Attendance Allowance for Alzheimer's and Lewy Body Dementia: What Counts as a Care Need

A dementia diagnosis is not one condition — it is a group of related diseases, and each type creates different care and supervision needs that matter on the Attendance Allowance form. The DWP does not award AA based on the diagnosis itself; it assesses the practical help you need because of it. Knowing how your specific type of dementia affects daily life helps you describe needs the decision-maker is looking for.

Alzheimer's Disease

Alzheimer's is the most common type, accounting for about 60% of dementia cases. The progressive memory loss and executive dysfunction it causes translate directly into AA care needs:

Daytime attention: forgetting to eat or drink, needing prompting through the steps of washing or dressing, or taking medication at the wrong times or not at all. These needs may count as attention in connection with bodily functions when they are frequent and needed throughout the day. Leaving the cooker on may instead be relevant to the supervision test if continual supervision is needed to avoid substantial danger.

Daytime supervision: leaving the house without a coat in winter, opening the door to strangers, attempting to use appliances unsafely. The statutory test is continual supervision throughout the day to avoid substantial danger.

Night needs: waking disoriented and trying to get dressed at 3am, wandering downstairs and attempting to leave the house, calling out repeatedly. Both prolonged or repeated attention at night and watching over to avoid danger are separate qualifying tests.

The important pattern with Alzheimer's is that needs often look invisible to outsiders because the person walks, talks, and appears physically capable. On the form, describe what would happen if no one was there to prompt, redirect, or intervene.

Lewy Body Dementia

Lewy body dementia (DLB) creates a distinctive cluster of symptoms that go well beyond memory loss. For Attendance Allowance purposes, the key differences are:

Visual hallucinations: the person sees people, animals, or objects that are not there. This is common in DLB and can cause significant distress, aggression, or attempts to leave the house. On the form, describe specific episodes — what they saw, how they reacted, and what you had to do.

Fluctuating cognition: one hour the person seems relatively clear; the next they cannot recognise their own kitchen. This makes the form harder because families tend to describe the good moments. DWP decision-makers consider the person's needs over the relevant period; there is no set number of days each week on which the needs must occur. Describe the variation between better and worse days.

Parkinsonism features: tremor, stiffness, shuffling gait, and balance problems overlap with physical disability. This can strengthen the case for both attention (help with dressing, toileting, moving around) and supervision (falls prevention).

REM sleep behaviour disorder: acting out dreams physically — punching, kicking, falling out of bed. It may be relevant to the night-time watching-over test if another person must be awake for a prolonged period or at frequent intervals to watch over the person and avoid substantial danger.

Vascular Dementia

Vascular dementia follows a different trajectory — symptoms often appear suddenly after a stroke or TIA and progress in a step-wise pattern rather than the gradual decline of Alzheimer's. The combination of cognitive damage and potential physical disabilities from strokes means many vascular dementia claims meet both care and supervision thresholds.

After each step-down, the care situation can change rapidly. If you are completing the form, describe needs as they are now, not as they were before the last event. Mention whether things have worsened over months, because the qualifying period requires care needs to have been present for at least six months in Scotland too.

Frontotemporal Dementia

Frontotemporal dementia (FTD) often changes personality and behaviour before it affects memory. The person may become impulsive, disinhibited, or apathetic — behaviours that create real supervision needs but do not look like a traditional care need to someone unfamiliar with the condition.

On the AA1 form, describe:

• Loss of social awareness and disinhibited behaviour in public (supervision to avoid danger)
• Compulsive eating or putting inappropriate items in their mouth (attention with nutrition)
• Apathy so severe they would not eat, drink, or maintain personal hygiene without prompting
• Language difficulties if the person has primary progressive aphasia (attention with communication)

What Matters on the Form, Regardless of Type

The AA1 form asks about personal care tasks and supervision. For any type of dementia:

• Describe what happens on a typical day AND on a bad day
• Explain what would happen if no one was there to help
• Use specific examples with times and frequencies, not general statements
• Cognitive prompting and verbal guidance can count when they are needed in connection with a bodily function and meet the frequency test — you do not need to be physically touching the person

Both rates are the same across all dementia types: £76.70 per week (lower) and £114.60 per week (higher) in 2026/27. The type of dementia does not determine the rate — the extent of day and night needs does.

If you want detailed guidance on describing cognitive care needs for each section of the form, our dementia claim guide walks through the AA1 and Scottish PADP application step by step.

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