29 – Residential communities for people with (and without) dementia
Fact sheet no. 29
Externally assisted residential communities provide an alternative to persons in need of care, in particular those suffering from dementia. Residential communities are not nursing homes or residential facilities. Rather, the residents live together as tenants in a separate, shared apartment. The support and care is provided by home care services. With respect to the care service and the nature and extent of the services, residents have a right to choose and vote.
ï‚• Important basics of externally assisted living communities:
Each resident has a private room, which is fitted with private furniture. There are usually a common living room and kitchen and one or more barrier-free bathrooms. The fitting of the apartment with personal, familiar furnishings is intended to help create a familiar and comfortable atmosphere.
Living together with other people with dementia nursing and care around the clock is ensured by one care service in the apartment and usually until the end of life.
The Berlin Residential Participatory Act (WTG) has as a prerequisite for a residential community (WG) that residents or their family members or legal guardians participate in the life of the WG. This is something that must be learned together and which repeatedly enlivens the lives of all involved. Every resident or his authorized representative signs a single contract and a care service contract. The rental must be separated according to WTG contractually and in fact from the care and support providers.
In each WG, in which at least one person at care level IV resides, there must be at least one assistant constantly present (daytime and night). Depending on the number of residents and the level of care required, multiple teams are possible and/or required in early and late shifts.
Relatives and legal guardians are an important factor in the functioning of the residential community. This will require joint organization and agreement on co-existence, their communal stance and actions. A written agreement in which family members and legal careers set out important cornerstones (e.g. dealing with major purchases or changing the care services) can be very supportive.
The daily organization is based on habits, needs, state of health, abilities and daily rhythm of the residents. Biographical work is used.
The residents should be actively involved in daily operations such as cooking or washing up, in group activities, exercise activities, excursions or shopping. In this way, social, motor and cognitive skills can be preserved and promoted. For nursing care and supervision, it is important that a stable staff team is responsible. A permanent change of caregivers has a very unfavourable effect on people with dementia and should accordingly be precluded.
The Selbstbestimmtes Wohnen im Alter e. V. (SWA) (Association for Independent Living for the Elderly) has formulated quality criteria for residential communities for people with dementia. All care services that are members of SWA and whom care for people in residential communities have agreed to work according to the SWA criteria (a so-called transparency initiative). Users of residential communities with a voluntary commitment to the SWAs can contact the association and seek advice or consult it for clarification purposes in case of conflicts within a residential community. For more information: SWA e.V. www.swa-berlin.de or Tel. 030 / 61 09 37 71.
Costs and funding
The cost is usually about 250 – 500 € incl. utilities for rental costs plus 200 – 250 € forhousehold money (e.g. food, laundry care, household supplies, minor purchases and repairs). The rent and the household money are usually borne by the residents themselves. All costs incurred should be transparent and explained in an understandable way by the service providers (care service, landlord) and be displayed and regularly billed accordingly.
For care and assistance within a Berlin residential community, a binding daily rate will be invoiced for care receivers with a care level from level 4. The daily rate is detailed in service complex 19. (Formerly LK 19 and LK 38) Currently the daily rate is € 124,96. Monthly care costs are therefore € 3,748,80 (for 30 days) or € 3.873,76 (for 31 days).
(see information sheet no. 36).
For residents whose costs cannot be covered either by care insurance benefits, savings or maintenance allowances, the Welfare Office provides additional assistance for care. It then determines how the need for help is best covered.
Services are individually agreed on in the case of care receivers below a care level IV and are billed in accordance with service complexes.
In addition, care services have the possibility to invoice investment costs for their services. This amounts to an average of 2.5 per cent of the services provided.
The care insurance scheme helps to cover the costs. Monthly benefits are:
| Care Level | Out-patient kind of service | Care / Respite care service § 45a SGB XI | Possibly, residential community allowance (§ 38a SGB XI) |
|---|---|---|---|
| Care Level 1 | - | € 125 | € 214 |
| Care Level 2 | € 689 | € 125 | € 214 |
| Care Level 3 | € 1298 | € 125 | € 214 |
| Care Level 4 | € 1612 | € 125 | € 214 |
| Care Level 5 | € 1995 | € 125 | € 214 |
The benefits in kind supplements if necessary, a monthly community residence allowancein the amount of € 214 according to § 38a SGB XI. The care service centres are happy to advise you.
In addition, any one in need of care from a care level 1 is entitled to care / respite carebenefits up to an amount of €125 per month. These services can be given by a care provider or an external service provider. (See Information Sheet 4)
In the Berlin Residential Participatory Act (WTG) residential communities are included in the scope of regulatory law. All assisted residential communities may be reviewed ad hoc basis by the home supervisory authorities when there are complaints about deficiencies in the care or supervision.
The State of Berlin has published the brochure “Residential communities for people with dementia. An alternative residential and care form.– The brochure is available in its careservices portal. This can help to consciously decide for or against an externally assisted residential community, can provide answers to the creation and design of WGs, to acclimatization, to daily routine and information for dealing with conflict and helpful contact persons.