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Older people in Düsseldorf: Most of those in need of care live at home
Photo:
Michael Gstettenbauer / IMAGO
The numbers are impressive. A place in one of the Caritas care facilities in North Rhine-Westphalia costs more than 200 euros per day. The house is not a luxury facility, but has a good reputation among those in need of care and their relatives. More than 6,000 euros a month, that's quite a sum. If you're wondering how this is going to be paid for? Here is a partial answer. I have to owe part of it.
Five million people in Germany are in need of care. And there are more every day because the baby boomers are now getting older, and the older they get, the higher the percentage of people in need of care is. Today, nine percent of 70-year-olds and more than 80 percent of those over ninety need care.
Care at home
Most people in need of care live at home, which is often best for them emotionally. At least if friends and relatives take care of you, if your social life still works. And it is cheaper for the welfare state, even if the apartment ends up being converted for a lot of money.
There is a care allowance for care at home - from 332 euros per month for care level 2 to 947 euros per month for care level 5. At the beginning of the year, the care allowance was increased by five percent. In addition, all people in need of care are entitled to 125 euros per month. This relief amount is already available for care level 1 - people with this light care level receive nothing when it comes to care allowance.
The carer can spend the money however they think makes sense. Only state-selected service providers can be commissioned for the 125 euro relief amount. This money will not be paid out. However, the relief amount can be used in many ways - and saved over several months in order to then use it as a larger investment. There are also plenty of other help options for care at home.
This starts with so-called free nursing stations, where you can get advice about what kind of help you are entitled to and where you can get this help locally. If you have submitted your application for care, you are also entitled to free care advice. And not just you: the people you are supposed to care for also have a right to get advice - regardless of whether it is a relative who will be caring or another person.
It continues with grants for remodeling the apartment, for example a new bathroom with a walk-in shower or handrails everywhere in the apartment where there is a step. The nursing care insurance subsidizes 4,000 euros for such a measure; an older couple in need of care could jointly provide 8,000 euros in assistance.
If you, as an employee, have to take care of organizing the care of a close relative at short notice and therefore take time off from your job, you are entitled to ten days of wage replacement benefits from the person in need of care's care fund. So far this has only been possible once - since this year you can receive care support allowance for this period every year.
Nursing care insurance also covers part of the costs for day care, for example. Those in need of care are looked after in a facility during the day, from lunch to group gymnastics to singing and playing the piano. People with care level 1 have to use their 125 euro relief amount again. From care level 2, the health insurance fund pays for day or night care, staggered from 689 euros for care level 2 to 1995 euros for care level 5.
Medical care is paid for by the health insurance company, and gloves and disinfectants are also available at the care insurance company’s expense.
And if care at home is unavailable, those in need of care can use short-term care in a suitable home for up to eight weeks a year. For short-term care in an inpatient facility, 1,774 euros per person are available annually for care level 2 and above. The basic rule is: various services, such as payments for the nursing service and nursing allowance, can already be combined with one another today.
As of July 1, 2025, the benefit amounts for preventive care and short-term care are to be combined into a common annual amount. This means that those in need of care have a total benefit amount of up to 3,539 euros available.
Many families use foreign helpers to provide care at home. They are often paid by Polish, Bulgarian or Romanian companies, are covered by social insurance and receive a proud salary by local standards. You then live in the household of the person you need to care for for a few weeks or months. Then they have to be replaced. In an ideal world, two or three of these helpers take turns and are essentially part of the family - but the world is rarely ideal.
At the start, families can also use the money from preventative care, 1,612 euros per year, for such care.
Significantly more financial help for inpatient care
If there are no available family and relatives and you can no longer organize home care yourself, there are still inpatient senior facilities. They are then the better choice.
Regardless of whether at home or in an inpatient setting - since January, the statutory nursing care insurance has added more money every month. If you have care level 5 and actually need to be looked after around the clock, the insurance will now pay 2,005 euros per month for care-related expenses for full-time care in a home, which also includes care and medical treatment (Section 43 Paragraph 2 SGB XI).
The state contributes to the costs that the person in need of care would have to pay as their own contribution for the care services and the training of nursing staff in such a house. Staggered according to the time the person in need of care has already spent in the home. Since January more than before, 15 percent more, and up to 75 percent from the fourth year (Section 43c SGB XI).
