Care of relatives

According to §14 SGB XI, "in need of care" is defined as people who: 

• due to physical, mental or psychological illnesses or disabilities 
• require a considerable or higher degree of assistance for the usual or regularly recurring activities of daily living 
• on a permanent basis, probably for at least six months.

If you or a relative meet these conditions, you are entitled to benefits from long-term care insurance. The amount of long-term care insurance benefits is determined by the degree of need for long-term care. There are five degrees of care dependency, which require different levels of benefits in kind or cash benefits.

There are additional entitlements for people who have been identified as having limited everyday competence. This may be the case, for example, if the applicant endangers themselves or others through misjudgements or aggressive behavior or is severely disoriented, both in a temporal and spatial sense. Dementia patients can therefore also apply for care services.

You can find more information on care rates in our family brochure. The brochure is available from the Family Service and for download.

FURTHER INFORMATION:

Care fund of your responsible social welfare office, social welfare centers, welfare associations, tax office
Info phone: 
(01805) 99 66 03
Internet:
www.pflege-deutschland.de
www.bmfsfj.de, help and care

1.  Contact your health insurance fund. The long-term care insurance fund is part of your health insurance fund. To submit the application on behalf of your relative, you need their written authorization. If you can already estimate at this point whether you want to care for your relative at home or have them cared for in a nursing home, let the long-term care insurance fund know when you submit your application.
2. The care/health insurance fund commissions the MDK (Medical Service of the Health Insurance Fund) to assess your relative to determine the care level. The MDK will then carry out the examination to determine which care level the person in need of care will be assigned to. The assessment takes place on site during a home visit. The person in need of care must give their consent; if this is refused, the care insurance fund can refuse to pay benefits. The MDK's assessment is standardized. Recommendations are also made as to what can be done to prevent a worsening of the need for care or what can be done for rehabilitation. It also assesses whether sufficient home care can be provided. To best prepare for the MDK visit, attend one of the free seminars offered by the Family Service at Trier University of Applied Sciences or make an appointment for a consultation.
3. Keep a care diary in which you list the activities for which your relative needed help (washing, dressing, eating) and note how much time this took. Show this diary to the MDK. 
4. Be present at the assessment by the MDK.
5. Try to assess whether you can provide long-term care alone at home or whether you need support from outpatient services. Let your care insurance company know and ask for a cost comparison of the various local providers.
6. If care at home is not possible, the care insurance fund will inform you about suitable care facilities in your area. Ask for a cost comparison of the various facilities. Visit the facilities and observe how other patients are treated there.

If you are privately insured under a private compulsory long-term care insurance policy, the benefits in kind will be replaced by a reimbursement of costs in the amount of the statutory compulsory insurance benefits. In the case of inpatient care, long-term care insurance covers the costs of care, medical treatment and social care, but again in monthly lump sums according to the level of care.

You can find more information on care rates in our family brochure. The brochure is available from the Family Service and for download.

FURTHER INFORMATION

Care fund of your responsible social welfare office, social welfare centers, welfare associations, tax office
Info phone: 
(01805) 99 66 03
Internet:
www.pflege-deutschland.de
www.bmfsfj.de, help and care

 §1601 of the German Civil Code provides for a maintenance obligation for relatives in a direct line. This means that parents are obliged to support their children, but conversely, children must also support their parents.

Parents in need of care initially pay the care costs incurred from their own income. This means that the parents must use up all their own assets (apart from a "protective asset" of €2,000 - €2,500). If only one spouse is accommodated in the home and the other still lives in their own home, special rules apply. If the parents have previously given away their assets and this gift was made no more than ten years ago, this gift must - if possible - be reclaimed.

If the parents' own income and assets are not sufficient to cover the care costs, the parents can apply for support from the social welfare office. This office will first check the children's ability to pay. If it is determined that the children are financially able to support their parents, the parents' maintenance entitlement is calculated according to their current living requirements. In the case of a stay in a home, for example, this is made up of uncovered home costs and pocket money (at least €100 per month). These costs are borne by the children on a pro rata basis according to their respective income. You can find out exactly how the maintenance claim is calculated and how the children's ability to pay is determined from your local social welfare office.

If this is still not enough to cover the care costs, there are two financial aids available from the state. The first is basic security in old age. This is not linked to a need for care and can be claimed by anyone who has reached the age of 65 and is no longer employed. The second benefit that can be claimed is social assistance for people in need of long-term care. 

