Care Residential options for people with a need for care or support

Our home is an important part of life. To compensate for limitations and disabilities and enable a self-determined life, elderly people with disabilities often require personal support and, above all, accessible homes.

There are various options open to them:

• Their own home with support from care and support services or personal assistants 
• Their own home, which has been modified or renovated to be fully accessible
• Supported living or serviced living
• Supported group homes
• Multi-generational living 
• Inpatient facilities

The decisive factor in determining the most suitable housing situation is not your illness or disability but the level of support you need, your lifestyle and how much you value your independence and privacy. Ultimately, the decision also depends on which options are available and affordable.

Private homes, multi-generational projects and group homes have the advantage that couples and families can live in them. Furthermore, life in such homes is more self-determined than in residential and care homes where residents are tied to certain processes, for example specific mealtimes.

Specialized residential options 

Some facilities have special residential options, for example for elderly people with disabilities, people with dementia, mental disorders or substance addictions or people in need of artificial ventilation.

The more specialized the facility needs to be, the fewer providers there are. You should therefore obtain information at an early stage and add yourself to waiting lists. Places are not usually available last minute.

There are various residential options for elderly people – both with and without care services. The quality assessment provided by the communal living association FORUM Gemeinschaftliches Wohnen e. V. Bundesvereinigung helps people find a suitable option.

If you are not or no longer able to manage on your own in your own apartment or house or relatives are unable to provide sufficient support, there are various options that will enable you to keep living there. 

Accessible homes 

It can sometimes help to redesign or renovate homes to enable people to move around and look after themselves independently. Measures for making homes accessible can be financed with benefits from statutory care insurance, participation services or funding programs.  

Information on renovations, aids and finance options can be found in the article Accessible living. 

Digital assistance systems and aids  

(Digital) aids and assistance systems can make everyday life easier for people with health issues. Examples include shower and commode chairs, rails and grip aids as well as digital medication dispensers, home emergency call systems and smoke detectors with a stove switch-off function. Under certain conditions, the costs are covered by long-term care insurance providers. 

Further information on digital products can be obtained in the article on the digitalization of care. 

Care and support services and personal assistants 

Care and support services assist you with all activities where you require support, for example help with personal hygiene, getting dressed and undressed, preparing meals, grocery shopping, doing housework and with leisure activities. Treatment care, for example administering medication and changing bandages, must only be provided by people with nursing qualifications. 

People with a care level can use care benefits in kind, nursing care allowance and the additional relief allowance to finance care and support services. 

Personal assistants help people with disabilities – including around the clock where necessary. They are financed by participation services.

Further information on personal assistants and the requirements that have to be fulfilled can be obtained from Aktion Mensch e.V.

Voluntary support 

In addition to the above, voluntary and neighborly helpers can provide support with more minor activities, for example buying groceries, accompanying people to medical appointments or providing companionship.

The hourly work provided by neighbors can be financed by the nursing care allowance and, under certain conditions, additional relief.

Supported or serviced living means that people live independently in their own home and can obtain assistance when required. This option is suitable for people who cannot or do not want to remain living in their own home but who value living as independently as possible and having a great deal of privacy. 

Additional support services can include the following: 

• Meal and grocery shopping services 
• Home emergency call system 
• Janitorial services  
• Cleaning services 
• Laundry services 
• Provision of care services 

However, supported or serviced living does not provide all-round care. It is therefore unsuitable for people with advanced care needs or dementia. 

The costs of supported or serviced living must be borne privately. If people have a care level, care benefits in kind can be used to partially finance a care service or a nursing care allowance can partially finance supportive assistance. 

It is important to precisely review the services offered. The term “supported living” is not legally protected. It is used to describe various different concepts with different prices. For example, apartments that are associated with a care home, apartments with a janitor service that have been designed as accessible or suitable for the elderly or hotel-like facilities with a concierge service, sauna and spa area. The term “serviced living” is also sometimes used.

It should also be noted that residents need a certain level of independence and may have to move to a care home if they develop a greater need for care and support. 

The Federal Working Group of Senior Citizens’ Organizations (Bundesarbeitsgemeinschaft der Senioren-Organisationen e.V. – BAGSO) provides guidance that helps people choose a facility.

Supported living for people with disabilities and chronic illnesses

Supported living is the term used to describe a residential concept for people who need support due to a mental illness, disability or chronic illness. This is a form of everyday socio-educational assistance that can be financed with social integration assistance benefits.

Group homes are also available for people in need of support. They move into a room in an apartment and share a bathroom, kitchen and other communal facilities. They receive support from care services, other residents and relatives.

