Senior caregiver

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Since the introduction of the Nursing Development Act , qualifications and further training courses for senior or everyday carers (often also called care assistants ) have been set up and offered nationwide . The term senior caregiver is not defined by law. Qualified people are increasingly offering their care services outside of the inpatient area in the home, depending on their training, under the label of senior carers, everyday companions or senior assistants.

Basics

The trend triggered by the above Article Act from 2008 continues in the relevant training and further education sector after several changes to SGB XI, differentiated according to areas of application. For example, through the Article Act Care Strengthening Act I (PSG I), which came into force on January 1, 2015, and especially through the Care Strengthening Act II (PSG II), which came into force on January 1, 2016 - with individual provisions only coming into effect after a transition period on January 1, 2017 In the future, in order to distinguish one another, a greater distinction must be made between the care services to be provided on an outpatient basis in the sense of the offers for everyday support according to the new § 45a (PSG II) and the inpatient area of ​​application according to the old, now deleted § 87b SGB XI.

The expected demographic development in Germany is the basis for the increasing care for the elderly. The proportion of those who will be in need of care will increase significantly due to their higher life expectancy. In 2005 there were more than two million people in need of care. According to the Federal Statistical Office, the number of people in need of care will increase to 2.91 million by 2020, and by 2030 it is even expected to reach 3.36 million. As a result, the need for caregivers is growing both in inpatient care facilities and in the outpatient sector. This additional need could be covered by senior caregivers.

The legislature responded to the empirically determined challenge with the new § 45a PSG II. It summarizes the previous definition of the low-threshold care and relief offers contained in § 45c (old) and now subdivides them in the new standard under the generic term “offers for support in everyday life”.

These offers should according to Section 45a, Paragraph 1, Clause 1 PSG II to relieve the burden on caregivers and help those in need of care to "stay in their home environment for as long as possible, maintain social contacts and continue to manage their everyday life as independently as possible". Paragraph 2 contains more detailed information on content and formalities. The offers require recognition by the respective state law. The state governments are acc. Section 45a (3) PSG II authorizes the issuing of relevant ordinances, taking into account certain federal requirements (concept for quality assurance, insurance protection, etc.).

In the course of the new regulations under the PGS II, which centrally define the new definition of the need for long-term care with all its differentiated legal consequences, not only the specially regulated area of ​​outpatient offers for everyday support according to § 45a PSG II are affected, but also the mainly inpatients Areas of application of the so-called everyday companions, attendants, additional carers, etc. according to the carer guideline in the sense of the old § 87b SGB XI. According to the new PSG II, the (old) norm of § 87b SGB XI is repealed. According to the justification for the new PSG II to § 53c "in view of the new regulation of the additional care and activation in inpatient care facilities in § 43b [...]", the mandate contained in the previous § 87b SGB XI for the National Association of Long-Term Care Funds, appropriate guidelines adopted, essentially unchanged in the new § 53c. Formally, new guidelines would have to be issued for the old area according to § 87b SGB XI.

Nationwide training or further education institutes hold appropriate qualification courses for both outpatient care services and for the inpatient area of ​​care facilities. At the same time, qualification and participation in such further training offer short and long-term unemployed people , career changers or lateral entrants and medium-term language-prepared migrants an opportunity to either enter into dependent employment or to strive for self-employment status. Senior or everyday carers work both in inpatient care facilities and as outpatients on site with senior citizens. You take on activities in the non-nursing area, so you have nothing to do with actual nursing. Her tasks range from organizing everyday life to reading the daily newspaper, cf. Incidentally, the non-exhaustive list of activities in Section 45a (2) PSG II and in the corresponding legal justification.

Legal bases

In § 87 b SGB ​​XI you can find the principles for the work of a senior carer in inpatient care facilities; § 45 applies to senior carers in outpatient facilities.

This legal status is partially outdated and needs to be revised, cf. insofar as the relevant changes by the new PSG II.

