Objective To investigate the challenges and needs of caregivers in long-term care for dementia patients. Methods From November 10 to December 8, 2025, a questionnaire was distributed to caregivers of dementia patients via the WeChat (Wenjuanxing). Data collected including demographics, disease characteristics, caregiving status, and the challenges and needs of caregivers in long-term care. Logistic regression analysis was performed to identify factors associated with caregivers' demand for respite services. Results A total of 410 questionnaires were returned, of which 401 (97.8%) were valid. Among the 401 caregivers, 267 (66.6%) were female, with a mean age of 51.5±12.9 years. Assistance with activities of daily living was the most energy-consuming task (164 cases, 40.9%), communication barriers were the greatest difficulty (112 cases, 27.9%), and economic burden resulted in the significant impact on caregivers (242 cases, 60.3%). Respite care was the most frequently requested service (249 cases, 62.1%). Multivariate logistic regression showed that male caregivers (OR=2.201, 95% CI: 1.328-3.649), part-time caregiving status (OR=2.012, 95% CI: 1.071-3.778), caring for patients with severe dementia (OR=1.626, 95% CI: 1.111-2.379), and the duration >5 years since diagnosis (OR=1.363, 95% CI: 1.059-1.755) were significant associated with higher demand for respite services. Conclusion The challenges of long-term care for dementia patients encompass heavy daily care tasks, communication barriers, and substantial economic burden, and the most urgent need is respite care. Caregivers who are male, provide part-time care, or care for patients with severe dementia over an extended period exhibit the greatest need for respite services and warrant special attention.