementia care home will usually have more extensive dementia care experience, tailored activities and an environment designed around the needs of people living with the condition.

Some specialist homes also provide dementia nursing care for residents with additional medical needs.

General care home offering dementia care	Specialist dementia care home
May support people with mild or moderate dementia	May support people with more advanced or complex dementia
Staff may have general dementia awareness training	Staff generally have more extensive dementia-specific training
May have some dementia-friendly features	Often designed or adapted specifically for people with dementia
May not be able to meet complex dementia care needs	May provide additional support for residents with more complex needs

The distinction is not always clear-cut. Some general care homes provide excellent dementia care, while specialist homes differ in the services they offer.

How are specialist dementia care homes designed?

The environment can make a significant difference to someone living with dementia.

Memory loss, confusion and difficulties recognising familiar places can make everyday surroundings harder to navigate.

Specialist dementia care homes often use dementia-friendly design to help residents feel comfortable, confident and safe.

Features may include:

• Simple layouts: Easy-to-follow corridors and clearly defined rooms help residents find their way around.
• Clear signs: Signs using words, pictures or photographs can help residents recognise bedrooms, bathrooms and communal areas.
• Colour and contrast: Contrasting colours can make doors, toilets, grab rails and other important features easier to identify.
• Good lighting: Natural light and well-lit spaces can improve visibility and reduce confusing shadows.
• Accessible gardens: Safe outdoor areas provide opportunities for fresh air, exercise, gardening and relaxation.
• Quiet spaces: Comfortable areas away from noise and activity offer somewhere to relax.
• Suitable flooring: Even, non-slip flooring without confusing patterns or reflective surfaces can make moving around easier.

However, there is no single design that works for everyone living with dementia.

For example, mirrors may cause confusion or distress for one person but be familiar and reassuring for another.

The best dementia-friendly environments are those that adapt to the needs and preferences of the people living there.

Creating familiar surroundings

Familiarity can help people living with dementia feel more comfortable and maintain a sense of identity.

Specialist dementia care homes often encourage residents to bring photographs, favourite ornaments, books and other personal belongings to make their bedrooms feel more like home.

Some homes use memory boxes or personalised displays outside bedroom doors to help residents recognise their rooms.

However, creating a sense of home is about more than the physical environment.

Familiar routines, meaningful activities and relationships are equally important.

For example, someone who has always enjoyed gardening may like helping to care for plants, while another resident may find comfort in listening to familiar music or helping to set the table.

These everyday activities can provide enjoyment, encourage communication and help residents maintain a sense of purpose.

How lighting can help people with dementia

Some people living with dementia experience increased confusion, anxiety or restlessness during the late afternoon or evening.

This is sometimes called sundowning.

Good lighting can help by reducing shadows, improving visibility and supporting a regular day-and-night routine.

For example, natural light during the day and softer lighting in the evening may help residents recognise when it is time to rest.

However, changes in behaviour should not automatically be attributed to dementia or sundowning. Pain, tiredness, hunger, illness or an unfamiliar environment may also contribute to distress.

Why gardens and outdoor spaces matter

Access to outdoor space can be particularly valuable for people living with dementia.

A garden provides opportunities to walk, relax, socialise, enjoy nature or take part in familiar activities such as gardening.

For someone who has always enjoyed growing plants, gardening may provide a sense of purpose. For another person, simply sitting outside and listening to birds may be enjoyable.

When visiting a care home, ask whether residents can access the garden regularly and how staff support people to enjoy outdoor activities safely.

Creating a dementia-friendly dining environment

Mealtimes are an important part of everyday life, but dementia can sometimes affect a person’s ability to recognise food, use cutlery or concentrate while eating.

Specialist dementia care homes may use:

• Contrasting plates and tableware to make food easier to see.
• Adapted cutlery or finger foods to support independence.
• Calm dining areas with fewer distractions.
• Familiar meals that reflect residents’ preferences and cultural backgrounds.
• Flexible mealtimes and individual support where needed.

Food can also bring back memories and provide opportunities for conversation and social connection.

What care do specialist dementia care home staff provide?

Staff play an important role in helping people living with dementia feel safe, understood and supported.

In specialist dementia care homes, care workers should receive appropriate dementia-specific training and ongoing support to help them respond to residents’ changing needs.

Their responsibilities may include:

• Helping residents with washing, dressing, eating and other daily activities.
• Supporting people who experience memory loss, confusion or difficulties communicating.
• Recognising signs of distress and responding calmly and sensitively.
• Encouraging residents to remain active and independent where possible.
• Providing meaningful activities based on individual interests.
• Working with families to understand residents’ routines, preferences and life histories.
• Monitoring changes in residents’ wellbeing and seeking medical advice when needed.

Why person-centred dementia care matters

Dementia affects everyone differently, and a diagnosis does not tell you everything about a person’s personality, interests or what makes them feel comfortable.

Good dementia care begins with getting to know the individual.

A resident’s previous occupation, family life, hobbies, favourite music and daily routines can all help staff find meaningful ways to communicate and connect.

For example, if someone becomes distressed during personal care, staff should consider what might be causing that distress rather than focusing only on the behaviour.

