Servizio Comunitario di Informazione in materia di Ricerca e Sviluppo - CORDIS

Documentation of services for reintegration of the aged in Germany

The result (Del 10) provides on overview on the development of home-based, semi-residential and residential care facilities in Germany since the introduction of the long-term care insurance in 1995/96. Moreover it gives information on the social care and counselling offers established by the municipalities. As context information figures on demographic change in Germany, the pension system and the economic situation of the pensioners as well as the regulations of the long-term care insurance defined by law are discussed. The evaluation is based on a wide range of statistics and interviews with high-ranking experts.

In the course of the evaluation statistics on the availability and use of service offers, user structures and costs for the users, situation of the staff, strengths, obstacles and future developments are considered. The findings reveal an expansion, modernisation and diversification of all types of care facilities. Despite this, a range of difficulties were found. One difficulty concerns the issue of access to different types of formal care offers. The orientation of the long-term care insurance towards basic funding of care services only, limits the use of services.

This applies in particular to the members of the lower socio-economic classes and results in lower take-up rates. In addition, regional inequality can be found with regard to the social services provided by the municipalities. The service offer is voluntary for the municipalities and thus in economically poor regions and in the country side the service offers are less developed. Quality problems apply to the fragmentation between home-based care and the local offers, hospital and ambulant care and different counselling offers. The semi-residential care offers, e.g. short-term care facilities, are not sufficiently oriented towards rehabilitation of the care-dependent elderly and counselling of the relatives.

There are no adequate service offers for elderly with dementia illness or further psychological difficulties respectively for unburdening of their relatives. Due to the lack of an adequate home-based care an increasing nursing home admission can be stated. A final problem applies to the financial basis of the long-term care insurance.

The introduction of two separate branches, i.e. a social long-term care insurance which covers 90% of the population and a private long-term care insurance which covers the 10% more wealthy inhabitants results in a difficult financial situation. For the social long-term care insurance the expenditure exceeds the income (insurance contributions), while the private insurances use their surplus to build up big financial reserves.

The report provides a lot of information on the quantitative and qualitative development of different types of care services or care facilities in Germany. It can be used by national and international researchers within the area of elderly care, but also by social politicians and experts within service provider associations. It is already used by social politicians, or high-ranking experts within the care insurance or associations in Germany and other European countries, e.g. Italy, Spain. Further it is already read and discussed by researchers in Germany and other European countries.

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