Old people's home
A home for the elderly , even old people's home, Feierabendheim, Feierabendhaus, nursing home or retirement home called, is a residential facility for the elderly, where they can receive support and care. The word “old people's home” is increasingly used as a synonym for nursing home .
Definition of terms
In general, old people's home is used as a generic term for any form of inpatient external care in old age. In technical terms, however, the retirement home is the middle link between retirement homes and retirement homes in a tripartite structure of inpatient care facilities for the elderly, which is differentiated according to the severity of the residents' need for help and care :
- Retirement home - the residential area has the greatest weight here - other services are only offered to a limited extent.
- Old people's home - here there is a (still) low need for care, the self-determined life predominates. Services such as cleaning and tidying up in the room, food supply are regularly used. The residents do not run their own household.
- Nursing home for the elderly - Inpatient care for people in need of care is the focus in these facilities around the clock.
The alternative and commonly used term "Alter s heim" (with "s") is usually avoided as a technical term because the home is run for "the elderly".
While the public perception of old people's homes is dominated by the tasks of care for the elderly , professionals write: “The range of care offered by a care facility has never consisted only of care. Modern, lifeworld-oriented facilities are committed to the principle of normality and the participation of their residents. "
Situation in Germany
In Germany there is usually a three-tier supply under the umbrella term “old people's home”: old people's home, old people's home and old people's care home. Nursing homes are the most common. The number of nursing homes in Germany rose from 2003 to 2005 by seven percent to 10,424 homes, in 2015 there were a total of 13,596 nursing homes. They offer full inpatient long-term care.
In Germany, long-term care insurance law (SGB XI) and social assistance law (SGB XII) determine the framework for the recognition and financing of inpatient care for the elderly. On this basis, health insurance providers and nursing homes conclude framework agreements in which minimum quality standards are also defined. The Home Minimum Building Ordinance (HeimMindBauVO) and the building regulations of the federal states set building law requirements and the state law regulated home law standardizes the operating conditions and the co-determination and consumer rights of the residents. Retirement and nursing homes are subject to home supervision (often located at the city or district social welfare offices, but also at the health offices). Among other things, this ensures that the statutory minimum requirements for personnel are met. The medical service of the health insurance (MDK) carries out quality checks of the homes on behalf of the long-term care insurance funds .
Many institutions criticize the fact that they can no longer employ or pay enough staff or insufficiently qualified staff due to stricter performance remuneration regulations. According to a controversial report by the Social Association of Germany (SoVD), at least 10,000 people died in German retirement homes in 2004 due to inadequate care. In the opinion of the advisor for health and care policy at SoVD, Gabriele Hesseken, the situation in many of the 8,440 old people's facilities with a total of 717,000 places (as of 2006) is dramatic: “It is the greatest social and human catastrophe since the Second World War ".
A Federal Social Minister responsible for elderly care Renate Schmidt (SPD) publicly complained in autumn 2004 that a certified elderly care worker spends an average of a third of their working time on superfluous organizational and documentation work . This time should be better used for the care and support of the residents.
Differentiation according to carriers
Institutionally, old people's homes are often run by state sponsors (usually a municipality or district), non-profit (church or charitable- social organizations) or private operators with different business objectives. In Germany, based on the number of accommodations, their share is around
| State sponsors | about 10% |
| non-profit organizations (1) | about 30-60% |
| Foundations that are prohibited from seeking profit | about 1–5% |
| Private operators (small businesses) | about 15% |
| Private operators (chain companies) | under 15% |
(1) There are large regional differences among “non-profit organizations”. Further explanation under non-profit organization .
If they build an old people's home and nursing home, some of the public or non-profit elderly welfare organizations receive low-interest loans and grants from public funds. Private and commercial operators receive almost no funding. The financing of operating costs for all geriatric care facilities in Germany, Austria and Switzerland is regulated differently by law. An official body sets a remuneration rate per day and resident, which includes the housing costs (accommodation, hotel costs), care and meals and care separately in the form of daily flat rates. The resident pays with his pension as well as by using state or private long-term care insurance .
Buildings erected by foundations were formerly known as “monastery” or “residential monastery”.
