26/08/2026
No one with dementia should be left stranded in hospital because the right care is unavailable.
I read the story shared by journalist Ben East about his mother’s dementia care which is desperately sad. Still, it highlights a discussion we urgently need to have about the relationship between the NHS, social care and specialist dementia nursing homes.
His mother spent 17 days in hospital despite being ready to leave. Returning home was no longer safe, but no suitable community hospital bed or care-home place was immediately available.
Eventually, the family found a private care home themselves, arranged for staff to assess her in hospital and secured agreement from the relevant discharge and social care teams. Ben described it as effectively having to “buy her out of hospital”.
His story raises a deeply uncomfortable question: what happens to families who lack the knowledge, confidence, or financial resources to do this? They remain trapped in the system.
Hospitals are not designed to provide long-term dementia care.
Hospitals are essential when somebody needs acute medical treatment, but they are rarely the best environment for a person living with dementia once that treatment has finished.
Busy wards, unfamiliar faces, noise, disrupted routines and repeated moves can increase confusion and distress. NHS England recognises that hospital admission can contribute to delirium and a decline in functioning, potentially reducing a person’s ability to return home and live independently.
The longer someone remains in hospital unnecessarily, the greater the risk of deconditioning, infection and further loss of independence.
This is not a criticism of NHS staff. Doctors, nurses, discharge coordinators and other hospital professionals are often doing everything possible within an overstretched and fragmented system. The problem is what happens when someone no longer requires hospital treatment but still needs significant nursing, dementia or end-of-life care.
The Telegraph article reports that almost one in six NHS beds is occupied by someone with dementia. Separately, analysis of NHS England data by Alzheimer’s Society found that almost a third of people aged 65 and over who were medically ready to leave hospital but remained there for at least another three weeks were believed to have dementia.
Behind every statistic is a person and a family living through an already distressing situation.
Our family was offered another way.
When my own mother-in-law, who was living with dementia, was approaching the end of her life, she was discharged from hospital to a local care home.
There, she could receive the nursing and end-of-life care she needed in an environment that was calmer, more comfortable and better suited to her circumstances than a busy hospital ward.
It made me question why this type of pathway is not consistently available throughout England.
Why should access depend on where someone lives, which services operate locally, whether a suitable bed is available, or whether their family knows how to navigate the system?
Should every area have a dedicated dementia discharge pathway?
The answer is not that every person living with dementia should automatically be discharged to a nursing home. Many people will be best supported in their own homes with the right package of care. In contrast, others may need rehabilitation, temporary assessment beds, residential care, specialist dementia nursing or end-of-life support.
Decisions must always be based on the individual’s needs, wishes, safety and best interests.
However, every area should have a clearly defined and adequately funded pathway through which people with dementia can move promptly from hospital to the most appropriate setting.
England already operates a “discharge to assess” model. Government guidance says clinically ready people should leave hospital safely and have their longer-term needs assessed in the most appropriate environment. This is intended to prevent unnecessary hospital stays and improve people’s independence and outcomes.
The principle is sound. The difficulty is that a pathway cannot work without enough suitable places, trained professionals and cooperation between hospitals, local authorities, community health teams and care providers.
Rather than relying on families to coordinate everything, each local health and care system should have:
A dementia-trained discharge coordinator involved from the beginning of the hospital stay.
A shared NHS and social care team able to make timely decisions.
Access to temporary dementia nursing and assessment beds.
Strong working relationships with appropriate local care homes.
Early conversations with families about funding, care options and timescales.
A named person whom relatives can contact for honest updates.
Clear escalation procedures when no suitable placement is available.
The Government’s hospital discharge guidance already calls for safe and timely discharge. Families need confidence that this will be delivered consistently, wherever they live.
Families should not have to fight the system.
When someone you love is seriously ill or approaching the end of their life, your time should be spent with them. You should not have to spend those precious days making repeated telephone calls, searching for beds and trying to persuade disconnected organisations to work together.
Nor should access to appropriate care depend on a family’s ability to pay privately.
We need to stop viewing health care and social care as two separate worlds. To the person with dementia and their family, it is all care.
The real question is not simply how we free NHS beds. It is how we make sure a vulnerable person moves to the place best able to meet their needs, without delay, unnecessary distress or financial inequality.
Ben East’s story should begin a national conversation. Should every integrated care system in England be required to provide a consistent, dementia-specific discharge pathway, including access to appropriate nursing and end-of-life placements?
I believe it should.
No person living with dementia should remain unnecessarily in hospital because the services around them are unable to work together. We can and must create a more compassionate, coordinated and dignified way forward.
Do share your thoughts and experiences in the comments.
Here is a link to the article
Mum is ready to leave hospital, but there is nowhere suitable for her to go. We are watching her deteriorate as the days go by