Social Welfare for people in need of care

Long-term care insurance can only provide basic cover. If the case arises that the care costs are not covered by this basic cover (not by the assets of the person in need of care and also not or only partially by dependent or capable relatives, such as a spouse or biological children), social welfare will cover the remaining costs for both inpatient and outpatient care.

If the person in need of care lives in a care home, social welfare also covers the costs of accommodation and meals as well as the investment costs of the care home, which are not covered by care insurance. A monthly cash amount is transferred for everyday needs that are not provided by the care home.

You can obtain further information on these topics from your local social welfare office.

Your first point of contact on the subject of "long-term care" should be your long-term care insurance fund (part of your health insurance fund).

However, since the 2009 care reform, all citizens have been legally entitled to advice. This was taken into account by the creation of care support centers. They are contact points only for those with statutory insurance. Privately insured persons can contact the private care advice service COMPASS.

At all care support centers, you will be advised by specialists who can give you detailed information about social law, care law, care and the services offered by the care insurance funds. At your request, these consultations can also take place in your home.If your relative receives care allowance, you will receive a home care consultation once every six months for care levels I + II and once every three months for care level III. The purpose of this is to ensure the quality of care at home, to receive practical advice and help with problems. These services are offered by the care services and, since 2008, people who are not yet registered in any care level can also take advantage of this service.

If you decide that you no longer wish to care for your relative at home, you can obtain information from your care insurance fund or care support center about the facilities in your area.

In order to find out about the performance and quality of the facilities, there is a quality report for each individual care facility, which you can view on the Internet. On the website of the Rhineland-Palatinate Consumer Advice Center, you will find various links to health insurance companies and other institutions that publish quality reports on their websites. You can there select a page where you can view the quality report by entering the address of the nursing home

There is the option of partial inpatient care. This means that the person in need of care can, for example, stay at home during the day and be cared for in a care facility at night. The reverse is just as conceivable, or the possibility that the person in need of care only attends day care for a certain number of days a week.

It is also possible to combine care allowance, care benefits in kind and semi-residential care. For more information, please contact your local care support center or the Family Service of Trier University of Applied Sciences.

As a home carer, i.e. if you take on the care of your relative(s) yourself and you look after them for at least 14 hours a week on a non-professional basis, you are covered by statutory accident insurance.

For carers who are unable to work more than 30 hours per week due to providing at least 14 hours of care per week in their home environment, the long-term care insurance pays contributions to statutory pension and social insurance.

FAMILY SERVICE OF THE UNIVERSITY OF TRIER
Birkenfeld site 
P.O. Box 1380 
55761 Birkenfeld 
Building 9925
We offer consultations at all locations! Please feel free to make an appointment with us:
Tel.: 06782/17 - 1913 (secretary's office)
gsb.beratung(at)hochschule-trier.de

The social services available for people in need of care include social care centers and private care services. They are facilities run by private or public organizations that provide nursing care and care for the elderly, as well as home and family care in people's own homes.

The costs for this can be covered by health insurance, long-term care insurance or the social welfare office under various conditions.

Whether you opt for a private care service or care provided by a social care center should not be decided solely on the basis of cost comparisons.

The following are important:

• Quality and range of services
• Accessibility
• First impression of competence
• Friendliness and reliability of employeesWhen choosing the right provider, it can be beneficial to ask your friends and acquaintances about their experiences with local care services.

Your health insurance company can also provide you with advice. However, it is important to remember that you must take action yourself as soon as you need care support.

On the website mentioned below you will find a list of questions that can help you to find the right provider for you.

Further services:

• Mobile therapies: carried out at home by specialists under medical supervision, they serve to prevent a worsening of the need for care
• Meal services
• Driving and escort services
• Cleaning services
• Repair and laundry services

FURTHER INFORMATION

www.medizinfo.de, care services

If you, as the carer, are unable to provide care due to illness or for other reasons, you can apply for respite care from your health insurance provider.

This substitute care can be provided on an inpatient or outpatient basis, by private care services or by friends who have agreed to do so. The decision is at your discretion. The care insurance fund will cover the costs, even if a friend is caring for the person requiring care. The care insurance fund will reimburse your expenses for this service (please discuss this with the care insurance fund in advance to ensure that you meet all the formal requirements for reimbursement).

You are entitled to a maximum of 42 calendar days of respite care per year and can be granted an allowance of €1,612. However, you do not necessarily have to take advantage of these four weeks at a time, but can even apply for them on an hourly basis. The prerequisite is that you have a care level (at least 0 with limited everyday competence) and that you have been providing uninterrupted care for six months.

