Caring for someone living with dementia is a major responsibility, both emotionally and financially. One of the most pressing concerns for families is understanding the cost of dementia care and what help is available. In Scotland, the system is different from the rest of the UK. Since 2002, adults aged 65 and over have been entitled to free personal care, and those of any age with complex health conditions may qualify for free nursing care. However, many families still face significant residential dementia care costs, in-home dementia care costs, and the hidden costs of care.
This guide explains how dementia care costs work in Scotland, what support is provided by the NHS and local authority, and what families need to know about paying for care homes, live in carers, and nursing dementia care.
Dementia Care Needs in Scotland
Every person’s journey with dementia is unique. Some people living with dementia can manage with minimal personal care at first, while others need specialist dementia care much earlier. Care needs increase over time, often progressing from help at home with daily routines to round the clock support in a residential home or nursing home.
In Scotland, care providers deliver several types of dementia support:
- Home care: A professional carer visits or lives in the person’s own home to provide assistance.
- Residential dementia care: Accommodation in a residential home, where staff help with daily activities and social care.
- Nursing dementia care: Support in a nursing home, where a registered nurse monitors vital signs and manages health conditions.
- Respite care: Short-term support to give family carers a break.
Care costs will vary depending on whether the person needs basic personal care or advanced dementia care with clinical supervision.
Free Personal and Nursing Care in Scotland
Scotland is different from England, Wales, and Northern Ireland when it comes to funding. The Scottish Government provides free personal care for anyone over 65 who is assessed as needing it. For those under 65, the same entitlement applies if the person requires personal or nursing care because of health conditions such as advanced dementia.
What free personal care covers
Personal care includes help with:
- Washing and dressing
- Eating and drinking
- Managing medication
- Using the toilet and maintaining dignity
- Assistance with mobility
Nursing care component
Where nursing is required, families may also receive free nursing care. This covers clinical tasks delivered by a registered nurse, including monitoring vital signs, managing medication, and providing proper care for people with complex needs.
Although personal care and the nursing care component are free, they do not cover accommodation, food, heating, and other home costs in a residential setting. This is where most dementia care costs arise.
Dementia Care Costs Families Still Pay
Even with Scotland’s free care entitlement, many families need to pay care home fees, live in care fees, or other additional costs.
Residential dementia care costs
The average weekly cost of residential dementia care in Scotland is between £1,000 and £1,400. This is higher than general residential care costs, reflecting the need for specialist dementia care and additional staff training.
Nursing dementia care costs
When a loved one requires nursing dementia care in a nursing home, costs are higher. Nursing home fees often exceed £1,500 per week, although the NHS may cover some of the nursing dementia care costs through NHS funded nursing care.
In-home dementia care costs
Many families prefer to keep a loved one in their own home for as long as possible. In-home dementia care costs vary depending on whether support is hourly or full-time with 24 hour care.
- Hourly care: £20–£30 per hour.
- Overnight care: £120–£200 per night.
- Live in dementia care costs: £900–£1,400 per week for a live in carer.
While free personal care reduces some of these costs, families still pay for accommodation, meals, and other home fees.
Local Authority Funding and Financial Assessments
When considering residential dementia care costs in Scotland, the local authority carries out a financial assessment to decide how much a person will pay.
- If savings and assets are above a certain level, the person is a self funder.
- If finances are below the threshold, local authority funding helps with residential care costs.
- A personal budget or direct payments may be provided, giving families control over which care provider delivers support.
Family members may also face a top up fee if the chosen residential home charges more than the local council will cover.
NHS Continuing Healthcare and Funded Support
In Scotland, people with advanced dementia may qualify for NHS continuing healthcare. This is different from social care and covers all costs if the person’s needs are primarily medical. Decisions are made by the integrated care board, previously known as clinical commissioning groups.
- NHS continuing healthcare is not means tested.
- NHS funded nursing care pays for the nursing care component in a nursing home.
- The NHS does not usually pay for accommodation, but it may in cases of extreme medical need.
Families should always request an assessment for NHS funding when dementia progresses to later stages.
Hidden Costs of Dementia Care
Beyond residential dementia care costs and in-home dementia care costs, there are hidden costs that families need to plan for. These can include:
- Equipment such as hoists, hospital beds, and mobility aids.
- Home adaptations to make living with dementia safer.
- Transport to medical appointments.
- Private care extras in a dementia care home, such as hairdressing or activities.
- Emotional and financial pressure on family carers, who may reduce working hours.
These additional costs mean the overall cost of dementia can be higher than expected.
Comparing Scotland with the Rest of the UK
It is useful to compare how care is funded across the UK:
- England and Wales: Families must undergo a means test, and self funders are common. The average cost of dementia care homes UK ranges from £1,200–£1,600 per week.
- Northern Ireland: Some care costs are funded differently, with contributions from social services.
- Scotland: Free personal care and the nursing care component reduce overall costs, but accommodation and residential home fees still apply.
Although Scotland’s system is more generous, many families still need to pay care fees or rely on self funding.
Cost of Dementia Care at Home vs Residential Care
Choosing between live in care and a residential dementia care home is a key decision.
- A residential care home provides structure, activities, and staff always on hand.
- A live in carer offers one-to-one personal care in a person’s own home.
- For couples, live in care may be cost effective compared to two separate residential care places.
The average dementia care cost is similar whether families choose live in care or residential dementia care, but the right option depends on the loved one’s wishes and health conditions.
Respite Care and Short-Term Costs
Family carers often need a break. Respite care allows them to rest while ensuring their loved one continues to receive proper care.
- Residential respite care: £1,000–£1,400 per week.
- Nursing respite care: £1,300–£1,600 per week.
- Live in respite care: Similar to long-term live in dementia care costs.
Planning for respite prevents carer burnout and ensures continuity of care.
Financial Planning and Support Options
To manage dementia care costs, Scottish families should explore all possible funding routes:
- Apply for a financial assessment with the local authority.
- Request NHS continuing healthcare if the person’s care needs are primarily health related.
- Use direct payments to choose a preferred care provider.
- Consider equity release to cover long-term care fees.
- Seek advice from social services about additional funding or respite options.
Family members play a crucial role in ensuring a loved one receives the proper care needed while balancing affordability.
Conclusion
The cost of dementia care in Scotland is shaped by a unique funding system that offers free personal care and a nursing care component, easing the burden compared to the rest of the UK. However, families must still plan for residential dementia care costs, nursing home fees, and in-home dementia care costs, which can be significant.
By understanding local authority funding, NHS continuing healthcare, hidden costs, and options like live in carers and respite care, families can make informed choices about care in the UK. With the right financial support and forward planning, people living with dementia can receive compassionate, specialist dementia care while maintaining dignity and quality of life.
Michael Mensah brings over seven years of experience as a Nutritionist, guided by a genuine passion for improving people’s wellbeing. His strong commitment to supporting others in living with dignity and independence led him into the care sector.
He began his journey at Careline Home Support as a Care Worker, progressed to Team Leader, then Assistant Care Co-ordinator, and now works as a Care Co-ordinator. In this role, he provides personalised, person-centred care that respects each individual’s needs, while upholding the highest standards of compassion, safeguarding, and respect.
For Michael, caregiving is not just a profession but a meaningful exchange rooted in empathy. He believes that just as nature supports itself, those who need help should be met by those ready to offer it. His work brings him a deep sense of purpose, and he is proud to help foster a team culture built on kindness, professionalism, and mutual support.
