stage: 4

NHS Continuing Healthcare and dementia — who qualifies, how to apply, and what to do if refused

Dementia alone does not automatically qualify someone for NHS Continuing Healthcare, but many people with dementia do qualify, particularly in the moderate to advanced stages. Eligibility is based on whether the person's primary need is a health need rather than a social care need, determined through a structured multidisciplinary assessment. The decision support tool scores needs across twelve care domains. Behavioural symptoms, high levels of nursing input, complex medication needs, and the unpredictable nature of advanced dementia all support a case for eligibility. If an initial assessment returns a negative result, the decision can be challenged through a formal review and appeal process.