Table 1 German policies and definitions of terms specific to German long-term care
Outpatient care | Outpatient care includes nursing, care and support services, and support with housekeeping |
Informal care | Informal care includes in-cash benefits to compensate informal caregivers. |
Respite care | Respite care is a term to describe any kind of temporary provision of care in order to give the caregiver temporary relief from caregiving [10]. In this article and based on German LTC insurance understanding, we define respite care as adult day care and adult night care, provided in a dedicated institution. |
Levels of care dependency for people with dementia in 2013 | In the year 2013, there were three LoCD and an additional LoCD 0 for people with a limited capability to manage their everyday life. With a higher LoCD the claim for benefits increases. A LoCD 0 does not allow claiming all kinds of LTC services. In the year 2013, amongst others, the following services were available in the different LoCD: LoCD 0: in-kind services in-cash services LoCD 1–3: in-kind services, in-cash services, nursing home care, respite care Hardship case: Hardship cases are people in LoCD 3 who receive more benefits due to severe need for LTC. |
Long-Term Care Benefits Amendment Act | Entry into force: January 2002 Changes for people with dementia: first time possibility to claim financial aids through LTC insurance by people with dementia to use for care and support services; introduction of the so-called ‘LoCD 0’ [12] |
Long-Term Care Further Development Act | Entry into force: July 2008 Changes for people with dementia: increase in the amount of benefits to claim [13] |
Act to Realign Long-Term Care | Entry into force: January 2013 Changes for people with dementia: first time possibility to claim in-kind or in-cash benefits in home care for people with dementia in a LoCD 0 [14] |
1st Act to Strengthen Long-Term Care | Entry into force: January 2015 Changes for people with dementia: first time possibility to claim respite care benefits, short-term care, and substitutional care (for when the informal caregiver is on vacation) [15] |
2nd Act to Strengthen Long-Term Care | Entry into force: January 2017 Introduction of the new definition of the need of long-term care, considering not only physical but also cognitive impairments [9] |