Care level 4

Care level 4 is one of five care levels in the German care system and is awarded to people with a severe impairment in their independence and everyday skills. Affected persons are dependent on extensive support in many areas of life and need help with everyday activities such as personal hygiene, nutrition and mobility. In 2019, about 1.1 million people in Germany were affected by care level 4, which shows that the number of people in Germany in need of severe care is increasing. Care degree 4 can arise due to various causes, such as chronic diseases, accidents or advancing age. The care of people with care level 4 often requires intensive and elaborate care by professional caregivers and/or relatives.
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What are the requirements for care level 4?

Criteria for classification in care level 4 include the ability to care for oneself, mobility, cognitive and communicative ability, as well as behavior and psychological stress.

Care level 4 differs from care level 3 in that it represents a higher care level and is associated with a significantly higher need for support. In contrast to care level 4, a certain degree of independence is usually still present in care level 3, but this is no longer sufficient to cope with all everyday tasks on one's own. Compared to care level 5, care level 4 is less severe. Persons in need of care with care grade 5 have an even more severe impairment and require 24-hour care and support.

An assessment by the Medical Service of the Health Insurance Funds (MDK or, since the MDK Reform Act of 2019, "only" Medical Service or MD) is necessary to be classified in care grade 4. Various questions are asked that relate to the ability of the person in need of care to independently manage everyday tasks. These include:

Self-care:

Mobility:

Cognitive and communication skills:

Coping with and independently dealing with demands and stresses caused by illness or therapy:


The answers to these questions are evaluated by the MD and assigned points. Points are allocated in various areas, each of which is weighted differently. A score of at least 70 points is required to be classified in care level 4. Individual areas can also be weighted higher or lower if, for example, a certain area is particularly difficult for the person in need of care.
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Amount of benefits in care level 4

As a person in need of care with care level 4, you are entitled to a variety of benefits from long-term care insurance. These include, among others:
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The amounts stated are to be understood as guidelines and may vary depending on the individual situation. From January 1, 2024, an increase in care allowance and care benefits in kind of 5 percent is planned.
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Care degree 4 in everyday life -
An example for care degree 4

Mr. Meyer is 82 years old and suffers from advanced dementia. He can no longer orient himself independently, is often confused and does not always recognize his family. Mr. Meyer is dependent on help with dressing and undressing, personal hygiene and eating. In addition, he has limited mobility and requires assistance when transferring from his bed to a wheelchair. Due to his dementia and limited mobility, he also relies on constant supervision to ensure his safety. In this case, Mr. Müller would probably receive care level 4, as he requires extensive help and support with his daily activities.
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Mobility support from a caregiver can make a big difference in the lives of older people, helping them to remain active and independent


Care level 4 - marta makes everyday life easier with individualized care

As your expert provider of 24-hour caregivers, we understand that caring for and nurturing beloved family members, as in Mr. Meyer's example, can be very challenging.

Our qualified and experienced caregivers are there for you and your family around the clock. They stand by the person in need of care and ensure their safety by lovingly attending to their needs. Caregivers from marta help with personal hygiene, dressing and undressing, and eating. They are trained to assist the person in need of care with their daily activities, such as transferring from bed to wheelchair. In this way, mobility and independence are promoted in the best possible way and maintained for as long as possible.

At marta, we place particular emphasis on individual and personal care. We make sure that you receive the caregiver who suits you best. Our caregivers cater to the special needs of the person in need of care, giving them a sense of security and familiarity. With our loving and attentive care, we create an environment in which persons in need of care feel comfortable and are supported in the best possible way.

Our goal is to give you and your family the security of knowing that your loved one is being cared for professionally and lovingly at all times. We want to give you the opportunity to get back to enjoying the good moments in life and not having to worry about caring for your loved one.

Choose marta to ensure that you and your loved one receive the best possible care and support. Contact us today to learn more about our comprehensive services. We look forward to making life easier for you and your family!


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The term "24-hour care" has become established in the public domain for care in the home. "Care in the home community" corresponds to real family structures and accurately describes the complex relationship between caregivers, people in need of care and relatives. This does not mean, however, that our caregivers work continuously or are on call 24 hours a day. Caregivers placed by us usually work a maximum of 48 hours/week. The working hours can be divided by arrangement. Night shifts can be arranged to a certain extent. However, a permanent readiness (e.g. baby monitor during the whole night) is excluded. In order to ensure good and legally permissible working conditions for the caregivers, the caregivers are entitled to sufficient continuous daily rest periods, as well as at least 1 day off/week. We are happy to support you in developing a comprehensive care concept to organize seamless care. For further explanations, our team is at your disposal.We are a member of the Bundesverband für häusliche Betreuung und Pflege e.V. (VHBP). Here we are committed to fair and legally secure framework conditions - for the caregivers, the people in need of care, as well as their relatives.

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