-Funding for a child who requires care. We encourage you to take advantage of all available benefits to make your daily care routine easier.
When is a child in need of care?
If your child does not have the same independence and abilities as their peers and is limited in their daily life, they may be in need of care. According to the Eleventh Book of the German Social Code (SGB XI), a child is considered to be in need of care if they are limited in their age-appropriate independence and/or abilities due to health impairments.
By law, the need for long-term care means that a person's abilities and independence are impaired due to their health situation and they are therefore dependent on the help of others. This need for care must be permanent, i.e. it must exist for at least six months.
When assessing children's need for care, it is assumed that there is a certain "natural" need for care. Even healthy children do not have the same independence and abilities as adults and are dependent on the support of their parents in many areas. For this reason, the need for care in children is assessed on the basis of a comparison with children of a similar age.
Causes of a need for care in children
There are many reasons why children may need special care. Some children are born with chronic or severe illnesses or disabilities, although only about three percent of all disabilities are congenital.
More often, however, serious illnesses and disabilities only occur during childhood. An accident can also suddenly lead to a child needing care.
Common causes of care dependency in children are various illnesses and disabilities, including:
- Chronic diseases such as pediatric rheumatism, Crohn's disease or cystic fibrosis
- Serious illnesses such as childhood cancer
- Neurological developmental disorders such as autism spectrum disorders
- Mental health conditions such as ADHD, depression, and anxiety disorders
- Mental disabilities, which can be caused by various factors such as oxygen deprivation at birth or fetal alcohol syndrome (FAS)
- Physical disabilities such as polio or accidents
- Combined mental and physical disabilities such as Down syndrome (trisomy 21)
- Skin diseases such as neurodermatitis
- Metabolic diseases such as diabetes mellitus
- Rare diseases such as childhood dementia (NCL)
- severe allergies
Degrees of care for children
If your child has special care needs due to health restrictions, you should check whether you are entitled to a care degree.
In Germany, the need for care is assessed on the basis of care grades, which range from 1 to 5 and determine the degree of impairment and the support required. Care level 1 means a minor impairment, while care level 5 indicates a severe impairment with special care requirements.
With an officially recognized care degree, you have the opportunity to apply for supportive care services for yourself and your child, which can help you in everyday life.
Special regulations for children and young people in need of care
In general, the care levels for children are determined using the same assessment tools as for adults. However, there are two special rules that must be observed.
Special regulation for children up to 18 months of age
The criteria for determining a level of care for small children and infants are different to those for adults. This is because even healthy children are dependent on comprehensive care in the first years of life and need the support of their parents. A natural need for care is therefore assumed. For this reason, there is a special regulation for children under 18 months in need of care: they are classified one degree of care higher than adults.
Special regulations for children under the age of 11
As children develop their independence and abilities up to the age of eleven, the same standards cannot be used to determine the level of care as for adults. The assessment is therefore always based on a comparison with healthy children of the same age.
The following applies to children and young people aged 11 and over: It is assumed that healthy children aged 11 and over are independent in all relevant areas of the care degree assessment. Therefore, from this age, the same criteria as for adults are used for the assessment of a care degree.
Calculate care level (degree of care) for children
Since January 2017, as part of the 2017 care reform, people insured under social long-term care insurance have been assigned a care level based on the severity of their impairment. This is determined on the basis of their independence or abilities.
Children and young people can also be in need of care, whether from birth or due to an accident or illness. In such cases, those affected or their parents are entitled to benefits.
Before financial support and other assistance can be granted, the need for care must be determined. As children can have different care needs depending on their age, a precise assessment is necessary.
The child's abilities and independence are considered in comparison to their peers. If impairments are identified here, classification into a care degree may be considered.
Six modules provide important information for evaluation:
- Mobility
- Cognitive and communicative skills
- Behavioral and psychological problems
- Self-sufficiency
- Coping with and independently dealing with illness- or therapy-related demands and stresses
- Organization of everyday life and social contacts
Points are awarded for each module and then weighted. The total number of points then determines the child's care level. A special regulation applies to children under 18 months of age, they are classified one level of care higher across the board.
Children in need of care: Preparing for the expert appointment
Once the application for a care degree has been submitted, a specially trained assessor will come to determine your child's care needs. A home visit will be arranged for this, at which you and your child should be present. An additional caregiver can also provide valuable information.
