Attendance Allowance in hospital and care homes: the 28-day rule explained

Two different questions hide under this heading, and mixing them up costs families money in both directions: can you get Attendance Allowance in a care home? and what happens to payments during a hospital stay? Here are both, with the 28-day rule that runs through everything.

Care homes: it depends who pays

If the council later starts funding the placement, payment stops after the 28-day rule below; if you later become self-funding, it can start again. Tell the DWP whenever the funding picture changes.

Hospital: payment pauses at 28 days

Attendance Allowance keeps being paid for the first 28 days of an NHS hospital stay, then pauses. It restarts from the day you come home. The same 28-day clock applies to care home stays funded by the council or NHS.

The linked-stays rule - the one that surprises people

Separate stays less than 28 days apart count as one stay. Ten days in hospital, three weeks at home, then twelve more days in hospital adds up to 22 days on the same clock - not two fresh starts. And days move with you: someone transferred from 20 days in hospital straight into a council-funded home has 8 days of payment left, not 28.

What to do practically

• Report stays on 0800 731 0122 (the number the form's own declaration points to) - unreported stays create overpayments that get clawed back later.
• Do not cancel the claim for a hospital stay - it pauses and resumes; cancelling throws away the award.
• Claiming FROM hospital or a care home: the form asks about current stays (questions 47 and 48) - you can still claim, the answers just decide when payment can start.
• Carers, note the knock-on: if the cared-for person's Attendance Allowance pauses past 28 days, a Carer's Allowance linked to it is affected too - do the household sums before and after long stays.

Scotland

Pension Age Disability Payment follows the same idea - care home stays funded publicly affect payment, self-funders can be paid, and stays get reported to Social Security Scotland on 0800 182 2222.

The form asks about this before you are ever paid

Two questions near the end of the AA1 exist purely for these rules. Question 47 asks whether you are in a hospital or care home NOW - since when, at what address, and who funds it. Question 48 asks whether you have come out of one within the last 6 weeks. Answer them precisely, with dates, because they set the payment position from day one; a claim made from inside a hospital is perfectly valid (entitlement can be established), it simply cannot be PAID until discharge if the stay has passed the 28-day mark. If you are claiming for a parent currently on a ward, do not wait for discharge to claim - the claim-date rules apply from the ward exactly as from the kitchen table.

Self-funders: the exception worth thousands

Gov.uk's rule is stated in one line: you can still get Attendance Allowance if you pay for all your care home costs yourself. At the higher rate that is £5,959.20 a year continuing to arrive through a placement the family is funding - and it is missed constantly, usually because everyone assumes "care home means benefits stop", or because the claim was never made in the first place ("she is looked after now, what would it be for?"). The answer: the benefit follows the care needs, and the care needs are precisely why the home was chosen. If your relative funds their own placement and has never claimed, a claim is likely still worth making now - the claiming guide applies unchanged, and question 47 simply records the position honestly.

The 28-day clock, in practice

For NHS hospital stays (and local-authority-funded residential care), payment continues for the first 28 days and pauses from day 29. The entitlement itself does not die - payment starts again when you come home. The practical load falls on whoever manages the letters: tell the DWP the admission date, and then - the call families forget - tell them the discharge date, so payment resumes promptly. Both calls go to 0800 731 0122. Keep a note of the dates yourself; hospital paperwork rarely thinks about benefits, and the person who knows the exact dates is you.

Linked stays: one worked example

The 28 days are not counted per admission. Stays separated by 28 days or fewer at home link together and their days add up. So: three weeks on a ward (21 days), ten days at home, then two more weeks admitted - the second stay starts at day 22 of the count, and payment pauses a week into it. But a full month at home between admissions resets the clock, and each stay counts from zero. For conditions with revolving-door admissions - heart failure and COPD winters are the classic patterns - this rule decides real money, and it is worth diarising home-days between admissions for exactly that reason.

Respite counts too - by who pays, not by the label

Respite stays trip the same wire. A fortnight of respite arranged and funded by the council is a stay in local-authority-funded care - it counts toward the 28 days, and linked respite fortnights can add up across a season. Respite the family books and pays for privately sits on the self-funder side of the line. The test is never the word "respite" - it is who pays for the bed. When planning regular respite, count the year's pattern against the linking rule before assuming payment is unaffected.

The carer's position moves with yours

Where a carer's entitlements are built on caring for you, a long stay ripples outward - the caring hours change and the qualifying benefit pauses, so the household's other claims may need a look at the same time. Check both positions together as a stay approaches four weeks rather than letting each letter arrive as a surprise; the moving parts on the carer's side are set out in Carer's Allowance and Attendance Allowance, and the wider money picture in the Pension Credit guide.

What does NOT affect payment

The stay rules reach exactly as far as hospitals and funded care homes, and no further. Living in your own home with any amount of care - family, private carers morning and evening, live-in help you pay for - leaves Attendance Allowance completely untouched, because the benefit has no means test and no rule against buying help. Day services, lunch clubs and day-centre attendance change nothing. Outpatient appointments, day surgery and A&E visits that end the same day are not stays at all. The clock in this guide starts only when there is an admission - a bed, overnight, in an NHS hospital or a funded care home placement.

An admission checklist for families

• On admission: note the date, and tell the DWP on 0800 731 0122 if the stay looks like passing 28 days.
• During: keep the care needs diary going - what the ward is helping with daily is a preview of the needs coming home.
• On discharge: ring again with the date so payment resumes; ask for the discharge summary and keep a copy.
• After: if the stay left needs higher than the current award reflects - nights now broken, supervision now constant - the award can be looked at again, and the rate guide shows what the higher rate requires. If a new claim is being made within 6 weeks of discharge, question 48 expects the stay's details.

Why the rule exists at all

The logic is unglamorous but consistent: Attendance Allowance pays toward care needs that you (or your family) otherwise carry. During an NHS admission, the state is already providing round-the-clock care; in a council-funded placement, public money is already buying it. The benefit pauses so the same care is not funded twice. The self-funder exception follows the same logic in mirror: when the placement is bought with your own money, nothing is double-funded, so the benefit - designed for exactly such costs - keeps flowing. Seen this way, the who-pays test stops feeling arbitrary and starts being predictable, which is what a family planning respite or a long admission actually needs.

And a note for the long view: a stay often marks the moment needs step up permanently. If the pre-admission award was the lower rate and the post-discharge nights no longer match it, do not let the old award quietly continue out of relief that it survived the stay - the higher rate test exists for exactly this turning point.

Keep this page's dates with the award letter, and the rules stop being surprises: 28 days, 28-day gaps, and the who-pays test are the whole machine.

Common questions