ADHD: Home Help, Care Levels, and Cost Coverage for Those Affected and Their Families

Is your home in constant disarray, do you feel like you’re going in circles—and still can’t seem to “just clean up”? This could be a typical sign of ADHD, not a sign of laziness or a lack of willpower. The main characteristics of the disorder include inattention, hyperactivity, and impulsivity. Many people with ADHD find that they start out full of good intentions, but then lose track of things, get stuck, and ultimately end up accomplishing nothing. Many parents of children with ADHD experience something very similar, as they must also juggle school organization, appointments, and emotional support.

In this article, learn when you may be eligible for home care assistance if you have ADHD (attention-deficit/hyperactivity disorder)—whether you have the condition yourself or your child has been diagnosed with ADHD—who covers the costs, and how to apply step by step, including specific options for getting help with daily tasks.

ADHD Explained in a Nutshell

ADHD is a neurologically based developmental disorder that usually begins in childhood and affects development and daily life during childhood. Signal transmission in the brain is altered in ADHD. In particular, the neurotransmitters dopamine and norepinephrine play an important role in filtering stimuli and maintaining concentration. ADHD affects both children and adults and often persists throughout life. Sugar or parenting mistakes are not causes of this disorder. Unlike ADD, where attention deficit is the primary feature without pronounced hyperactivity, hyperactivity is a central symptom of ADHD, which is also relevant for assessing care needs. People with ADHD often possess exceptional creativity, enthusiasm, and a willingness to help others.

ADHD and Household Chores: Why They Often Don't Mix

In people with ADHD, the neurotransmitters dopamine and norepinephrine function differently in the brain. This manifests itself in three main symptoms: inattention, hyperactivity, and impulsivity. This disorder primarily affects what are known as executive functions—essentially the brain’s internal “secretary.” Clear explanations of the symptoms and effects of ADHD are important for understanding the challenges of daily life.

Common problems associated with ADHD include:

• Planning (What should I do first?)
• Prioritization (What really matters?)
• How to Build and Maintain Motivation
• Filter out distractions (noise, thoughts, cell phones, kids, to-do lists)

Signs of ADHD include difficulty paying attention, pronounced hyperactivity, and impulsive behavior. The symptoms of ADHD can lead to learning difficulties and problems with social behavior.

In everyday life, this often means:

• They start things but don't finish them.
• They seem to be "frozen" when faced with multiple tasks at once.
• Instead of taking action, we feel a sense of inner resistance and shame.

This isn’t a personal failure, but a direct result of how your brain works. Help with household chores can provide much-needed relief from a medical and social welfare perspective—it’s not a luxury you have to earn.

What is a home help?

A home care worker is a person or service that assists you with tasks that you are currently unable to perform yourself, or cannot perform adequately, due to health reasons. Mental health conditions such as ADHD can significantly increase the effort required to manage daily life, as coping with everyday tasks often involves additional challenges. The increased effort required to manage daily life due to such conditions can be a criterion for approval of a home care assistant.

Typical duties of a housekeeper:

• Clean the apartment (vacuuming, mopping, bathroom, kitchen)
• Wash, hang, and fold the laundry
• Shopping, preparing simple meals
• Childcare when you are temporarily unable to care for your children yourself

The goal is always to make your daily life easier and more stable, not to have someone clean for you just because you “don’t feel like it.”

Are people with ADHD eligible for home care assistance?

Whether you, as someone with ADHD, are eligible for home care assistance depends not only on the diagnosis, but primarily on:

• the severity of your limitations in daily life and the associated difficulties compared to healthy peers
• Your family situation (e.g., children in the household)
• whether someone else in the household can help

People with ADHD are often affected as early as infancy or childhood. The condition can impact the development and daily lives of children, adolescents, and adults.

The Need for long-term care in ADHD is often not immediately recognized, as the symptoms do not fit the classic profile of needing care and the daily impairments are generally not severe enough. Long-term care insurance reviews the application for a care level based on legally established criteria that assess the independence of the person in need of care. The assessment of the need for care in children with ADHD is made in comparison to healthy children. As a rule, the need for care in ADHD is recognized only in severe cases.

