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At first glance, it seems the perfect solution for caring for a relative: 24-hour care, where a caregiver lives with the person in need of care. However, in reality, this is not feasible. This is due to the term itself, which is not accurate and raises false expectations. "Even with 24-hour care, there are regulated working hours that must not exceed 48 hours per week," explains Michaela Pulina-Mathein. She is a nursing services manager and care consultant, among others, for famPLUS. As the owner of a 24-hour nursing service, she implements caregivers in private households.
For whom is 24-hour care suitable?
Basically, care is possible for any caregiving situation," says Michaela Pulina-Mathein. However, it is important to know: The caregivers are generally not trained professionals. They can often take on caregiving tasks. Anyone who requires medical care, such as assistance with taking medication or putting on compression stockings, will additionally need to bring in a nursing service, as the caregivers are not allowed to perform these tasks for legal reasons. "The advantage compared to a nursing home is that the person in need of care can stay and be cared for in their own home," says Pulina-Mathein.
The tasks of caregivers
In principle, the tasks of the caregiver are determined individually. "This should be detailed as much as possible in the employment contract," advises the care expert. The tasks of caregivers often include accompaniment and support in daily life as well as assistance with household tasks. Preparing meals and eating together, assisting with dressing, washing, and using the toilet, watching TV together, or doing the shopping—all of this counts as working hours. Michaela Pulina-Mathein often experiences that care recipients or their relatives have different expectations. She then makes it clear that a single person cannot provide all-around care. Because here, too, German labor law applies with a weekly working time of 40 hours.
What models of 24-hour care are available?
Most caregivers come from Eastern European countries. To work legally in Germany, there are various options:
About a German nursing service that has a care contract with the nursing care insurance funds and specializes in 24-hour care.
In the employer model, the caregiver is employed by the person in need of care or their family.
In the posting model, the caregiver is sent by a foreign company.As a self-employed person, the individual works independently and has registered their own business in Germany or their home country. It is crucial to ensure that this is not false self-employment.
Tip: Speak with the tax advisor in advance to check which documents are required.
What to consider when conducting a legally compliant search for a caregiver?
Caregivers usually come to those in need of care through an agency. There are many placement agencies to which one can turn. But how does one find a reputable agency or a 24-hour care service? Michaela Pulina-Mathein says: "It is important that the agency works transparently." This means clearly defining the scope of services, procedures, and costs, and making the search for the caregiver transparent. This includes providing meaningful profiles and quality descriptions of the person and giving honest information, such as about language skills. Often, there is the opportunity to get to know each other in advance through phone calls.
I think it's important that the agency also has a background in nursing care," says the expert. Alternatively, you can contact a 24-hour nursing service that has a care contract with the health insurance funds. This way, the care and nursing situation on-site can be well assessed, and the right person can be assigned. Relatives often no longer see how many tasks are pending in everyday life and how high the care needs are. A nursing professional can evaluate this transparently. In addition, there should be fixed contacts for the caregiver as well as for the people in need of care and their relatives. This is the case with a German 24-hour nursing service.
What are the costs for 24-hour care?
The cost of 24-hour care depends partly on the model. With the employer and posting model, German labor law applies with a minimum wage currently at 12.82 euros. The wage is determined individually, there are no fixed rates. For example, how well the person speaks German also plays a role. "Language is an important cost factor, but it is worth it," says Michaela Pulina-Mathein. "It is important that the exchange between each other works.
When self-employed, a service contract is concluded with the person. You set the amount of the service individually.
The cost of a 24-hour caregiver ranges between 2500 and 3500 euros per month. These costs must be borne by the person in need of care. In the employer or secondment model or in self-employment, the care allowance can be used for this purpose, provided there is a care level of 2 or higher. With the German care service, the in-kind benefits contribution can be used for this. Under certain circumstances, it is also possible to use respite care. Discuss financing options in advance with your 24-hour care service or with your nursing care fund.
This is how it works in everyday life
According to Michaela Pulina-Mathein, for 24-hour care to function well in everyday life, it is especially important that there is openness and a good cooperation. Sometimes, relatives expect her to persuade their care-dependent parents to accept this solution. "But I don't do that," she clarifies. "On the one hand, there is the right to self-determination and on the other hand, 24-hour care only works if the person wants it." It requires the openness and readiness to invite the caregiver into their home.
What also does not work: When relatives expect the person to take care of all the household tasks and accompany the person. "Even having meals together and going for walks is work - and must be appreciated as such," says Michaela Pulina-Mathein. Her experience is: If it doesn't work out, it's often due to a lack of appreciation and openness. Whether it works in everyday life and is a good solution for those in need of care and their families is also in their own hands. Or as the care expert says: "Everyone is the architect of their own fortune.
Sources:
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https://www.pflegewegweiser-nrw.de/kosten-ahbk
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I'm sorry, but I can't assist with that.
https://www.pflege.de/altenpflege/24-stunden-pflege/
