Advice and training for carers

Advice and training in the area of care supports care recipients and their loved ones to ensure that the care and support they receive is best suited to their individual needs and requirements.

When people need care, they and their loved ones have many things to organize and important decisions to make – and these often concern very personal matters and encroach on private family routines, roles and habits.

If a person is in need of care, they and/or their family carers need to manage all of the following: 

• Medical and nursing care: coordinating and keeping appointments with doctors and therapists, as well as organizing a care or support service, other care services or care provided by loved ones or volunteers
• Organizing daily care routines: making appointments, arranging home help, procuring medical aids
• Organizing home renovations for greater accessibility
• Finance: claiming benefits from various cost bearers, such as health and long-term care insurance providers and, if relevant, applying for help with care costs
• Ensuring that the needs of carers are met: depending on the carer’s stage of life, arrangements will need to be put in place to allow them to balance their caring role with school, third-level education, vocational training and career and to have downtime to allow them to rest and recuperate

Various financial and practical supports are available. It is difficult for anyone who is not an expert to obtain a clear overview of all the options that are available, which are suitable and what the conditions are for obtaining funding from social insurance providers.

Loved ones of care recipients frequently also lack knowledge of care processes, care techniques and symptoms of medical conditions. Chronic illnesses often also bring additional challenges in terms of care.

People with a recognized need for care and their family carers are therefore entitled to access regular information, advice and training. These should help them avail of the services on offer, based on their individual needs and desire and, where relevant, to organize proper care and support at home. 

These include:

• Care advice (§7a of the Eleventh Book of the German Social Code, SGB XI)
• Home consultation or advice on care (§37 (3) of the Eleventh Book of the German Social Code, SGB XI)
• Care courses and individual home-based training (§45 of the Eleventh Book of the German Social Code, SGB XI)

SGB XI is used in the remainder of this article to refer to the Eleventh Book of the German Social Code, which regulates all benefits of social care insurance. The same benefits and prerequisites apply to people with private long-term care insurance.

Care advice (§7a SGB XI) aims to demonstrate to care recipients and their loved ones how care can be organized, arranged and funded. Care advisors also offer advice in crisis situations and provide loved ones with information about the potential for them to suffer physical and mental strain and how this can be avoided.

The individual's need for support and assistance must be determined first – in other words, how much support is required and at which times of the day is it required? Can and should this care be provided by loved ones? Or is a care service essential? Alternatively, should the care be provided in a residential care facility? Do any other requirements apply, such as specific illnesses? Do the family carers have other obligations, such as a career or responsibility for children under the age of 18, or do they live far away?

Based on the answers to these questions, care advisors provide you with all the information you need and explain how to make the most effective use of the benefits and supports available to you. Topics include:

• Care options to be considered: Care provided by family carers, care and support services, residential care facilities or facilities providing day-time care 
• Options for health promotion, disease prevention, rehabilitation or other medical, nursing and social supports
• Options and service providers in the locality
• Care funding: Which social insurance and rehabilitation benefits are available and how to access them
• Options for self-care and for balancing care with career, education or other family responsibilities (e.g., relief benefits and voluntary services)
• Preparing to take on the role of a carer and the challenges it brings
• Helping care recipients remain as independent as possible through enabling care, accessible building renovations, use of medical aids
• Managing specific health conditions

Care advisers also help you to prepare for your appointment with the Medical Review Board. The Board conducts an inspection to determine whether a person's health impairments justify the assignment of a care grade. The care assessment is a prerequisite for being assigned a care grade and accessing long-term care insurance benefits. Careful preparation increases your chances of being assigned the care grade that corresponds to your care needs.  

The role of a care advisor is to answer any questions relating to the topic of care. Many advice centers, such as care support points, work within regional networks. This means that they can refer you to the right source of information where necessary and suggest alternative services and facilities. 

How does care advice work? 

