EMI and enhanced dementia care homes: what the terms mean

“EMI” stands for elderly mentally infirm, an old term still used by councils, hospitals and some care homes. Today it usually means a care home that specialises in dementia, sometimes for people whose dementia causes distress or behaviour that needs more staff. “Enhanced dementia care” means the same kind of care, and often a higher fee.

In short

• EMI, specialist dementia and enhanced dementia care are not official CQC categories. What matters is whether the home is registered for dementia and has the staff and skills for the person’s needs.
• An EMI nursing home is a nursing home that specialises in dementia, for people who also need nursing care.
• Fees are usually higher than standard residential care because more staff are needed.

Who needs EMI or enhanced dementia care

Many people with dementia live well in an ordinary residential home that supports dementia. A specialist or enhanced placement is usually for someone who:

• becomes very distressed, agitated or aggressive, or tries to leave and is at risk
• needs one-to-one support for part of the day
• has dementia alongside a mental health condition
• has advanced dementia with nursing needs (an EMI nursing home)

See stages of dementia and the care needed.

What good looks like

• Staff trained in dementia care, with enough of them on shift, including at night
• Calm, easy-to-navigate surroundings and safe outdoor space
• Personalised activities and a “life story” approach
• Low use of sedative medication, and clear plans for distressed behaviour

Read choosing a dementia care home and the questions to ask when visiting.

Costs and funding

Specialist dementia care usually costs more than standard residential care, and nursing more again. Councils often pay a higher “enhanced” or “EMI” rate for people who need it. If needs are complex or unpredictable, ask for an assessment for NHS Continuing Healthcare, which pays the whole fee. See dementia care costs by region.

Finding a dementia care home

Every care home page on The Care Panel shows whether the home is registered with CQC for dementia. Search care homes by town and open the Dementia care filter, then ask the homes you like whether they can meet the person’s specific needs. A home’s own assessment before admission is the real test.

Reviewed by The Care Panel team on 27 October 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.