Option 1: Household assistance through health insurance for ADHD

Your public health insurance may cover the cost of a housekeeper if you are temporarily unable to manage your household due to illness.

Key points:

• Typical: following a hospital stay, a health retreat, rehabilitation, or a serious acute illness
• Mental health conditions such as ADHD or ADD can also be a valid reason if they limit you to the extent that you are unable to manage your household
• It is often assumed that there is a child under the age of 12 or a child with a disability in the household; however, health insurance fund bylaws may allow for more extensive provisions

ADHD can be considered a mental health condition, especially if it leads to a severe deterioration and consequently triggers other conditions, such as depression or burnout.

An Overview of the Requirements for Household Assistance for ADHD

• Medical certificate: Your doctor confirms that, due to your illness, you are unable to continue managing your household
• Specific requirement: It must be clear that you are no longer able to manage relevant daily tasks; “just being stressed” is not sufficient. Mental health conditions such as ADHD and the associated increased difficulty in managing daily life can affect eligibility for home care assistance.
• Children in the household: This is particularly relevant for children under 12 or children with special needs. For children with ADHD, the additional care required compared to healthy children should be documented.
• Documenting care needs: Keep a care diary to record the actual challenges you face in your daily life. This will help the assessor evaluate your case when you submit your application.

Option 2: Home help through the long-term care insurance fund – is it worth applying?

If your ability to care for yourself is significantly and permanently limited, you can apply for a care level at ADHD . Mental illnesses and disorders such as ADHD or ADD are taken into account if they severely impair your ability to function in daily life and your participation in everyday activities and social interactions. This applies to people of all age groups, from children and adolescents to adults.

The level of care is determined through a care assessment, which is typically conducted by the Medical Service (MD) in the person’s home environment. During this assessment, the actual impairments and the individual’s need for support are evaluated.

Those affected should provide the assessor with comprehensive information about all relevant aspects of care and support during the assessment appointment. Thorough preparation for the assessment appointment is crucial to clearly demonstrate the actual care needs—particularly the increased care and organizational demands associated with ADHD—as these are not always automatically recognized. It is recommended to document the daily demands and support provided in a care diary .

Relevant factors in determining the care level for ADHD

During the assessment, the long-term care insurance fund reviews, among other things:

• Self-sufficiency
• Coping with the demands of everyday life
• Dealing with mental and cognitive impairments

Various modules are assessed as part of the evaluation. Module 3, which addresses behavioral patterns and psychological issues, is particularly relevant for ADHD. The ability to integrate into daily life and maintain social relationships is also considered a key criterion.

The module on organizing daily life and social interactions also plays an important role, as impairments in these areas can increase the amount of care required. The assessment of care needs for children with ADHD is always made in comparison to healthy peers of the same age. A child with ADHD often requires more care, guidance, and supervision than other children of the same age. The actual care requirements are documented and compared with the care needs of healthy children of the same age. These explanations apply to children and adolescents as well as to adult patients with ADHD, as the impairments and need for support can vary from person to person. People with ADHD who exhibited symptoms during childhood or adolescence may continue to require support into adulthood.

Since the transition from care levels to care levels , limitations are assessed more comprehensively. A care grade for ADHD is assigned under certain conditions if the disorder leads to significant impairments in daily life.

What matters most are your specific everyday skills:

• Are you able to eat and drink regularly?
• Can you manage your own appointments, medications, and daily routine?
• Is your home in a condition that poses a constant danger to you or your children?
• Do you regularly need help with basic tasks (shopping, cooking, laundry, personal hygiene)?

What a care level actually means for ADHD

With Care Level 1 or 2, you may be entitled to:

• Care allowance (for care levels 2 and above) or in-kind care benefits
• A monthly allowance of 131 euros for approved household assistance services (e.g., cleaning services, caregiving services)
• Additional services such as day care, short-term care, or combined models, if applicable

Care Level for ADHD: Examples from Everyday Life

Lisa (32) has ADHD and experiences periods of depression. She struggles to clean her apartment and manage her shopping, forgets appointments, leaves laundry lying around, and eats irregularly. With a care level of 2, she uses the respite care allowance to hire regular housekeeping help. This significantly reduces her stress and gives her the space to focus on her treatment.