Criticism of the designations
The term old people's home is often associated with “deporting”. To avoid this, some old people's home operators advertise euphemisms such as “senior citizens' residence”. Furthermore, one should take into account that younger people who - after an accident or a serious illness ( stroke ) - require constant care, live permanently in a nursing home. So if not only old people should live in the facility, the term nursing home is appropriate and not old people's home .
“Assisted living” as an alternative
Many elderly people prefer to spend the last years of their life as independently as possible, for example in an assisted living facility . Ideally, these are buildings or settlements with senior citizen apartments in an age-appropriate, barrier - free construction . The term “assisted living” is neither standardized nor protected; such facilities therefore vary widely. The elderly and, in some cases, chronically ill residents of the corresponding residential complexes are looked after by outpatient services on a regular basis or on call (in the case of light care needs or temporary illness). These services can be carried out by private or non-profit outpatient care services or social stations and billed individually or as a lump sum as a complete package. Often the owners of retirement and nursing homes also operate facilities for assisted living and use shared resources for this purpose. In the best case, the principle of living until the end of life is offered, which enables the resident not to move out of his usual area of life and to move to a care facility, even if he is in severe need of care.
As a relatively new development in this area , residential communities with outpatient care and in particular the so-called dementia residential communities should be emphasized. Seniors in need of physical care are also cared for on an outpatient basis in senior living communities. As a rule, the seniors move in together when they are still agile in order not to have to live alone. If a roommate needs care, a care service takes over care. A qualified “supervisor” is crucial for the success of a senior citizens' flat-sharing community. Another alternative to assisted living is the multi-generation shared flat. Young families live there with elderly people in need of care, while outside nursing staff take care of professional care. In this way, the healthy residents can take care of the weak, but they don't have to. Even if seniors are often forced to choose this type of shared apartment with previously unknown people because it is impossible to live alone at home, the community helps against loneliness. The residents share joys and sorrows, mourn deaths together and are happy about births.
Organizational matters
In Germany, the costs of inpatient care services are divided into care costs ( care rate ), costs for accommodation and meals, investment costs and additional costs for optional services. These costs are the basis for calculating the home fee . There are also refinancing options for training costs. The home resident, who is usually entitled to benefits from long-term care insurance in Germany , which pays a portion of the care- related costs, is liable to pay the costs. The other portions of the home income must be raised privately from income and / or assets, or through maintenance payments from relatives who are obliged to provide maintenance. If these funds are insufficient, there is an entitlement to care assistance as part of social assistance in Germany .
In the past, old people's homes were often operated with a surplus in relation to the investment effort and risk. However, in the meantime, in the so-called maintenance rate negotiations, the cost bearers refuse to recognize collective bargaining requirements in the calculation of personnel costs . The result is that non-profit or municipal retirement homes, which usually continue to pay collectively agreed wages, nowadays often have to accept considerable losses, which can even go as far as underfunding. Private organizations, on the other hand, usually do not have these problems, as they are usually not bound by collective bargaining agreements in the payment of their employees or have negotiated in-house collective agreements.
The construction and operation of old people's homes is regulated by law in all of the countries mentioned.
Medical care
Although a large number of residents live in such homes, some with multiple and severe illnesses and disabilities, the general and specialist medical care is inadequate. For example, a study by the “Daheim im Heim” foundation in 2005, through a survey of 782 homes with 65,000 places, found that there are only employed home doctors in eight of these 782 homes. No visits to the doctor outside the home were recorded for 81 percent of the residents. Nothing fundamental has changed in this situation since then. The inadequate remuneration of doctors is often cited as a cause for this. In principle, health politician Ursula Lehr as co-author of the study states: "How often could specialist treatment not only help the quality of life and greater independence of the residents, but also reduce the amount of care required." In 2013, the German Institute for Medical Documentation and Information admitted an extensive publication this problem out. Because the topic is hardly consciously taken up and only rarely taken up by the media, the News Enlightenment Initiative placed it in the 5th place of the most neglected topics in 2011.
Special old people's homes
Giuseppe Verdi donated the Casa di Riposo per Musicisti in Milan , a retirement home for 60 musicians and opera singers. The Légion étrangère maintains one of many old people's homes in Puyloubier . The Father City Foundation offers assisted living for older people in Hamburg. The Heiligen-Geist-Hospital (Lübeck), which is still used as a retirement and nursing home, is a World Heritage Site. In the new federal states the people's solidarity operates many old people's homes (also for alcoholics).
