Who can avail of supported living?

Supported (also known as assisted) living is a living option for people who are largely independent and want to live in their own separate residence but who need or want support in certain areas of life.

It is aimed at:

• older people 
• people with disabilities and chronic illnesses

There is currently no clear definition of what exactly supported living for older people involves and how it is organized. As the term is not protected by law, it is applied to all possible types of supported living arrangements. Anyone considering availing of supported living should compare the options available and read contracts carefully, as the details can make a huge difference. Despite the name, supported living does not include comprehensive support and care. If someone requires this type of support, they will also need to enlist the help of a nursing care service or a voluntary service. If the care need is severe and long-term in nature, the question of whether care in a nursing home is required will need to be examined. 

Supported living for people with disabilities and chronic illnesses is more clearly defined. This type of living arrangement involves all-day care within the context of social educational support and, if necessary, nursing support that is based on the personal needs of the residents and is provided for a number of hours each day or week. All-day care is a participation benefit and/or a benefit of social long-term care insurance.

As supported living does not generally offer all-inclusive care, it is a less suitable option if the person:

• currently has a high support need or is expected to have a high support need in the future
• has a severe care need
• has advanced dementia

Supported living for older people can mean many different things. Two essential components are living and services. Most supported living arrangements include the provision of general services. Daily care is not usually offered. For this reason, the term “serviced living” is often also used.

Supported living is offered: 

• In supported living facilities, for example, in a building complex with residential units that are available to rent or purchase. Providers are frequently funding organizations within the social economy or commercial enterprises
• in apartments attached to a care facility. If an individual’s care need becomes greater, they can then move into a nursing care unit.

Supported living often offers communal spaces, in which residents can meet for shared activities. 

Which services are offered?

The range of services on offer may differ significantly between providers. Services can usually be classified as either basic services or optional/supplementary services. The basic services offered are often:

• Concierge services
• Housekeeping services, such as cleaning and shopping services
• A home emergency call system
• Dedicated on-site contact persons, who can organize help as required
• Arranging the provision of care services

Optional or supplementary services can be booked as required based on personal needs. These usually include:

• Home help
• Meal delivery
• Outpatient care
• Foot care and haircare

Residents have to pay for these services as optional extras.

What do I need to pay attention to when looking at contracts?

Normally, a rental contract must be concluded in addition to a service contract pertaining to basic services. These are paired together and one cannot be concluded or terminated in isolation from the other.

Note the following points in relation to the rental contract:

• Look for a precise description of the size of the apartment and its furnishings, as well as details of which exact apartment is described (address and apartment number).
• Be wary of terms like “accessible”, “age-appropriate”, “senior-friendly” and “disabled-friendly”. These terms are not very informative, as they are not legally defined. Instead, make sure that accessibility in accordance with DIN 18040 Part 2 can be contractually guaranteed, as well as compliance with DIN 77800 for supported living. These two DIN forms define certain standards.
• There should be a detailed breakdown of costs and service charges, indicating whether these are calculated using a flat rate or based on consumption.
• The rental contract should normally be concluded for an unlimited period of time. Termination of the contract on the basis of personal needs should be excluded. 
• The rent charged should be based on rents charged in the local area for comparable apartments. Structural features and communal areas are usually associated with additional charges. These surcharges should be reasonable.

The service contract is sometimes also referred to as the care contract. Note the following points in relation to the service contract:

• The service contract should list which services are provided and which of these are included as basic services. 
• Take particular care to ensure that the precise scope and frequency of the services provided are specified in the contract. For example, it may specify that windows are cleaned once each quarter. Be wary of non-specific terms such as “regular” or “suitable”.
• The contract should also explain how the services are billed. For basic services, there is usually a flat rate that is contractually specified. 
• The service contract should also list the optional or supplementary services that are offered and the costs associated with these.

It may be necessary to conclude additional contracts, e.g., for optional services or if a nursing service is needed.

Consumer advice centers provide more information about supported living for older people, serviced living and important points to consider when concluding contracts.

What costs arise and how can they be covered?  

In supported living situations, the following costs arise:

• Rent
• Service charges
• Basic services
• Optional or supplementary services

Rent and service charges

The resident has to pay the rent or purchase price and the associated real estate transfer taxes and service charges. 

People on low income can apply for housing benefit. The entitlement to this subsidy and its exact amount will be determined by the number of residents, the income and the charge or financial burden involved. An application for housing benefit must be submitted to the local housing benefit authority.

Publicly funded apartments are usually more affordable than the standard rental rates in the local area. A certificate of eligibility for subsidized housing (“Wohnberechtigungsschein”) is required in order to avail of these. This can be obtained from the local housing authority.

More information about housing benefit and social housing is available from the Federal Ministry for Housing, Urban Development and Building.

Basic services and optional or supplementary services

The cost of services offered in senior supported living vary widely. A monthly flat rate is often charged for basic services. This flat rate has to be paid even if you rarely if ever avail of any of these basic services. Residents have to cover these costs themselves. 