The M. family has a eight-year-old son with ADHD, who needs a lot of guidance, constant supervision, and help with homework and daily routines. The parents are under a lot of strain, and household chores often get neglected. The son is assigned a care level, and the family uses the relief allowance for domestic help and care services to ease the burden on the family.

Important: A diagnosis of ADHD alone does not guarantee a care level. It depends on the specific limitations on your ability to care for yourself.

Option 3: Domestic help through the social services office

If neither your health insurance nor your long-term care insurance covers the costs and you cannot afford to pay for the assistance yourself, the social services office may be responsible; however, this form of assistance is secondary and income-dependent. The type of insurance you have matters, as it can affect the application process and determine which agency is responsible.

Possible legal bases:

• Section 70 of Book XII of the Social Code – Assistance for maintaining household operations in the event of illness or disability
• Integration assistance or supported living for individuals with mental disabilities
• Assistance with specific social difficulties – e.g., in cases of imminent loss of housing

The social services office always reviews income and assets, as well as whether other agencies have primary responsibility. Particularly in cases of mental health conditions such as ADHD, which are associated with significant impairments in daily life, the increased effort required to care for and support people with ADHD is taken into account. Mental health impairments and the associated additional effort can significantly influence the social services office’s decision. People with ADHD often rely on additional support to cope with the challenges of daily life.

Children with ADHD: Special Considerations Regarding Eligibility and Application

Children with attention-deficit/hyperactivity disorder (ADHD) present families with special challenges in everyday life. However, a diagnosis of ADHD alone does not automatically entitle the child to a care level or care services. The decisive factors are the extent to which the child’s independence in daily life is limited and how much additional care is actually required compared to healthy children.

Parents of a child child with ADHD should familiarize themselves early on with the requirements and the application process. A care level for ADHD is generally only recognized if the need for care significantly exceeds the usual extent and the family’s daily life is substantially burdened by the child’s symptoms and behaviors. This includes, for example, significant difficulties in organizing daily life, self-care, or coping with illness- or therapy-related demands and stresses.

The assessment by the Medical Service (MD) is a key step in the application process. During this assessment, various aspects of daily life are evaluated, including the child’s level of independence, ability to cope with everyday demands, maintenance of social contacts, as well as behavioral and psychological challenges. Parents should document the actual care requirements and their child’s individual limitations as accurately as possible. A care diary, in which daily assistance, guidance, and supervision are recorded, is a valuable tool in this process. This allows you to demonstrate how much additional support your child needs compared to peers.

It is also important not to downplay emotional and social stressors. Many parents experience significant stress due to the constant care, organization, and emotional support required, and this should definitely be addressed during the assessment. Only in this way can the actual need for care be realistically assessed and an appropriate care level be assigned for ADHD.

Long-term care insurance providers offer comprehensive guidance on eligibility requirements, the application process, and available care services. In addition to financial support from long-term care insurance, there are numerous other resources available: from family support services and therapeutic programs to self-help groups and care counseling. Grandparents, friends, and social networks can also provide much-needed relief in daily life.

Parents of children with ADHD should not hesitate to take advantage of the available support services and to carefully prepare their application for a care level. With thorough documentation, a realistic assessment of the care needs, and the support of professional guidance, families can better manage the challenges of caregiving and improve the quality of life for everyone involved.

Preparing for the MDK Assessment: How to Make a Strong Impression at Your Appointment

The assessment by the Medical Service (MDK) is a key step in the process of determining the care level. Proper preparation can be crucial to ensuring that actual care needs and everyday challenges are assessed realistically.

Here's how to best prepare for your appointment:

• Keep all documents on hand: Gather medical diagnoses, reports from therapists, and certificates from school or daycare, and keep a care log. In it, note how much support your child needs in daily life—for example, in managing daily routines, coping with challenges and stress related to illness or therapy, or maintaining social connections.
• Document the care required: Note how often and in what situations your child needs guidance, supervision, or assistance. Describe typical ADHD symptoms such as impulsivity, trouble concentrating, or difficulties with independence, and how these affect daily life.
• Prepare questions for the assessor: Think in advance about specific examples you can provide to illustrate the increased care needs. Be honest: Even small but regular acts of assistance add up and are important for determining the level of care required.
• Bring someone along for support: It may be helpful to bring a trusted person with you to the appointment. Family members or caregivers can share additional observations and assist the evaluator in making their assessment.
• Be open: Don’t be afraid to describe even stressful or unpleasant situations. The evaluator needs to get a realistic picture of your daily life and the actual limitations you face.