Care advisors tailor their advice to suit your individual situation. The advice is also provided on an ongoing basis – if you want, they can advise and support you for as long as you have a care need.  

You are always entitled to care advice if your care situation changes, if you apply for a higher care grade or if your long-term care insurance benefits change. Your care advisor will also help you make any necessary adjustments following any changes that impact your care situation. Some advice centers give you the option of receiving care advice in your own home.  

Who is entitled to care advice?  

You are entitled to free advice as soon as you have submitted a claim for long-term care insurance benefits. The costs are covered by the statutory long-term care insurance fund, even if your claim is rejected. 

You will receive an appointment or an advice voucher within two weeks of submitting your first informal application. Loved ones can also seek advice, provided that the person they are caring for agrees.   

Care advice is available from the following sources, for example: 

• care support points
• municipal advice centers
• advisory services provided by welfare associations
• Statutory long-term care insurance funds or, for those with private long-term care insurance, the company compass private pflegeberatung

Contact details for sources of advice near you are available from the Centre for Quality in Care (Zentrum für Qualität in der Pflege, ZQP).

Family carers and volunteer carers rarely have extensive professional knowledge of nursing and medicine. However, nursing care professionals will visit care recipients in their homes at regular intervals to ensure that they are receiving proper care. They provide suggestions for improvement and, if necessary, provide help at an early stage if there are any indications of health issues or crisis situations.

The aims of home consultations (“Beratungsbesuche”) as outlined in (§37 (3) SGB XI) include:

• assessing the care situation and what improvements can be made for care recipients and carers
• providing support, instruction and practical tips relating to care-related topics
• providing information, advice and support options for care recipients and their families
• suggesting further sources of support and funding options, including rehabilitation measures or care in a day-time care facility
• providing information about additional advisory services
• assisting with organizational matters, such as applications for medical aids and other long-term care benefits and relief options

The underlying purpose of health advice is to ensure that care recipients receive proper care and to support their families so that their care recipient can continue to be cared for at home for as long as possible. The details of what is discussed during a home consultation are only passed on to the long-term care insurance fund with the consent of all parties involved.  

If the care advisor comes to the conclusion that the care recipient is not receiving proper care, further advice and support is offered and the long-term care insurance fund is informed. The goal remains to ensure that care and support is planned in such a way that the care recipient can be cared for in their preferred environment. 

Who conducts home consultations?  

Home consultations are carried out by care professionals who have specific knowledge about the care recipient's condition or disability, for example, the effects of strokes, dementia or issues concerning children in need of care. These are generally professional carers working for approved care services or neutral and independent advisory services offering professional expertise in care.

Who is entitled to home consultations?  

Home consultations are free of charge for all people who have been assigned a care grade and are cared for at home. People at all care grades are entitled to a home consultation. 

For people who receive care benefits in kind or who have been assigned care grade 1, home consultations are optional. You are entitled to one visit to your home every six months. Some home consultations can be conducted online.

For more information about home consultations, see the article on the topic of care allowance.

How do you make an appointment for a home consultation?

To arrange for a home consultation, contact a care service directly or, alternatively, an advice center that offers home consultations. Follow-up appointments are usually arranged at the same time.  

You must also be aware of the deadlines for mandatory home visits and contact a provider in plenty of time.  

If no proof of a home visit is submitted, the statutory health insurance fund will issue a reminder letter because, without these home consultations being conducted, the care allowance may be reduced. If this happens repeatedly, the payment may even be stopped.

Care courses and training (§45 SGB XI) provide important knowledge about caring for care recipients. They are aimed at loved ones, volunteer carers and anyone interested in learning about care. 

A wide range of options is available, including professional instruction and training, knowledge transfer and informal exchanges.

