Suddenly in need of care: And now?

Day X has come: Mother, father or partner can no longer cope alone. Support is needed - and quickly. In order to quickly get your everyday life back on track, it can help if you draw up a small checklist. This way you won't forget which offices you should definitely call, which deadlines need to be observed and whether you need to have special documents ready. In addition, you can free up the time you need for organising. The law gives you a few options for this. In addition, you are giving away money if you wait too long to apply for a care degree. Because with a care degree, your relative is entitled to benefits from the care insurance fund. From care level 2, they are entitled to care allowance and/or care benefits in kind, which are provided by an outpatient care service, for example. If, for example, only temporary care is needed after a stay in hospital, home nursing care in the sense of hospital avoidance care [1] is called for. This is also possible without classification into a care degree.

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I. Keep calm!

Even if the situation is very emotional and stressful, a lot needs to be thought about and events are happening all the time - the grass doesn't grow any faster just because you pull on it. Take the time to stop for a moment and make a list. Write down when you will call whom, the telephone number - and in short words what you would like to clarify with them.

II. talk to your employer.

If you cannot organise care for your relative on the side, you are allowed to take ten days off. During this period, you will receive the so-called care support allowance [2] - normally this is about 90 percent of your normal salary. You have to apply for this money from your long-term care insurance fund or your private long-term care insurance company. If your employer requires it, you have to submit a medical certificate confirming the need for care of your relative and justifying your absence from work. You have to pay for this certificate yourself.

III Describe the care needs in your own words

Make a note of the limitations of your relative and think directly about what you can and want to do yourself in the future - and what you don't want to do. If you are clear about what external help is needed, you can make more targeted calls to care insurance companies, counselling centres and service providers and ask more specific questions.

IV. Register with the competent long-term care insurance fund.

Contact the competent long-term care insurance fund, if your relative cannot do this himself/herself. You can do this by telephone - but you must bear in mind that this call will be recorded as a date when it comes to receiving benefits. If a care degree is granted, your relative is entitled to the relief amount and possibly also care allowance or care benefits in kind. The entire month in which the application was made is taken into account. In order to have proof, it is better to additionally apply to the long-term care insurance fund in writing.

V. Temporary inpatient accommodation?

You basically want to care for your relative at home or have them cared for - but after the unexpected stroke or the sudden deterioration of their health condition, you can't manage to organise everything ad hoc? If you need some breathing space, short-term care (see below) is a way of temporarily caring for your relative as an inpatient, provided he or she has already been certified as having at least care level 2 in hospital. Especially if everything has to be turned around at home without any warning after such a hospital stay, this temporary inpatient accommodation gives you some breathing space. If you want to take over the care yourself in the future, you can also take time off. This can be done by means of preventive care (see below).

VI. contact a care support centre.

Even if the long-term care insurance fund has to offer you advice: Call a care support centre. There are competent people there who know their way around your region. This way you can quickly get important information about support services in your neighbourhood. Lists of inpatient facilities for people in need of care are also available there.

VII. gather important documents.

Doctor's reports, discharge letters from the hospital, disability certificate - you should have everything at hand that has something to do with the need for care and a possible course of illness of your relative. It makes sense to telephone the family doctor in charge. However, your relative must also agree to you talking to the doctor. This will help you to speed up the process of being assigned a care level (EINSTUFUNG INEINEN PFLEGEGRAD). The employee of the Medical Service of the Health Insurance (MDK) gets a quick overview and you do not have to submit anything later.

VIII Contact a care service.

If your relative has been discharged from hospital and now needs immediate, but only temporary, medical care, look for an outpatient care service. Home care in the sense of short-term or hospital avoidance care is prescribed by the doctor and is initially possible for a certain period of time regardless of the classification into a care degree.

IX. What does it all cost?

Find out what costs you or your relative might have to pay in your particular case and how much money you can expect from the long-term care insurance fund. So that you do not have to spend sleepless nights, it is best to get help from experts. Advice on this is also available at the care support centres. They can also give you tips on special subsidies - for example, for age-appropriate renovations. You can get an initial overview of the benefits your relative is entitled to from the long-term care insurance fund using the long-term care benefits helper [3].

X. The private compulsory long-term care insurance.

The private compulsory long-term care insurance offers long-term care counselling through the company "COMPASS Private Pflegeberatung" [4]. The counselling is provided by care counsellors at your home, in an inpatient care facility, in hospital or in a rehabilitation facility.