Older people must pay for these services themselves, provided that they remain largely independent and do not have any major health issues. If they are in receipt of benefits from the social welfare office, they may also be able to claim financial support there to help cover these costs. If the costs of supported living are reasonable from a social welfare perspective, the social welfare office may cover part or all of the rental costs and the costs of basic services. It’s best to clarify this before moving in.

Residents who have been assigned a care grade can use the services of an external care and support service or service provider recognized by the federal state in question. These services can be partly funded by non-cash care benefits for care at home. In addition, long-term care insurance may cover some of the costs for nursing support, a home emergency call system and structural measures to ensure accessibility.

Medical post-treatment care may be covered completely by the health insurance fund, provided that it has been prescribed by a doctor and approved by the health insurance fund.

How can I find the right living option for me?

The most important factor to consider is how much support you want or need. Independent older people are often very happy to simply have a concierge service or a dedicated contact person available to them. If more help is required, an arrangement that offers greater support options makes more sense. 

Accessible accommodation is important, as this will allow you to be self-sufficient even if you have some health impairments. Another crucial factor in the decision may be that the accommodation is located in a senior-friendly environment. In rural areas, a regular transport service or good connections to local public transport may be important.

Make a list of the requirements that are important to you now or may become important in the future so that you can then compare offerings and prices.

A checklist that you can use to help you find a suitable supported living arrangement is provided by BAGSO, the German National Association of Senior Citizens’ Organizations ­(Bundesarbeitsgemeinschaft der Seniorenorganisationen e.V.).

Who is serviced living suitable for?

Supported living is most suited to older people who are still healthy enough to live largely independent lives and only require a small amount of support or want the security of knowing that they can get help quickly in the event of an emergency. Supported living is available to individuals and couples.

This type of living arrangement is less well suited to people who require comprehensive nursing care and support. If someone needs a high level of support on a frequent basis, they are advised to use a care and support service or a daycare facility. If a severe and long-term need for care arises while residing in supported living, it may not always be possible to receive the level of care required. It may then become necessary to move into a nursing home.

Under the right circumstances, supported living in one’s own home may also be an option. 

More information about supported living at home is available from the Federal Ministry of Family Affairs.

Supported living enables people who require daily support due to a disability or chronic illness to live in a home of their own independently and with control over their own lives.

Reasons for living in a supported living arrangement include, for example, having a physical or intellectual disability, a physical illness or an addiction. The individual needs will determine the type and scope of the support they receive. Social workers usually provide support for a number of hours each week by providing individual help, guidance, instruction and advice in the areas where it is needed.

Possible supports may include:

• Advice and support in all areas of life and in crisis situations
• Structuring everyday life
• Making and maintaining social contacts
• Recreational activities
• Developing career goals, help with job searches and applications
• Applying for and organizing nursing care
• Accompanying the person supported when attending doctor’s visits and appointments with authorities

Who is supported living suitable for?

Supported living is aimed at adolescents and adults who do not need to live in a residential care home and who lead or are capable of learning to lead a self-determined, independent life with some degree of support.

How can I find the right option for me?

The cost of care is covered, for example, by funding organizations within the social economy, welfare associations or self-help associations and organizations. Some supported living options specialize in certain target groups, such as: 

• young people with psychological problems
• people with a physical disability
• people at risk of suicide
• people with an addiction

It is possible for supported living to be arranged in the person’s own home. Some providers offer apartments for rent.

Supported living is also available in group homes or guest families. Therapeutic individual living for people with mental health issues is also available and includes, for example, one-to-one psychological counseling.

More information about supported living as a participation benefit is available from the Supplementary Independent Participation Advice Center (Ergänzende unabhängige Teilhabeberatung, EUTB).

More details of supported living with guest families are provided by the Association for Social Psychiatry (Verein für Sozialpsychiatrie e.V.).

What costs arise and how can they be covered?

In supported living situations, the following costs arise:

• Rent
• Service charges 
• Additional support services

Rent and service charges

The resident has to pay the rent or purchase price and the associated real estate transfer taxes and service charges. 

People on low income can apply for housing benefit. The entitlement to this subsidy and its exact amount will be determined by the number of residents, the income and the charge or financial burden involved. An application for housing benefit must be submitted to the local housing benefit authority.

More information about housing benefit and social housing is available from the Federal Ministry for Housing, Urban Development and Building.

Costs for additional support services

The costs of social education-based care are covered by integration assistance, provided that the person is entitled to benefits in accordance with the Ninth Book of the German Social Code (SGB IX). The providers help with the application process.

Nursing support is subsidized by long-term care insurance if the person has been assigned a care grade. Medical post-treatment care may be covered completely by the health insurance fund, provided that it has been prescribed by a doctor and approved by the health insurance fund.

The individual need for assistance is determined as part of the process of developing an overall plan and participation plan. 

More information about the participation planning process is available from the German Parity Welfare Association (Paritätische Gesamtverband).