How to Get the Higher Rate of Attendance Allowance for Dementia After a Lower-Rate Award

If someone with dementia was awarded the lower rate of Attendance Allowance and you believe their night-time needs should qualify them for the higher rate, you have two routes: request a mandatory reconsideration of the original decision (within one month of the decision date, or later with good reason), or report a change of circumstances showing that night needs have increased since the award. The higher rate is worth £114.60 per week in 2026/27 compared to £76.70 at the lower rate — a difference of £37.90 per week, or £1,970.80 per year. For many families, that gap also affects eligibility for linked benefits like the Pension Credit severe disability addition.

Why Dementia Claims Often Land at the Lower Rate

The lower rate is awarded when the decision-maker accepts that daytime care needs are met but concludes that the evidence for night-time needs is insufficient. In dementia claims, this happens for three recurring reasons:

Night supervision was understated on the form. Many carers describe daytime prompting and supervision in detail but write only a sentence about nights — "I check on them a couple of times" — because the intervention feels less structured. The night test requires either prolonged or repeated attention during the night in connection with bodily functions, or another person being awake for a prolonged period or at frequent intervals to watch over the claimant to avoid substantial danger. Vague descriptions don't demonstrate either threshold.

Sundowning was treated as a daytime issue. Sundowning — the late-afternoon and evening escalation of agitation, confusion and disorientation common in Alzheimer's and Lewy body dementia — often bleeds into the night hours. If the form described sundowning episodes only in the daytime section, the decision-maker may not have counted them toward the night condition at all.

The carer didn't record specific episodes. A care diary can help show how often the person wakes, how long each episode lasts, what intervention is needed, and what would have happened without it. DWP's AA1 notes say a record over one or two days may help and can be sent with the form if you want. DWP guidance treats 20 minutes as a starting point for "prolonged" night-time attention. It says watching over at frequent intervals can be concentrated in one part of the night, and separately defines repeated attention as more than once. Concrete records make the difference.

Route 1: Mandatory Reconsideration

If the decision was made recently (within about one month, though late requests may be accepted with good reason), you can ask the DWP to look at the decision again through mandatory reconsideration. In Scotland, Pension Age Disability Payment decisions go through a redetermination process with Social Security Scotland, which has a different timeline.

For a mandatory reconsideration focused on getting the higher rate:

1. Write a clear statement explaining that you believe the night-time condition is met. Describe the specific night-time needs: how often the person wakes or wanders, what you do each time (redirect to bed, check they haven't left the house, help with toileting, reassure them), how long each intervention takes, and what the risk would be if you weren't there.

2. Attach a care diary covering at least 7 nights if you can. A 7-night diary is a detailed preparation option, not a DWP requirement; the AA1 notes say a record over one or two days may help and can be sent with the form if you want. Record every waking, every intervention, the time it started and ended, and the nature of the risk. "12:40am — found Mum in the kitchen trying to use the kettle, disorientated, thought it was morning. Guided her back to bed, stayed until she settled, 25 minutes" is the level of detail that makes a difference.

3. Include any new medical evidence — a letter from the GP, memory clinic, or community psychiatric nurse confirming the night-time behavioural pattern, if available.

For England and Wales, request mandatory reconsideration by calling the DWP on 0800 731 0122 or writing to the address on the decision letter. Keep a copy of everything you send. In Northern Ireland, contact the Disability and Carers Service on 0800 587 0912.

Route 2: Change of Circumstances (Supersession)

If too much time has passed for mandatory reconsideration, or if night-time needs have genuinely worsened since the original assessment, you can report a change of circumstances. This asks the DWP to look at the award again based on the current situation. A supersession can increase the rate from lower to higher if the new evidence demonstrates that the night-time condition is now met.

Dementia is progressive, so it's common for night needs to develop or intensify after the initial claim. If the original application was submitted during a period of relative stability and sundowning, night wandering, or nocturnal confusion have since become regular, this is a legitimate change of circumstances.

Report it by phoning the Attendance Allowance helpline or writing to them. Provide the same evidence you would for a mandatory reconsideration: a detailed description of night-time needs, a care diary if available (for example, a current 7-night diary), and any recent medical or care documentation.

What Good Night-Needs Evidence Looks Like

The decision-maker is looking for evidence that meets specific statutory thresholds. Here is what strengthens a case for the higher rate:

• Frequency: multiple waking episodes per night, or one episode lasting around 20 minutes or longer, which may support prolonged attention. The 20-minute point is a starting point, not an automatic threshold; record exact times and durations.
• Nature of intervention: physical guidance back to bed, verbal reassurance during confusion, toileting assistance, checking the person hasn't left the house, preventing them from attempting unsafe activities.
• Risk if unattended: the person would fall on the stairs, leave the house in nightclothes, attempt to cook at 2am, become severely distressed or aggressive. The danger must be real and substantial.
• Pattern over time: a 7-night diary can show the pattern across a full week; the AA1 notes say a record over one or two days may help and can be sent if you want. If episodes vary in frequency, note that too — the form should reflect typical and worst nights, not just one snapshot.

A care diary paired with a supporting letter from a medical professional who sees the person regularly is the strongest combination. The diary shows what actually happens; the medical evidence confirms it's consistent with the clinical picture of the person's dementia.

Who This Is For

• A family carer who received a lower-rate Attendance Allowance decision and believes the night-time supervision or watching-over wasn't captured properly on the original form
• Someone whose parent's dementia has progressed since the original claim, with new or worsened night-time needs
• A carer who didn't keep a care diary for the original claim and now wants to build the evidence properly before challenging the decision

Who This Is NOT For

• Someone who has not yet claimed Attendance Allowance — start with the initial application instead (the dementia claim guide covers the full process from first call to submission)
• A person under State Pension age — they would claim PIP or Adult Disability Payment, which have different escalation routes
• Someone whose needs are primarily physical and daytime-only — the higher rate requires meeting both the day and night conditions

Frequently Asked Questions

How long does a mandatory reconsideration take?

The DWP aims to complete mandatory reconsiderations within about two weeks, though complex cases can take longer. During this period, the lower rate continues to be paid. In Scotland, Social Security Scotland must complete a redetermination within 56 days.

Can I go to a tribunal if the mandatory reconsideration keeps the lower rate?

Yes. If mandatory reconsideration doesn't change the decision, you can appeal to the First-tier Tribunal (Social Entitlement Chamber). The tribunal is independent of the DWP, and statistics consistently show that a significant proportion of appealed disability benefit decisions are overturned. Free help with appeals is available from Citizens Advice and local welfare rights services.

Does the higher rate affect Pension Credit?

It can. Attendance Allowance at either rate can act as a qualifying benefit for the Pension Credit severe disability addition (currently £86.05 per week in 2026/27). Moving from the lower rate to the higher rate doesn't change the severe disability addition amount, but if the original lower-rate award triggered it, the total household benefit increases by the rate difference alone. If the person wasn't getting Pension Credit at all, either rate can trigger a new claim.

Should I use the dementia claim guide for a mandatory reconsideration?

The Attendance Allowance and Pension Age Disability Payment for Dementia: A UK Claim Guide covers describing night-time cognitive needs, keeping a care diary, and gathering evidence — all directly relevant to building a mandatory reconsideration case. It also includes a decision review checklist worksheet designed for exactly this scenario.

See more United Kingdom guides →