The assessment of long-term-care, its quality assurance and results -The German perspective

Abstract

The consequences of demographic aging caused an impulse for German politics to establish an independent Social Long-Term-Care Insurance in 1995. Since then the assessment for long-term-care became stepwise more comprehensive to cover the bio-psycho-social needs of an increasing part of the population. Nowadays, about 3.3 Million persons receive benefits from this social insurance which help to cover a great part (but not in full) of financial and material support to overcome the impacts of long-term-care. About 2.5 Million persons are assessed every year with continuously increasing tendency by nursing experts working for the Statutory Medical Service mostly performing home visits. They assess the appropriate scores for mobility, cognitive and communicative abilities, behavior, attitudes, habits and psychic problems, self-sufficiency, coping and handling of requirements due to disease and therapy, management of everyday life and maintaining social contacts, adding up to one of 5 grades, the need for technical aids, flat conversion, therapeutic procedures, rehabilitation and educative support. The assessment guidelines and the monitoring of the quality of their realization are presented as well as the outcome for the Long-Term-Care Insurance on the federal level. Twenty-five years of Long-Term-Care Insurance have led to a well established and steadfast insurance but with increasing expenses as well as rising social security contributions to face the challenges of a human and dignified evening of life for an increasing part of the population.