41 – 24 – hour nursing care and supervision at home

Fact sheet no. 41

Many persons in need of care want   / or require 24-hour care in their home. Often, however, this exceeds the mental and physical capabilities of the relatives. The following options are available as full-time care and care can be organized in the patient’s home.

  1. Care services

Most care services offer a “24-hour service”. This does not mean, however, that a nurse or caregiver is present around the clock. As a rule, this service includes occasional visits by the caregivers during the day while at night for emergency situations telephone access is guaranteed. If the cost of care and nursing needs exceed the benefits paid by the care fund, the remaining cost is to be financed privately. Under certain conditions there is a possibility for financial assistance in the form of “assistance for nursing care” from the Welfare Office (further information can be found in our consumer information brochure “Assistance for nursing care”).

  1. Domestic intensive care

Some care services are specialized in 24-hour care. Here care teams are formed that alternately offer around the clock care to patient. The invoicing of the costs is done mainly through the health scheme and not only through the care insurance scheme. This is only possible with specific diseases and those critically ill in intensive medical care.

  1. Caregivers or domestic workers from countries of the European Union

The freedom to provide services within the EU makes it possible to employ nurses and domestic helpers from EU member states, including Croatia, in Germany. Various options are available:

The job centre model:
The central International Placement Services of the Federal Employment Agency (ZAV) helps in the placement of domestic helpers from other European countries. Prerequisites:

  •  The Client (carer/relatives) are employer with all rights and responsibilities (the organization of holidays or back up for sick leave is up to them)
  • Reasonable accommodation in the home of the person in need of care or in the surrounding area must be provided for the employee
  • The cost of meals for the employee must be assumed
  • The weekly working time corresponds to the collective bargaining laws or the customary full-time number of hours (38.5 hours / week) for 6 days a week.
  • The monthly gross wages are based on the applicable wage rate (Berlin: 1,632.00 Euro; as of July 2013)
  • The costs to employers are calculated from the standard rate, the  employer’s contribution, accommodation and food, as well as arrival and departure costs of the employee.
  • There are no time limits to the duration of employment
    These domestic workers/caregivers should assume the following responsibilities:
  • Everyday care help (e.g. simple assistance with personal hygiene, nutrition,  when using the toilet and mobility) and domestic help

For more information, please contact the central International Placement Services (ZAV)

Address: Villemombler Str 76, 53123 Bonn
Telephone 0228 – 713 21 32
Email: zav.haushaltshilfen@arbeitsagentur.de

The secondment model:


This is a temporary posting of employees from a European company (EU Member States and Croatia) to Germany, where the patient doesnot become an employer. Two variations are possible. You conclude with a European or German company (care services) a service contract for care, supervision and/or domestic help. The foreign company also provides the service in its own country and is not purely an agency. The advantage here is that you switch from the role of the employer to the role of a client, whereby you are not responsible for compliance with the statutory provisions.

Prerequisites for both variations:

  • The employee is employed by one of the aforementioned companies
  • The company pays the social security contributions and taxes. The proof for this is the form A-1 months)
  • The posting is temporary (up to 24 months)
  • The employees are replaced in a certain rhythm (3 months)
  • For employees, the German labour law and occupational health provisions apply (probation period, working hours, holidays, notice periods, tariff rate)
  • The level of the cost of labour depends on the training, previous  experience and knowledge of the German language
  • The total costs are composed of the standard rate, the cost of accommodation,  food and arrival and departures costs. As a rule, a one-time placement and administration fee is charged by the company.

Information on contact persons who assist in the placement and search for a suitable service provider, can be found on the website of the Federation of Recruitment Agencies for Domestic Workers and Elderly Care in 24-hour Care (BHSB) at: www.bhsb.de