Get some breathing space: Preventive care and short-term care

Do you have to make preparations at home before your relative can be adequately accommodated in his or her own four walls after a stay in hospital? Do you need to take a break from caring for your loved one later on? Are you temporarily out of action yourself because you are ill? Or then you can make use of preventive or short-term care - or combine both. Short-term care is generally provided in an inpatient care facility, while preventive care can be provided at home. However, because the conditions are different and the duration is limited in each case, it is worth taking a closer look at the entitlement. The prerequisite is that you have already been caring for your relative for at least six months. With care degree 1, you can only use the relief amount.

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Entitlement to short-term and preventive care

From care level 2, there is an entitlement to 1,612 euros per calendar year for short-term care and also for preventive care. The benefits for preventive care can be completely offset against short-term care. This means that a maximum of 3,224 euros per calendar year is available for short-term care (maximum eight weeks). However, the money for preventive care is then gone. During this time, only half of the care allowance is paid.

On the other hand, 50 percent of the entitlement to short-term care benefits (i.e. half of 1,612 euros = 806 euros per calendar year) can additionally be transferred to preventive care (maximum six weeks per year). This means that a maximum of 2,418 euros per calendar year is available for preventive care, and only 806 euros for short-term care. Even during the period of preventive care, only half of the care allowance is paid.

What does preventive care cost?

The bottom line is that it depends on what exactly you do for your loved one every day - and whether everything you do is absolutely necessary. If you mean well, you may be doing much more than is really needed. Therefore, you should be clear about which activities really have to be done during your absence and which things can be left out for a while or done less frequently. To put it bluntly: Your relative should of course be properly dressed and physically well-groomed, he should eat and drink properly and not be lonely. But do you really have to wet the hallway every day? Or whether the window sills should be dusted every two days while you are away?

Tip

Hourly substitute care of less than eight hours a day in the sense of preventive care saves money. Because: As soon as the daily need for substitute care falls below eight hours, the care allowance is also paid in full during the preventive care. Of course, you cannot go on holiday then. But if, for example, you want to go out or have to go to the doctor yourself, you can make use of this hourly substitute care.

Calculating is the order of the day

Ask yourself and your relative what they can do without for a while. Then you will be able to better estimate how much money the long-term care insurance fund will cover for preventive care. However, it is not automatically clear how much you have available. In principle, 1,612 euros per calendar year from care level 2 are available for a maximum of six weeks for preventive care. However, this is very simplified. On the one hand, up to 50 percent of the budget for short-term care can be used additionally. On the other hand, it also plays a role whether you hire a professional service provider, such as an outpatient care service, or whether another private person fills in for you.

You know?

Pension and unemployment insurance contributions continue to be paid by the long-term care insurance fund during preventive care. In this way, the pension entitlement is maintained without reductions and the unemployment insurance protection is preserved. 

Who steps in: care service or private person?

If you want everything to continue as usual at home with your relative, a professional service provider can temporarily take over your tasks within the framework of preventive care. As a kind of "holiday or sickness replacement", an outpatient care service is a good choice especially if someone already comes to the house to support you with treatment care, for example. In this case, your relative also knows the staff and vice versa. Care services usually give you an estimate and keep an eye on the budget.

If, instead of a professional service provider, another private person from your immediate environment stands in for you, the situation is different. In this case, 1.5 times the amount of the care allowance is the upper limit for the benefits paid by the long-term care insurance fund. Assuming that your relative with care level 3 has 545 euros per month at his or her disposal, the maximum amount that can be paid for preventive care is 817.50 euros. Unless additional costs, for example due to a longer journey, can be proven. In that case, the amount can be increased to 1,612 euros. In addition to preventive care, you can also use up to 50 per cent from the short-term care pot for preventive care - whereby the entitlement to short-term care is reduced accordingly.

Conclusion

Everything can be regulated step by step. The bottom line, however, is that the calculations for preventive care are somewhat complicated. In any case, keep in mind that the care allowance is halved as soon as the daily substitute care or your unavailability exceeds eight hours. And be aware that additional costs of more than 1,612 euros or more than the amount you are entitled to in the case of care by a private person must either be paid by you privately or can be deducted from the short-term care budget. Get advice from experts - either at a care support centre, or ask the care service if one is already involved in your daily routine. Make an honest note of your actual needs, then you can discuss realistically when and which help should come into your home instead of you.

Sources & Notes

[1] https://www.bundesgesundheitsministerium.de/haushaltshilfe.html
[2] https://www.wege-zur-pflege.de/themen/auszeit-im-akutfall.html
[3] https://www.bundesgesundheitsministerium.de/service/pflegeleistungs-helfer.html
[4] https://www.compass-pflegeberatung.de/
https://www.wege-zur-pflege.de/themen/auszeit-im-akutfall.html

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