My MIL was diagnosed with vascular dementia 2017 although symptoms have been developing since around 2011 but both she and my FIL avoided any discussion for years explaining her behaviour as depression following the death of her sister with Alzheimer’s. She became obsessed with walking ( nowhere in particular for hours on end ) until incontinence prevented this but she “imagined” a bad back and used this to explain stopping walking . The last two years have shown such changes in behaviour - insensitivity, rudeness , antisocial , eating only sweet foods ( size 12 - size 16 ) when previously very healthy and argumentative and aggressive behaviour. She is in a CH with a dementia unit following an emergency at Christmas and my FIL being unable to cope . The CH have been great so far but my MIL and her behaviour less so . Her medication is being monitored but she is still aggressive and it is getting worse . Social services have telephoned four times to discuss her behaviour/ CH. it has been suggested she may need a NH instead . Currently self funded but NH would be paid for ? Who decides ? What level of challenging behaviour is not acceptable to a CH but is acceptable in a NH ?