Supported group homes are aimed at people who want to be as self-determined as possible in their decisions and who desire lots of social contact and interaction with others.

What are care group homes (Pflege-WGs)? 

Care group homes are places where people with and without care needs can live together. Group homes enable people in need of care to live in a self-determined manner and independently determine their everyday life for longer. They receive support from a care and support service, relatives and domestic care assistants, who deal with the organization, management, support and promotion of community life. To this end, people with a care level receive a group home allowance from their long-term care insurance provider in addition to other care benefits.

Further information can be found in the article Care group homes: living in supported outpatient group homes.

Dementia group homes are care group homes where several people with dementia reside and live together. Even people with severe dementia can still reside in care group homes. 

Further information on dementia group homes can be obtained from the German Alzheimer’s Society (Deutsche Alzheimer Gesellschaft e.V.).

There are also supported group homes that specialize in certain illnesses, for example mental illnesses or substance addiction. 

What are intensive care and ventilation group homes (Intensiv-WGs and Beatmungs-WGs)? 

Supported group homes with a focus on intensive care are primarily aimed at people who require artificial ventilation or intensive care but who are still active and whose health is stable. Residents are supported by intensive care staff. Long-term care and health insurance contribute to the costs.

Further information can be obtained from the German Interdisciplinary Society for Non-Clinical Ventilation (Deutsche Interdisziplinäre Gesellschaft für außerklinische Beatmung e.V. – DIGAB).

What are inclusive group homes (inklusive WGs)? 

These are places where people both with and without disabilities reside and live together. The residents without disabilities often pay no or little rent in return for committing to support the residents with disabilities. The residential projects are also supported by educational and nursing professionals. Some cities also have inclusive multi-generational group homes. Subject to pre-requisites, financial assistance can be obtained via long-term care insurance, social integration assistance and, under some circumstances, basic income support.

Further information about inclusive group homes and a group home database can be obtained from the inclusive living association WOHN:SINN – Bündnis für inklusives Wohnen e.V.

A checklist for supported group homes can be obtained from the Federal Ministry for Family Affairs (Bundesfamilienministerium).

Multi-generational centers house both young and elderly people. In the case of inclusive multi-generational homes, this involves young and elderly people with and without disabilities.

Multi-generational living is similar to living in group homes except that people have more privacy. Instead of having their own room, people live in their own apartment and share communal spaces, such as a communal kitchen, recreational areas or a communal garden.

There are usually household rules for living together. These can stipulate, for example, that residents help each other: whereas younger people do the grocery shopping, more elderly residents can jump in if last-minute childcare is required.

If a resident is in need of care, consideration must be given as to what to do, exactly as it is in the other cases. Can relatives provide the care, is a care service required or does the person even need to move to a care home?

Further information about multi-generational living can be obtained from the Federal Program for Multi-Generational Centers (Bundesprogramm Mehrgenerationenhaus).

Open meeting points where people of any age and any origin or cultural background can come together are often also referred to as multi-generational centers. It is not possible to live in these.

Care homes and residential facilities for people with disabilities are primarily aimed at people with a particularly high and/or frequent need for support. These are inpatient facilities. That means that the residents live there and are cared for twenty-four-seven: the nursing staff are permanently on site.

Even in residential and care facilities, care is taken to ensure that residents have privacy and that their self-determination and independence are fostered. There are no visiting or closing times. However, residents are often more strictly tied to specific processes and services within the facilities. They mainly live in one or two-bed rooms and share communal spaces.

Special education and integrative residential options and inhouse facilities, such as boarding schools, are available for children and adolescents with disabilities.

Further information on residential facilities for people with disabilities can be obtained from Aktion Mensch e.V.

Further information on the cost of staying in a care institution or residential facility as well as related financing options can be found in the article Full-time residential care.

What are hospices? 

Hospices are specialized care facilities for people who are severely ill and in their final days of life. These facilities are especially designed to provide palliative care when recovery is no longer possible. The costs are covered by health insurance and donations.

Further information on services and the necessary prerequisites can be found in the articles on palliative care and palliative care for children.

Information about residential options in old age can be obtained from the “Aging at home” (“Zuhause im Alter”) service portal from the Federal Ministry of Family Affairs (Bundesfamilienministerium).

Information about residential options for people with disabilities is provided by the “Family advisory guide” (Familienratgeber) portal from Aktion Mensch e.V.

Personal consultations can be obtained from the  

• Care advice centers 
• Advice centers provided by the Supplementary Independent Participation Advice Center (Ergänzende unabhängige Teilhabeberatung – EUTB) 
• Housing advice centers
• Self-help associations
• Local senior citizens’ offices