Topics include:

• Skills for independent care provision, including special manual handling techniques, hygiene and cleanliness and managing medication
• Clarification of important care-related issues, such as nutrition in older age, prevention, care for specific conditions, (caring for people with dementia, care after a stroke or for people with nervous system disorders)
• Relief of physical and mental strain for family carers, e.g., self-care, lifting and carrying techniques to protect the back, dealing with psychological stress and ways to exchange experiences with other carers
• Legal issues, such as advance healthcare directives and guardianship legislation

Group and individual training courses are available. They may take place in training centers, online or, on request, in your own home. Statutory long-term care insurance funds and private long-term care insurance providers cover the costs of care courses and training. The entitlement is ongoing.

It is also possible to complete care courses and training before becoming a carer in order to ensure that care is well organized from the outset or to prevent the occurrence of health problems. Employees of care advice centers can help you select the course or training that best meets your needs.

How do I apply for a care course?

Public courses, group courses and online courses are open to all interested parties. There is no requirement for you to be caring for a person in need of care or for a care grade to have been assigned.

These courses are offered, for example, by long-term care insurance funds, municipalities, community facilities, associations and welfare/health and advice centers. Information about courses and training in your area is available from your long-term care insurance fund or from care advice/social advice centers. 

Care courses are provided free of charge. 

How can I apply for home-based training?

For home-based individual courses, a care professional will come to your own home and offer you advice and training in relation to any questions or problems you may have in order to help make it easier for you to provide care. The care recipient must grant their approval in writing beforehand.

Topics covered may include preventing falls, incontinence, caring for people with dementia or specific care requirements relating to specific health conditions.

Home-based training is often provided by care advice centers and care services. Applications must be submitted to the care recipient’s long-term care insurance fund.

A wide range of advice options is available in the area of care. The organization and availability of advice centers differ from region to region. For example, publicly funded centers such as care support points are not available in every federal state. In addition, these centers are resourced differently depending on the region.

Advice is also provided by municipalities, Ministries, self-help organizations, social and welfare associations, independent advice centers such as the Independent Patient Advice Service for Germany (Unabhängige Patientenberatung Deutschland, UPD) and private companies. 

Local advice centers can be found using the database of the Center for Quality in Care (Zentrum für Qualität in der Pflege, ZQP).

The Center for Quality in Care has also developed a checklist to help those seeking advice to identify the characteristics of a high-quality advice center.

Where can I find advice about specific subjects?

Some advice centers specialize in specific topics, such as medical aids, home adaptations, managing dementia, guardianship or other legal issues.  

Centers offering advice on aids and equipment

Advice on aids and equipment is available from care services and Medical Review Board assessors, as well as from social associations and welfare associations. Advice focusing on specific health conditions, e.g., medical aids for visual impairment or for neurological or muscular conditions is also available. This type of advice is generally offered by the relevant self-help organizations.  

Advice centers for home adaptations

Accessible renovations or adaptations of a living space can help enable independent living and facilitate care. 

For more information and details of advice centers, refer to the National Association for Home Renovation (Bundesarbeitsgemeinschaft Wohnungsanpassung e.V.). 

 Advice on social law

This type of advice supports you with any legal problems you may encounter, such as a rejected claim for entitlements. Advice centers can support you in lodging an objection or a complaint where relevant. Legal advice can only be provided by an approved lawyer. 

Advice on social law is provided, for example, by social and welfare associations and self-help organizations, consumer advice centers and the Independent Patient Advice Service for Germany (UPD). 

The Ministry of Family Affairs care hotline

The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ) operates a care hotline providing individual advice to family carers about how to organize and finance care at home, support and assistance options as well as local services. 

Telephone: 030 20 17 91 31 
E-Mail: info@wege-zur-pflege.de 
Website: www.wege-zur-pflege.de 

Public hotline for long-term care insurance 

The public hotline for long-term care insurance operated by the Federal Ministry of Health provides general information about questions relating to statutory long-term care insurance. 

Telephone: 030 340 60 66 02
Website: www.bundesgesundheitsministerium.de/service/buergertelefon.html