The more thoroughly you document your child’s daily routine and the specific challenges posed by their ADHD diagnosis, the greater the likelihood that their need for care—and thus their application for a care level—will be approved. Careful preparation for the assessment is therefore the key to success.

Step by step: How to apply for home care assistance through ADHS

1. Determine needs & documentation

• Make a list of tasks that keep getting put off (cleaning, laundry, grocery shopping, taking care of the kids)
• Recognizing Your Feelings (Overwhelm, Blockage, Exhaustion)
• Document hazardous situations (e.g., tripping hazards, unsupervised children)
• For children with ADHD: describe the additional care required
• Ideally, keep a care log

2. Obtain a medical certificate

• Consultation with a family doctor / psychiatrist / specialist
• Obtain a certificate of limited financial capacity
• Mention children and special challenges
• Illustrating ADHD (in yourself or your child) and its specific effects

3. Submit an application

• Health insurance:
  • Request a form
  • Submit a medical certificate
  • Specify the time period and scope
• Long-term care insurance fund:
  • Applying for a care degree
  • Be honest with the appraiser about any limitations

4. Review the decision & file an appeal if necessary

• Approval: Check scope, duration, and costs
• Rejection: File an appeal within 4 weeks
• Provide a detailed explanation of the restrictions + attach medical documentation

5. Find a housekeeper

• Choose a provider with experience in ADHD and mental health issues
• Goal: Support without judgment

Support services and resources for people with ADHD

Anyone who struggles with ADHD in their daily life —whether as someone with the condition, a parent, or a family member—doesn’t have to face these challenges alone. There are numerous support services available to help you structure your daily routine, organize care, and promote independence.

Important resources and support:

• Long-Term Care Insurance Providers: They offer comprehensive advice on all matters related to care levels, the application process, and long-term care insurance benefits. Here you can also find information on respite care services and support options for long-term care and assistance.
• Care counseling: Independent care counselors will help you assess your care needs and select appropriate care services free of charge, and will guide you through the entire application process.
• ADHD support groups: Organizations or local support groups offer a forum for sharing experiences, counseling, and practical tips for managing daily life with ADHD, for both children and adults.
• Therapy options: Specialized therapists help individuals manage ADHD symptoms, improve their daily functioning, and develop personalized strategies to increase their independence.
• Home care services: Depending on the level of care required, home care services provide assistance with household chores, personal care, and nursing care, thereby relieving the burden on families and relatives.
• Family Support Services: These services are specifically designed for families with children who have ADHD or other chronic conditions. They provide counseling, support, and practical assistance with daily life.
• Online resources: You can find numerous information portals, forums, and counseling services online regarding ADHD, care services, and managing daily life.

Take advantage of these wide-ranging support services to make daily life with ADHD easier, organize care, and improve the quality of life for everyone involved. It’s especially worthwhile to seek professional help when applying for a care level or if you have questions about care services. This way, you’ll receive the support that you and your family truly need.

Conclusion: Support for ADHD

If ADHD causes household chores to feel like an insurmountable mountain, this is not a sign of weakness, but rather a manifestation of a neurobiological disorder. People with ADHD are entitled to support due to their disorder, the associated challenges, and the increased effort required. Clearly explaining one’s individual situation and the daily challenges—for example, through a care diary—increases the chances of receiving appropriate assistance.

If your child has ADHD, it’s especially worth looking into options for household help, care levels, and respite services, because this support is designed not only to help your child but also to ease the burden on you as parents in your daily lives. Learn more about ADHD and burnout: How you can get help with household chores and daily life!

Your next steps:

• Talk openly with your doctor about feeling overwhelmed by household chores
• Consider whether it makes sense to file a claim with your health insurance provider, long-term care insurance provider, or social services office
• Get help filling out the applications—and, if necessary, with filing an appeal