Dementia & Alzheimer's Care in South Africa: A Family Guide

Understanding dementia

Dementia is not a single disease - it's a term for a group of conditions that cause progressive decline in memory, thinking, and the ability to perform everyday activities. The most common types are:

• Alzheimer's disease - the most common form, accounting for 60–70% of cases
• Vascular dementia - caused by reduced blood flow to the brain, often after a stroke
• Lewy body dementia - characterised by visual hallucinations and movement problems
• Frontotemporal dementia - affects personality, behaviour, and language

An estimated 186,000 people in South Africa live with some form of dementia, with numbers expected to grow as the population ages. For medical information, contact Dementia SA or the Alzheimer's South Africa helpline.

When is it time for professional care?

Many families care for a person with dementia at home for years. But there comes a point where professional care becomes necessary - for the safety of the person and the wellbeing of the family. Warning signs include:

• Wandering or getting lost - even in familiar places
• Leaving the stove on, flooding the bath, or other safety hazards
• Aggression, agitation, or sundowning that the family can't manage
• Needing help with all daily activities - eating, dressing, toileting, bathing
• The primary caregiver is exhausted, unwell, or unable to cope
• The person needs supervision 24 hours a day
• Falls or injuries are becoming frequent

Moving a loved one into professional care is not a failure - it's often the most loving decision a family can make. Read our home care vs facility guide for help making this decision.

Care options for dementia

Browse dementia care facilities in our directory

What to look for in a dementia care facility

Not all care facilities are equipped for dementia. When evaluating options, look for:

• Staff specifically trained in dementia care - ask about their qualifications and ongoing training
• Secure premises - locked or coded gates/doors to prevent wandering
• Low staff-to-resident ratios - dementia care requires more individual attention
• Structured daily routines - consistency helps reduce anxiety and confusion
• Therapeutic activities - music therapy, reminiscence therapy, sensory gardens, gentle exercise
• Adapted environment - clear signage, safe outdoor spaces, calm colours, good lighting
• Person-centred care plans - each resident's history, preferences, and needs are known and respected
• Family involvement - regular updates, family meetings, visiting flexibility

Visit multiple facilities before deciding. Read our facility visiting checklist for a comprehensive list of things to check.

Dementia care costs

Dementia care is typically the most expensive form of residential care because of the specialised staffing, security, and programmes required.

Why it costs more than standard care: higher staff-to-resident ratios (often 1:4 vs 1:8), specialised training requirements, secured premises, and therapeutic programmes all add to the cost.

Read our complete cost guide for a broader comparison across all care types.

Does medical aid cover dementia care?

Unfortunately, most medical aids in South Africa do not cover long-term residential dementia care. Here's what you can typically expect:

• Diagnosis and medication - usually covered under chronic benefits (Alzheimer's is a PMB condition)
• Hospital stays and acute care - covered under hospitalisation benefits
• Short-term frail care (14–90 days/year) - some comprehensive plans cover this
• Long-term residential care - NOT covered by most medical aids
• Day care programmes - rarely covered

Read our medical aid and frail care guide for more detail on what specific schemes offer.

Support organisations

These organisations provide information, support groups, and helplines for families dealing with dementia in South Africa:

Caregiver support and respite care

Caring for someone with dementia is physically and emotionally exhausting. Caregiver burnout is real and common. If you're a family caregiver:

• Join a support group - Dementia SA and Alzheimer's SA run groups across the country
• Use respite care - short-term stays at a facility give you a break (1–4 weeks)
• Consider day care - structured daytime programmes while you work or rest
• Ask for help - share the load with family members, friends, or a professional carer
• Look after yourself - caregiver burnout helps nobody

Browse respite care facilities

Legal considerations

Dementia progressively affects a person's ability to make decisions. It's important to address legal matters as early as possible after diagnosis:

• Power of attorney - appoint someone to manage financial and legal affairs while the person can still consent
• Living will / advance directive - document the person's wishes for future medical care
• Curatorship - if the person can no longer manage their affairs and no power of attorney exists, a family member can apply to the High Court for curatorship (costly and time-consuming)
• Will and estate planning - ensure the will is up to date and reflects current wishes

Consult a lawyer who specialises in elder law as soon as possible after a dementia diagnosis.