Pain, discomfort, anxiety, tiredness or an unfamiliar routine may all play a part.

Families and friends can provide valuable information about the person’s life and preferences, helping staff understand what makes them feel comfortable and secure.

Dementia-specific training is important, but good care also depends on supportive leadership, ongoing learning and a culture where residents are treated with patience, warmth and respect.

Do specialist dementia care homes have nurses?

Not all specialist dementia care homes have registered nurses on-site.

Residential dementia care homes provide personal care and support with everyday activities. Nursing care, when needed, is usually arranged through external healthcare professionals.

Dementia nursing homes have registered nurses available around the clock to support residents with nursing needs alongside their dementia.

These may include people who have complex medical conditions, significant mobility difficulties or require more intensive clinical support.

If your loved one has advanced dementia or complex health needs, ask whether the home provides dementia nursing care and what level of support is available.

What is an EMI unit in a care home?

Some care homes have a separate unit or wing dedicated to residents living with dementia.

These are sometimes called EMI units, which stands for Elderly Mentally Infirm.

EMI is an older term that is still used by some care providers, although many now prefer ‘specialist dementia care unit’, ‘dementia care community’ or ‘dementia care unit’.

These units may support residents who have more complex dementia care needs, including people who experience significant confusion, distress or changes in behaviour.

A specialist dementia care unit may have:

• Staff with additional dementia care training.
• Smaller communal areas and quieter surroundings.
• Dementia-friendly bedrooms and living spaces.
• Safe access to outdoor areas.
• Activities tailored to residents’ abilities and interests.
• Additional support for people with complex needs.

Some dementia care units provide residential care, while others offer nursing care.

An EMI unit does not automatically mean registered nurses or mental health nurses are available 24 hours a day. This depends on the home’s registration, staffing and services.

Can residents move between different care units?

Some care homes offer residential care, dementia care and nursing care within the same building.

This may allow residents to move to a different unit if their needs change, rather than having to move to another care home.

However, this is not guaranteed. A move will depend on the resident’s needs, the home’s ability to meet them and whether suitable accommodation is available.

If you are choosing a care home for someone with dementia, ask what would happen if they needed more support in the future.

How to choose a specialist dementia care home

Choosing a care home for someone living with dementia is a deeply personal decision. There is no single setting that will be right for everyone.

Although a home may advertise specialist dementia care, it is worth visiting to see how staff interact with residents and whether the environment feels comfortable and welcoming.

Alongside looking at the facilities, pay attention to everyday life.

Do staff speak to residents with warmth and respect? Are people given time to communicate? Do residents have choices about how they spend their day?

These everyday interactions can tell you more about a home’s culture than a list of facilities.

Questions to ask when visiting

About dementia care

• What stages and types of dementia can the home support?
• What dementia-specific training do staff receive?
• How does the home support residents who become distressed or agitated?
• Can the home continue caring for my loved one if their dementia progresses?

About the environment

• Is the home easy to navigate, with clear signs and good lighting?
• Can residents access a safe garden?
• Can bedrooms be personalised with familiar belongings?
• Are there quiet areas for residents who become overwhelmed?

About daily life

• What activities are available for people living with dementia?
• How are residents encouraged to maintain their independence?
• How are families involved in care planning?
• Will residents receive care from familiar members of staff?
• Are residents supported to maintain their interests and relationships?

About medical and nursing needs

• Are registered nurses available on-site?
• How are changes in health or behaviour monitored?
• What happens if a resident develops more complex care needs?
• Does the home provide end of life care?

It is also worth speaking to other families, reading reviews and checking the home’s latest inspection report where available.

For more advice, read our guide on how to choose a care home for someone with dementia.

What is NaDCAS dementia care accreditation?

The National Dementia Care Accreditation Scheme (NaDCAS) helps families identify care homes that have undergone an independent assessment of their dementia care.

Care homes accredited by NaDCAS have been assessed against recognised dementia care standards, with a focus on the quality of care and experiences of people living with dementia.

NaDCAS accreditation indicates that a care home has:

• Undergone an independent assessment of its dementia care.
• Demonstrated a commitment to providing high-quality, person-centred dementia care.
• Shown a commitment to continuous improvement.

Accreditation can provide additional reassurance when comparing care homes, although it should be considered alongside inspection reports, reviews and personal visits.

You can now find NaDCAS-accredited care homes on carehome.co.uk, making it easier to identify homes that have achieved this specialist dementia care accreditation.

When should someone move into a specialist dementia care home?

There is no single point at which someone living with dementia needs to move into a care home.

Some people continue living safely at home for many years with support from family, friends and professional carers.

However, specialist dementia care may become an option if:

• The person needs supervision or support throughout the day and night.
• They are frequently confused or at risk of getting lost.
• Their behaviour or distress is becoming difficult to manage safely at home.
• They need increasing help with eating, washing or other everyday activities.
• Their physical health or mobility has deteriorated.
• Family carers are struggling to provide the level of support needed.

A care needs assessment can help establish what support is required and whether residential or nursing care may be appropriate.

For further guidance, read when should someone with dementia move into a care home?.