A case study
Let's take the 6,000 euro case mentioned above and make an example calculation. The 6,000 euros are made up of 3,005 euros in care costs and a training allowance, 1,500 euros in rent, i.e. room and board, and another 1,500 euros in the so-called investment allowance. With this, the care facility pays for a modern standard of care for buildings and technology and for the expansion of the facility.
more on the subject
Financial help from the state: This is how care time works by Veronika Silberg
Cost shock due to collective wages and inflation: This is how expensive care in homes has become by Florian Diekmann
Cost shock caused by collective wages: When the nursing home becomes unaffordableBy Florian Diekmann
The whole thing from the perspective of the senior citizen in need of care: She receives 2,005 euros from the nursing care fund and has 1,000 euros in pension at her disposal. There are still around 3,000 euros left that are uncovered. The state will add 15 percent to the 3,005 euros in care costs minus the 2,005 euros for the level of care, i.e. the 1,000 euros in pension that are left over, in the first year from 2024. In this example that would be 150 euros. There are still 2,850 euros per month that have to be paid from savings or assets.
Since 2024, in the second year of care, the extra subsidy has been 30 percent, i.e. 300 euros, in the third year it is 50 percent, i.e. 500 euros, and in the fourth year it is at least 75 percent, i.e. 750 euros.
After four years, our model senior citizen would have used up the following assets: 34,200 euros in the first year, 32,400 euros in the second year, 30,000 euros in the third year and 27,000 euros in the fourth year, for a total of 123,600 euros. As a result of this year's new regulations, the state subsidy for your own payments is 3,000 euros higher than under the rules that still applied in 2023. If you have so much wealth, savings, a house or an apartment - everything is good.
If not, the social welfare office will step in. There you can also apply for help with care if your assets have been used up. Money is available from the month in which you applied for help and are also entitled because your own assets have actually been used up or there are none.
The personal contribution will not decrease
The office only gets money back from relatives in exceptional cases. Either when children each earn an annual salary of over 100,000 euros. Or when, for example, seniors give away their house to their children or sell it dirt cheaply in order to save their assets in the years before they need care. Such assets are used by the social welfare office.
The more generous help for the costs of the care facility does not mean that the person in need of care actually has to pay 3,000 euros less themselves. Since 2021 alone, the average home costs for seniors have increased by 500 euros per month to a national average of 2,576 euros.
This way you will be financially prepared
Not every senior will need care as they get older, but the chance is quite high. So what can you do to prepare financially?
Saving:
You can put money aside in the classic way, i.e. simply save. And if you start early, you might have a few thousand dollars available later. An ETF savings plan, for example, is ideal for saving over such long periods of time. With a deposit of 100 euros per month, with a five percent return, you have 82,000 euros available after 30 years, and after 40 years even 148,000 euros. Some people with particularly high incomes even buy a condominium so that they can finance their care later.
You can pay into
private nursing care insurance
. There are essentially three different types of contracts. There are contracts that pay out a predetermined amount of money each month for free use in the event of care (daily care allowance). There are contracts that pay out a monthly pension in the event of care, which can certainly increase later. And there are contracts that simply cover care costs at a certain level. The money flows directly from the insurance company to the service provider. As a customer, you will not see this money. At Finanztip we primarily see daily care allowance insurance as an option. If the worst comes to the worst, you can decide for yourself how you spend the money from the insurance company.
If you start paying into such insurance at the age of 45, it will cost you, for example, 80 euros today. If you only start at 55, the monthly costs are already well over 100 euros.
The most important disadvantage of the products, however, is that if you can no longer afford the monthly premiums at some point later, the insurance coverage is gone - and the money you have paid in up to that point anyway.
Renovation as an alternative
Some households have another alternative: They convert their own property to suit their age at an early age. You can get inexpensive loans from the German development bank KfW.
You can also use money from your Riester contract for this. And of course you can draw on your savings as mentioned above. This is especially worthwhile if, for whatever reason, those affected are determined to stay in their house or apartment: because it has always been the balcony of their dreams, because the social and family environment is right and because it may also be a very inexpensive solution is.
But don't just think about yourself. You should help family and friends help out. And it won't do any harm if you plan a pleasant room or a small separate apartment for your later professional care. At some point you're going to need someone to just be there 24/7.
And it's not primarily about the medical questions. The health insurance company also provides medical care at home. From administering medication to weekly injections, changing bandages and putting on support stockings.
All the best to you and us. Growing old is great. Being old is the challenge.