“(1) Notwithstanding Section 84 (2) sentence 2 and (4) sentence 1 and with corresponding application of Sections 45a, 85 and 87a, full inpatient care facilities have for the additional care and activation of residents in need of care with a significant need for general supervision and Care Entitlement to the agreement of performance-based surcharges for care remuneration The agreement of the remuneration surcharges presupposes that

  1. the home residents are additionally cared for and activated beyond the care necessary for the type and severity of the need for care,
  2. the nursing home has additional caring staff who are subject to social insurance contributions for the additional care and activation of the home residents and the expenses for this staff are not taken into account either in the calculation of the care rates or in the additional services according to § 88,
  3. the remuneration surcharges are agreed on the basis that, as a rule, the twenty-fifth part of the personnel expenses for an additional full-time employee is financed for every resident with a considerable general need for supervision and care, and
  4. the contracting parties have reached an agreement that the agreed remuneration surcharge may not be calculated if the additional support and activation for home residents is not provided.

In addition, an agreement may only be made with nursing homes that clearly and verifiably indicate to the person in need of care and their relatives in the context of the negotiation and conclusion of the home contract that an additional care offer exists for which a remuneration surcharge according to paragraph 1 is paid. The list of services and price comparisons in accordance with Section 7 (3) must be amended accordingly.

(2) The remuneration surcharge is to be borne by the long-term care insurance and reimbursed by the private insurance company within the scope of the agreed insurance cover. The remuneration surcharges cover all additional support and activation services for home residents within the meaning of paragraph 1. The home residents and the social assistance providers may not be burdened with the remuneration surcharges, either in whole or in part. With the payment of the remuneration surcharge from the care fund to the care facility, the person in need of care has the right to additional support and activation from the care facility.

(3) The National Association of Long-Term Care Funds has to adopt guidelines for the additional caregivers to be deployed on the basis of Section 45c (3) by August 31, 2008, on the qualifications and tasks involved in full inpatient care for those in need of care; To this end, he must listen to the federal associations of carriers of fully inpatient care facilities and observe the generally recognized state of medical and nursing knowledge. The guidelines only become effective for all nursing care funds and their associations as well as for nursing homes after approval by the Federal Ministry of Health; Section 17 (2) applies accordingly. "

On the basis of these standards, various educational institutes have been offering the qualification as legally undefined senior caregivers for years. An adjustment of the corresponding training content to the new legal situation is to be expected.

Participant targets

The regionally different admission requirements for further training to become a senior caregiver require in particular responsible and helpful job seekers with empathy, lateral and re-entry into professional life as well as start-ups in the non-care sector.

Goals of further training

The following main topics are still relevant, taking into account the new legislation:

  1. Basics in dealing with older people
  2. Age-related changes
  3. Situation-related care for people in need
  4. Documentation of the support process
  5. Participation in the rehabilitation of the elderly and disabled
  6. Recognize emergency situations and provide first aid
  7. Measures to promote health and preventive health care (e.g. nutrition for people with dementia)
  8. Taking into account the social environment and including it in daily work as well as promoting social contacts
  9. Living space and living environment design
  10. Everyday design
  11. Typical occupational problems in dealing with older, mentally confused people
  12. Legal regulations as a senior caregiver
  13. Legal aspects of caring for older people
  14. Inclusion of personal biography in daily work

Content

The certificate course consists of several regionally different training modules:

  1. Legal framework in care for the elderly
  2. Aging as a process - gerontologically based working methods
  3. Intercultural support
  4. Methods of everyday organization, event management
  5. Care for the elderly as an interprofessional field of work
  6. Support for people in need
  7. Special care for mentally changed and sick elderly people
  8. Cooking for people with dementia

Individual evidence

  1. BAGSO, brochure: “Well supplied at home”, 2016, p. 16.
  2. Numbers: Stat. Federal Office
  3. § 87b SGB ​​XI
  4. Senior carer in geriatric care (IHK)