Sudden nursing case - And now?

General nursing guide

When one of us suddenly needs care, we as family members are faced with a great challenge and often do not know how to proceed.

Therefore, we have created an overview for you here, which explains step by step how you should proceed in case of sudden need for care of a relative and which supports you can receive.

Table of contents

Focus on important care topics - Discover more

Step by step guide

Care advice

If a family member suffers an accident, stroke or chronic illness, it is important to take it one step at a time!

At the beginning of a sudden nursing case, you can take unpaid leave from your employer for 10 days to take over the short-term care of the person in need of care. In order not to have to completely forego your salary, you can apply for care support allowance from your care insurance fund for this period. During this time, you can then take care of the first important steps and measures.

Your first step should be to contact a care counseling service. In most federal states, free care advice is offered in care support centers. However, there are also many other contact points in Germany that offer advice. You can find out exactly where to find a suitable care advice center from your local care insurance fund or health insurance fund or your local social services department.

Once you find an appropriate care consultation, you can work with your care consultant to complete an initial needs assessment and determine your assistance and support needs.

Determine degree of care and prepare appointment with expert

As part of the 2017 care reform, the three-tier system of care levels was replaced by a five-tier system of care degrees that takes greater account of mental and cognitive impairments.

It is only possible to apply for care allowances or services after you have applied for the care degree. Therefore, this should be one of your first steps, as it may take some time. During a care consultation, you will usually also be informed about the differences of the care degrees, which are measured on the basis of 6 modules and the corresponding restrictions. Nevertheless, we would like to provide you with a brief overview of the 5 degrees of care:

Care level 1Care degree 1 describes a slight impairment of the independence of the person in need of care.

Care degree 2Care degree 2 refers to a considerable impairment of the independence of the person in need of care.

Care degree 3Severe impairment of independence falls under care level 3.

Care degree 4If there is a severe impairment of independence, this falls under care level 4.

Care level 5: Care level 5 is the highest care level and the most severe impairment of independence with special requirements for nursing care.

The degree of impairment of independence is determined by an employee of the MDK, who can also be contacted by the care advisor. In any case, it is helpful that you prepare for this appointment with the help of a long-term care diary. In addition, people in need of care should not be afraid to openly state and explain limitations.
You can find detailed information in our care degree guide.

What form of care is available?

After or even during the initial care consultation, you should consider what type of care is possible in the event that it occurs and what the person in need of care and the relatives prefer. Mainly, the types of care differ in home care and inpatient care. Would there possibly be relatives who can take over the care of the person in need of care? Or does the care have to be carried out by professional staff?

Many questions that need to be clarified.

The most important thing here is to openly discuss the new situation together with all relatives and the person in need of care and decide together which type of care suits everyone best.

Home care & "24 hours care

A frequently popular type of care, is the 24 hour care. In this case, an independent caregiver, often of Polish or Romanian origin, lives with the person in need of care and is there for them "around the clock". It should be noted that the term 24-hour care only describes the concept and not the service - neither does 24-hour care involve nursing professionals, but experienced but not certified caregivers.

If you are interested in home care, where a caregiver moves into the home with the person in need of care and takes care of household chores and basic care, we here at marta are happy to help.  

We offer you a digital platform through which you, after your registration, are brought together directly with private caregivers for a live-in 24h care. Based on short profiles of the caregiver and your own needs analysis, you can choose on our platform which caregiver suits you best.

A frequently occurring problem of "24 hour care" is the lack of transparency, which is mostly caused by placement agencies. As a result, caregivers are often unfairly remunerated, as high placement costs are often incurred that are not always visible in the contract at first glance.

We at marta have made it our business to solve this problem and offer a transparent solution. You enter into a direct contractual relationship with the caregiver and can view the invoice at the end of each month, which always states exactly how much your caregiver earns. You can find more information about home care here.

  • The costs of "24h care" can be partially covered by the care allowance. Depending on the case, the prevention/short-term care can also be used. Parts of the care services can also be deducted annually from tax. More about this here.

Outpatient care

Outpatient care is similar to home care in that in both cases the person in need of care can be cared for and attended to at home.

However, the expertise of outpatient care services lies in treatment care, which also includes medical assistance, such as wound care, administering tablets or giving injections. Whereas the expertise of home care lies in basic care, which includes the recurring tasks to cope with everyday life, such as help with dressing and undressing, going to the toilet or personal hygiene.

  • Depending on the level of care, outpatient care is covered by the health insurance from 689 euros to 1,995 euros per month. You can find more information about the care benefits here.

Home care by relatives

An inexpensive but also time-consuming alternative to home care can also be provided by relatives of the person in need of care. In the case of care provided by relatives, the long-term care insurance pays a care allowance, depending on the care level, directly to the insured person. The insured person is then free to decide how to use the funds.

However, you - as the caregiver - should be aware of the physical, emotional and time burdens involved. But here, too, there are opportunities for psychosocial counseling or accompanying support.

Outpatient assisted living groups

Assisted living allows those affected to live an independent life to the greatest possible extent. In assisted living facilities, people in need of care have their own living space. These are age-appropriate and barrier-free. In addition, there are offers to take advantage of care services or other services. In addition to their own apartments, there are communal rooms, outdoor areas and service points. Thus, the respective advantages of an own household and a care facility are combined.  

  • If you have a care degree, certain services can be covered by the care insurance fund. For example, in assisted living there is also an entitlement to care benefits in kind, subsidies and the relief amount. For more details, please click here.

Short-term care

Short-term care is ideal for you if you are providing care yourself and need some time off. It is temporary inpatient care in a nursing facility.