At the beginning of the appointment, a conversation takes place in which empathy is required. Parents who look after children in need of care already have a lot to deal with. The classification of one's own child into a care degree can be perceived as stressful.
The assessment of children therefore requires special expertise, which is guaranteed by specially trained assessors. In addition to conducting sensitive interviews, they also have extensive medical knowledge. If necessary, experts with experience in care assessments can also be consulted.
The assessor will ask you to describe your child's development and provide information about the care routine and the need for help. There may be questions about your child's independence when getting dressed, for example.
You can support the assessor in his work by preparing and keeping important documents ready.
The following documents are important for the assessment:
- Medical reports
- Hospital reports
- Examination findings
- Prevention booklet
- Documents from kindergarten or school
- Care protocol
Questions during the care assessment of your child
During the care assessment, which takes place in your home, you and your child will be asked a series of questions. These questions are aimed at gaining a comprehensive insight into your child's health and development. As a parent, you will be asked about various aspects, including:
- The existing illnesses of your child.
- The prominent physical, emotional, psychological and mental impairments.
- The milestones in early childhood development, such as crawling, walking, talking and learning to be clean.
You will also be asked to assess your child's abilities, especially in comparison with other children of the same age. For example, you will be asked about independence in movement, personal hygiene, feeding, dressing and undressing and controlling excretions.
The assessment includes questions on the following areas:
1. state of health and illnesses: What illnesses does your child have?
2. physical, emotional, psychological and mental impairments: Which limitations are the most important?
3. development: When did your child crawl, walk and speak their first words? When was your child's toilet training complete?
4 Independence: How well can your child move independently? What about personal hygiene? How is feeding going? How well does dressing and undressing work? How does excretion control work?
These questions will help you to assess your child's care needs and determine the right support services.
Children under 18 months are also asked about problems with food intake. This involves describing how often and for how long the child eats or drinks on average.
When assessing children, the child concerned should be present, as the assessor will also make contact with your child. However, you do not need to worry, as the assessor will interact with your child in a playful way, depending on their age and development. By playing, he can check your child's abilities and limitations.
Your child may be asked to draw a picture, solve a puzzle or complete a simple math problem. Age-appropriate questions are also often asked, such as: How are things going at school? What do you want for your birthday?
Sometimes the assessor will also ask your child to demonstrate certain activities, such as brushing their teeth, to verify the information provided by the parents.
Children receive customized services
Some parents hesitate to apply for a care degree for their child because they are unsure whether their child's care needs are really significantly higher than those of children of the same age. In such cases, it can be helpful to talk to other families and find out how much time and effort it takes to care for your child. The pediatrician can also provide valuable insights and help with the assessment of care needs.
Degree of disability in children
The need for care and disability in children are not always linked: Not every child with a care degree has a disability, and not every child with a disability has a care degree.
If your child's need for care is due to a disability, you may be entitled to a severely disabled person's pass, depending on the degree of disability (GdB). The GdB is assessed in steps of ten from 20 to 100.
If you have a GdB of 50 or more, you can apply for a disabled person's pass for your child. This card entitles you and your child to a number of benefits, such as free public transport or the use of disabled parking spaces.
A disabled person's pass can make everyday life with a disabled child much easier. So if your child is entitled to such a card, you should definitely apply for it.
As a rule, regional pension offices are responsible for the application for a severely disabled person's pass.
Care services for children in need of care
The care services are designed to help you and your child in everyday life. If your child has a recognized care level, they are entitled to certain benefits from the care insurance fund, similar to older people with a care level. The type of care benefits to which you and your child are entitled depends on the type of care required. The amount of financial support is determined by the respective care level. As a general rule, the higher the care level, the more extensive the care benefits.
Family caregivers can apply for the following care services when caring for a child at home:
- Care allowance
- Long-term care benefits in kind
- Combination services
- Relief amount
- Short-term care
- Preventive care
- Care aids for consumption
- Technical aids
Care allowance for a child
As soon as the care assessment is available, the long-term care insurance company decides whether a care degree is determined and which one it is. Care allowance is granted if your child has at least care level 2. It is important to note that you must apply for care allowance from your care insurance fund. Payment is made retroactively from the day you submit your application.