A special form in Switzerland is the servants home Oeschberg (Koppigen) . There servants and maids who have reached retirement age have been accompanied into old age in their familiar surroundings for years. These old people continue to do work in the stable, household or forest as they are used to, and to the extent that they are adapted to their abilities. There is less and less demand for this type of living because there are fewer and fewer former servants and maidservants in Switzerland . But it enables these people to continue their simple life, which consists of work, until the end of their lives.
literature
- Susanne Aeschbach: Volunteer work in retirement and nursing homes. Thesis. Edition Soziothek, Bern 2003, ISBN 3-03796-031-0 .
- Martin Heinzelmann: The old people's home - still a “total institution”? An investigation into the inner life of two old people's homes. Cuvillier, Göttingen 2004, ISBN 3-86537-276-7 ( review in socialnet ).
- Martin Huber, Siglinde A. Siegel: Autonomy in old age. Living and getting old in nursing homes - How caregivers promote the autonomy of the elderly and those in need of care. Schlütersche Verlagsgesellschaft, Hanover 2005, ISBN 3-87706-688-7 .
- Kenan H. Irmak: The sick one. Old people and inpatient care for the elderly in Germany 1924–1961. Klartext, Essen 2002, ISBN 3-89861-004-7 (Sven Lind: Review , in socialnet.de, January 28, 2003).
- Christian Jagsch, Irmgard Wintgen-Samhaber (ed.): Quality of life in a retirement home. Medical, psychotherapeutic and sociological aspects. Trauner Verlag, Linz 2005, ISBN 3-85487-789-7 .
- Bernhard Mann : Structure of offers for old people's homes - using the example of a large city ( Nuremberg ) In: Current Gerontology. Thieme, Stuttgart / New York 1982, pp. 176-179.
- Bernhard Mann: Entry into old people's home and social strategies. In: Bernhard Claußen , Karlheinz Filipp, Klaus Wasmund (eds.): Materials for social science research. (MaSoFo) Volume 3. Haag + Herchen, Frankfurt am Main 1987, ISBN 3-89228-117-3 .
- Andreas Reeg: Servants and Maids, the other old people's home. Benteli, Bern 2006, ISBN 3-7165-1433-0 .
- Corina Salis Gross: The contagious death. An ethnological study on dying in old people's homes. Campus, Frankfurt 2001, ISBN 3-593-36867-6 .
- Helfert Obermüller: New forms of living and living together in old age. Suedwestdeutscher Verlag für Hochschulschriften, 2011, ISBN 978-3-8381-2365-3 .
Web links
- Elderly care structures ( Memento from October 20, 2007 in the Internet Archive )
Individual evidence
- ↑ Böttjer, Monika and Paaßen, Urte: Quality tests as an opportunity. Stand by what you do! , published in the magazine “Pro Hauswirtschaft”, issue 3 | 2017, pages 12–15, Vincentz Verlang, Hanover
- ^ State & Society - Care - Federal Statistical Office (Destatis). Retrieved July 20, 2017 .
- ↑ Stift, das - entry in Duden, accessed on July 18; see. also entry on "Wohnstift"
- ↑ See also the homepage of the Federal Working Group on Quality Assurance in WGs with outpatient care
- ^ Johannes Hallauer, Christel Bienstein , Ursula Lehr and Hannelore Rönsch : SÄVIP - Study on Medical Care in Nursing Homes. Vincentz Network, Hannover 2005, ISBN 3-87870-138-1 .
- ↑ Eckart Roloff : Where are the doctors in old people's homes? In: Dr. med. Mabuse, issue 162 from July / August 2006, p. 8, ISSN 0173-430X .
- ↑ TV program "report from Mainz" from August 18, 2008 on medical care in homes.
- ↑ Katrin Balzer et al .: Description and evaluation of specialist medical care for nursing home residents in Germany .
- ↑ 2011: Top 5 - Medical care in old people's homes inadequate In: derblindefleck.de , accessed on May 28, 2019
- ↑ Verdi's Casa di Riposo (The Time, 1956)
- ↑ For more, see the Oeschberg home service home