During your leave or illness, your pension insurance contributions will continue to be paid by the long-term care insurance fund. Your other social security contributions will also continue to be paid.

Short-term care

Short-term care is the temporary placement of people in need of care in inpatient care. You are entitled to 28 days of short-term care per year, which is also subsidized with €1,612. However, it can also be doubled by up to €1,612 to €3,224 by offsetting it against the benefit amount due for respite care if respite care has not yet been claimed.

Short-term care can be applied for following inpatient treatment, for example, if regular care is not yet assured. It can also be used to take a vacation and recover from everyday care.

However, the difference is that short-term care can only be provided on an inpatient basis in a retirement home. There is also no time limit for short-term care (respite care is only permitted after an uninterrupted care period of six months); you can apply for it directly. Another common feature of respite care is that you can freely choose the period of substitute care.

You are therefore entitled to a total of eight weeks of substitute care, but please note the different requirements for short-term care and respite care in order to find the most suitable one for your current situation.

You can obtain further information on this topic from your health insurance company.

Relatives have the option of taking up to ten working days off work in order to organize needs-based care in an acute care situation or to ensure nursing care during this time. A wage replacement benefit, the care support allowance, is provided for this period.

This can be applied for from the relative's care insurance provider. This right applies to all employers, regardless of the size of the company. However, an acute care situation does not mean caring for a close relative due to illness. In order to be eligible for up to 10 days' leave and the care support allowance, the close relative must meet the requirements of a need for care as defined in §§ 14 and 15 SGB XI.

The mere possibility of a need for care is not sufficient. What is required are facts that indicate that the need for care is predominantly likely to occur.

FURTHER INFORMATION
Internet:
www.pflege-deutschland.de
www.bmfsfj.de, help and care

 Since 01.01.2015, new legal regulations have been in force in the care sector.

Legal entitlement to full or partial leave of absence for up to 6 monthsEmployees still have the opportunity to take up to six months of full or partial leave from work to care for a close relative in need of care with at least care level I at home. A new option is to apply for an interest-free loan from the Federal Office of Family Affairs and Civil Society Functions for this period in order to cushion the loss of income during this time.

There is no legal entitlement for employers with 15 or fewer employees. The interest-free loan is applied for by employees directly from the Federal Office of Family Affairs and Civil Society Functions (BAFzA) and must be repaid in installments after the end of the care period. This also includes a hardship provision. Upon application, the BAFzA can defer repayment of the loan in order to avoid particular hardship for the employee. In addition, there is the possibility of partial loan forgiveness or the loan debt being canceled.

For more information on caring for close relatives who are minors in need of care, on leave of absence to accompany a close relative in the last months of life and on partial leave of absence for up to 24 months, see pages 70 to 71 of our family brochure.

The brochure is available from the Family Service and can be downloaded here.

FURTHER INFORMATION
Internet:
www.pflege-deutschland.de

www.bmfsfj.de, help and care
 

The Family Service at Trier University of Applied Sciences organizes annual seminars on the topic of care.

The topics are practice-oriented and are intended to help employees and students prepare for situations with relatives in need of care. As participants have the opportunity to ask questions about specific situations, these seminars are also of interest to employees and students who already provide care services for relatives.

Previous seminars have covered the correct application for care levels, the various options for using care support, living wills and health care proxies as well as maintenance claims against children of care patients.The seminars are free of charge for all university members. Depending on the topic, they last between half a day and a full working day and are led by nursing professionals.The seminars usually take place at the two locations Trier and Environmental Campus Birkenfeld.

You will be informed of the exact dates by e-mail and on our "News and Events" page.

FURTHER INFORMATION
Family Services 
Birkenfeld site 
P.O. Box 1380 
55761 Birkenfeld 
Building 9925

We offer consultations at all locations! Please feel free to make an appointment with us:

Tel.: 06782/17 - 1913 (secretary's office)
gsb.beratung(at)hochschule-trier.de

Your care insurance fund offers care courses that take place in cooperation with various organizations, e.g. independent welfare services, adult education centres, neighbourhood help or educational associations. The courses cover the correct application of care techniques, for example the correct positioning of the person in need of care or changing dressings, as well as information on all aspects of care, advice and support.

These courses also offer the opportunity to exchange ideas with other sufferers and make contacts.

Further information from your health insurance company or your local care support center