Care level 1: 0 euros
Care level 2: 347 euros
Care level 3: 599 euros
Care level 4: 800 euros
Care level 5: 990 euros
Alternative services for caring parents
The care allowance is not always the right support for families with disabled children or for family carers. caring relatives. You may be working and are therefore unable to provide care yourself. In such cases care benefits in kind can be a suitable solution. An outpatient care service can then support you in your everyday life. The maximum monthly contribution changes with the corresponding care level.
Care benefits in kind for children with a care degree
Care level 1: For care level 1, there is no entitlement to care benefits in kind.
Care level 2: € 796.00
Care level 3: €1,497
Care level 4: € 1,859
Care level 5: €2,299
Day and night care for children with a care degree
There are also day and night care facilities that specialize in caring for children. Day care is a good option if you have to work during the day. Night care is an option if a particularly high level of care is required at night. Care insurance covers part of the costs for these facilities, whereby the level of care plays a decisive role.
Care level 1: For care level 1, there is no entitlement to subsidies for day and night care.
Care level 2: 721 €
Care level 3: €1,357
Care level 4: €1,685
Care level 5: 2.085 €
Preventive care and short-term care for children with a care degree
The respite care and short-term care are also options. These forms of care are only temporary and can be used if you are temporarily unable to provide care or if you need time off. Both respite care and short-term care are set at a fixed amount that can be claimed regardless of the level of care.
If you are the primary caregiver for your child but are temporarily ill and therefore unable to take over the care of your child, you can use the respite care to take advantage of respite care. This allows you to temporarily organize the care of your child in a different way. Another person can be paid to take over the care of your child at home as your temporary replacement - be it on an hourly, daily or weekly basis. This substitute care can be provided either by an outpatient care service or by private individuals such as neighbors, friends or relatives.
If you are unable to be the primary carer, there is another option for organizing care for your child - short-term care. This is a temporary stay for your child in a residential care facility, which is financially supported by short-term care. Short-term care covers a limited period of time and can be used for up to 56 days a year. It can be used not only if you as the main carer are unable to attend, but also if your child temporarily requires particularly intensive care and needs to be cared for as an inpatient, for example as part of intensive care for children. Respite stays for your child, such as short-term living, can also be financed via short-term care.
Preventive care: The maximum annual amount is €1,685.
Short-term care: The maximum annual amount is €1,854
In addition, personal 24-hour care or supportive household help can also be provided. domestic help can also be an advantage. This way, parents can get to know the caregivers personally and ensure more individualized care for their child.
Support with childcare at home? Curative education nurses and social assistants will help you
There are various professions that specialize in looking after children in need of care. While nursery nurses are not necessarily confronted with this task in their daily working life, curative education nurses have made a conscious decision to take on this demanding challenge.
Training to become a curative education nurse takes place either through school-based training or further training at universities of applied sciences, which usually takes 2 to 3 years. After completing this training, a final state examination is taken in order to obtain the title of curative education nurse.
Training as a curative education nurse lays the foundation for working in various facilities later on, including day care centers, care facilities for people with disabilities or corresponding workshops. In addition, social psychiatry facilities, outpatient services, daycare centers, schools and rehabilitation clinics are also part of the working environment of curative education nurses.
Combination services for childcare at home
If you care for your child at home but also receive support from an outpatient care service, you can claim financial support in the form of combined benefits. These benefits are paid pro rata from care allowance and care benefits in kind and vary in their financial amount depending on the level of care.
Additional benefits through the relief amount
You have the option of claiming the relief amount of 131 euros per month to finance additional care and respite services for the care of your child. This can be, for example, household help or assistance in everyday life, such as hourly care for your child.
Care aids for consumption for children with a care degree
In addition to the care services already mentioned, health and care insurance funds also cover various aids for children with disabilities or care needs, either in part or in full. One example is care aids for consumption, which your child can claim as soon as a care degree has been determined. As soon as your child has this level of care, they are entitled to care aids for consumption worth up to €42 per month. You can purchase this Hilfe im Paket individually and have it delivered to your home, for example. The box can contain disposable gloves, disinfectant for hands and surfaces, face masks and bed protection pads.