  • The amount of the benefit of short-term care includes up to 1,612 euros per year and can be used for up to 8 weeks per calendar year.

Day/night care

These forms of care are partial inpatient care in a day or night clinic. They serve to supplement home care if, for example, you are a dependent person pursuing a profession. Thus, the person in need of care can be cared for as an inpatient during working hours and can also pursue activities there.

Full inpatient care

Full inpatient care means continuous accommodation of the person in need of care in a corresponding nursing accommodation. Here, the nursing care insurance pays flat-rate lines depending on the degree of nursing care. Basically, a distinction is made here between residential homes for the elderly, retirement homes and nursing homes. Combinations of these home types are often found. Unlike the other inpatient forms of care, here the supply and care can be taken over completely.

What financial assistance and benefits can you request?

Another question that arises early in the planning process in the event of a sudden need for care is usually who will pay for the additional costs. Often families are not prepared for such a sudden circumstance and suffer from costs for the adaptation of the living space, necessary purchases for care, various care products or even nursing staff.

In order to provide the necessary and best care, the Care Strengthening Act ensures that people in need of care are entitled to numerous benefits from care insurance, depending on the recognized care level.

Nevertheless, it is sometimes difficult to keep track of all the different options. Therefore, we have summarized all the important information and differences between the care services here.

Care allowance

In order for you to receive care allowance, the home care must be carried out by you as a relative or by caregivers working on a voluntary basis, and you must have at least a care degree of 2.

The care allowance is transferred to the person in need of care by the care insurance fund. The person can freely dispose of the care allowance. In addition, the care allowance can also be combined with outpatient care benefits in kind. You can find out more about this here.

Nursing degrees
Care benefits*
Care level 1
Care level 2
316 Euro
Care level 3
545 euros
Care level 4
728 Euro
Care level 5
901 Euro

*Care allowance you always receive monthly

Care benefits in kind

If a person in need of care with a care level of 2 or higher uses a nursing service, nursing care or help in managing the household, the nursing care insurance covers the costs of this use in the form of an outpatient care benefit in kind.

There is a statutory maximum amount of 2,095 euros , which also depends on the degree of care.

Nursing degrees
Care benefits in kind*
Care level 1
Care level 2
724 Euro
Care level 3
1.363 Euro
Care level 4
1.693 Euro
Care level 5
2.095 Euro

*You always receive care benefits in kind on a monthly basis

Combination power

You also have the option of combining the receipt of the care allowance with the use of outpatient care services in kind to ensure optimal care tailored to individual needs. In this case, the care allowance is reduced proportionately in relation to the value of the outpatient care services used.

Example calculation:

If you are a person in need of care and have a care degree of 2 and receive, for example, 80% of the outpatient care benefit in kind, i.e. 579.20 euros (724€ x 0.8), then you are entitled to 20% of the care allowance. In this case 63,20 Euro (316€ x 0.2).

Relief amount

A relief amount of up to 125 euros per month (up to a total of 1,500 euros per year) is available to those in need of care in the home and serves to relieve your burden as a caring relative or other close caregiver and to promote the independence and self-determination of those in need of care in the organization of their daily lives. It is important to note that this relief amount also applies to those in need of care in care level 1.

Partial inpatient services (day and night care)

In the case of day care or night care, for example, long-term care insurance also covers care-related expenses, and here, too, the maximum benefit amounts differ between the various degrees of care.

Nursing degrees
Partial inpatient services*
Care level 1
Care level 2
689 Euro
Care level 3
1.298 Euro
Care level 4
1.612 Euro
Care level 5
1.995 Euro

*partial inpatient services you always receive monthly

Full inpatient services (short-term care)

Many people in need of long-term care only require inpatient care for a short period of time. Often to cope with crisis situations in home care or as a temporary solution following a hospital stay. In these cases, there are short-term care options in appropriate licensed full inpatient care facilities.

  • As a benefit of long-term care insurance, short-term care can be claimed from care level 2 in particular if home care cannot be provided temporarily.

Preventive care

If the caregiver of a person in need of care is temporarily prevented for various reasons, long-term care insurance covers the costs of substitute care.

  • The benefit for financing a substitute caregiver through long-term care insurance is 1,612 euros for a period of up to 6 weeks per year.

Measures to improve the living environment

A home adaptation is intended to make it easier for residents in need of care to live independently in their homes. In most cases, outpatient care or assistance is only made possible by certain modifications, or care activities are facilitated by these measures. This is the only way to ensure a certain degree of independence even in old age, in the event of disability or need for care.

Long-term care insurances offer, as part of the long-term care benefits, a subsidy for the adaptation of living space for people in need of long-term care of a maximum of 4,000 euros once for all accessibility measures per person in need of long-term care. If the need for care changes, the insurance company may provide subsidies again under certain circumstances.

Nursing aids for consumption

Nursing aids, also known as nursing boxes, which are needed to facilitate nursing or care are listed in the list of aids of the statutory health and nursing care insurers. The insurance companies cover the costs of all products listed in this list.

Care costs tax deductible

Costs incurred for the care or provision of care for relatives in need of care are usually tax-deductible. However, you must also bear a certain portion of the costs yourself.

In principle, care costs are usually considered an extraordinary burden or a household-related service, which can then be deducted from taxes. Care costs include, for example, accommodation in a nursing home, use of an outpatient care service, care devices, food, clothing, or similar.  

Application for cost absorption by the social welfare office

Not in every case are relatives or other voluntary caregivers available to take over and finance the care or assistance. Inpatient care in a nursing home, for example, is usually expensive and often there is not enough money available each month. In this case, the social welfare office then takes over the care costs as "help for care", so that the costs for care for those in need of care are covered.