Only a small fraction of people cared for at home who are eligible for social assistance actually receive it. In contrast, most residents in care homes receive social assistance when the money is not enough to cover the high out‑of‑pocket costs, according to a study by a team led by lawyer and nursing expert Thomas Klie on behalf of the Paritätischer Gesamtverband, which was reported by “Der Spiegel”.
In 2023, out of roughly 4.9 million people receiving home care in Germany, an estimated 390,000 people in poverty‑situations had an entitlement to “Hilfe zur Pflege” – a form of social assistance – because their income, assets and long‑term care insurance benefits were insufficient to cover their needs. Yet only about 76,000, just under one‑fifth of those entitled, actually received the aid.
The figures come from model calculations using nursing statistics and data on basic income security for the elderly. They show that whether a person in need receives the social assistance depends heavily on geographic location. In the Saarland the proportion is lowest, at around one‑tenth of those entitled. In Saxony‑Anhalt it is slightly more than one‑fifth. In Hamburg roughly every third person cared for at home who is entitled to social assistance receives it. “Right now, the postal code decides how well home‑care recipients are supported” said Joachim Rock, CEO of the Paritätischer Gesamtverband.
The authors of the study emphasize that their estimates carry considerable uncertainty. This is because there are very few reliable official statistics on home care, especially when it is entirely or largely provided by relatives. Consequently, much of this support takes place in a statistical “dark field”. Very little is known about the financial and social circumstances of recipients and their caregivers.
However, official statistics do provide evidence that many people cared for at home who are entitled to assistance do not receive it, and that this is strongly location‑dependent. In Berlin and Hamburg, 45 % and 42 % respectively of those who receive social assistance are cared for at home. In all other federal states the share ranges from 9 % to 23 %. In response, the Paritätischer Gesamtverband calls for, among other measures, more intensive counseling for people cared for at home.