Caring for Relatives

When relatives start needing care, many people feel the need to become actively involved themselves. However, family carers often run up against the limits of their own resilience. They often feel that they are not acknowledged or appreciated enough, despite the sacrifices they make to become carers, giving up such things as their job or their free time. The expectations placed on them by others, combined with the serious mental, physical or financial challenges they face, can develop into a heavy psychological burden for those affected.

Care needs in Germany

Caring for people with long-term needs is one of the great social challenges of our time because the number of people in need of long-term care is set to increase significantly in the coming years. The importance of long-term care and questions relating to financing, service design and quality of care are increasingly a matter of interest for politics and society. According to the Pflege-Report, which provides an annual assessment of current care needs in Germany and how they are being met, 4.3 million people were in need of care at the end of 2020, about 80 percent of whom were being cared for while living at home. More than half of those in need of care are 80 years of age and older. However, the need for care is not only evident in the older population. Almost one fifth of those affected are under the age of 60. 

In addition to children and young people, this group includes adults of working age as well as people with particular underlying conditions such as early-onset dementia, people who require ongoing breathing support and people with disabilities. 4 to 5 million people care for a relative. Around half of the carers are still working themselves. Assuming responsibility for the provision of care is usually physically and psychologically stressful for everyone involved. Not only is the organisational effort required initially very high; often, the onset of the need for care occurs unexpectedly or has not been the subject of much previous discussion within the family.  

"Persons in need of care are those who have health-related impairments of their independence or abilities and therefore require help from others. The need for care must be long-term, being expected to last for at least 6 months."
The German Social Code (SGB) - Book XI - Social Care

What is helpful when talking to people who are in need of care?

The first conversation with your own parents about possible care needs can be challenging. However, it is a good idea to get to grips with this subject before any decisions have to be made further down the road. Keep the following tips in mind: 

1. Think first, then act
When considering the care needs of your parents or your children, you’re considering the needs of your own family. Try to look at things in an understanding and sympathetic way - with regard to both your family and yourself. What is important to your family? What makes you happy? What sort of things are important to the person who is in need of care? And what might they be afraid of losing?
2. Stay focused
It is helpful to solve small problems first. More serious matters, such as death and inheritance, can be discussed later. These arouse fears in most people, particularly if the situation is complicated by existing illnesses or conflicts. Comforting and reassuring experiences are helpful. For example, hiring a domestic helper to take care of household chores when they can no longer be done alone is a positive experience. It enables the person who is receiving care to stay in their own home for longer. Provide concrete solutions to any problems.
3. Take things slowly
It is not helpful to tackle this important issue against the background of a family gathering, for example, where you might only have brief contact with the person in need of care. They might feel themselves under attack and resort to a fight-or-flight response. Take advantage of quieter situations where members of the family can have a proper conversation – during an evening meal, for example. Make sure that the person who is in need of care can withdraw from the conversation if they don’t feel ready.
4. Express your own concerns
Talk about things from your perspective instead of giving advice or making demands. By starting a conversation with "You know, Dad, I think a lot about how I want to grow old" or "I sometimes worry about how well you’re managing around the house", you are much more likely to smooth the way for an open and honest discussion than by saying something like "You shouldn't drive at your age and you ought to hand in your driving licence". Show that you want to live up to your responsibility as a family member.
5. Describe things instead of judging them
Support your observations with concrete examples, without providing emotional colouring or coming to any conclusions. Put your own point of view across while remaining open to the perspective of the person who is in need of care. For example, ask whether they think any changes need to be made and whether they need any help with this.
6. Not everything needs to be done at once
Changes need time. Make sure that the person who is in need of care has time to come to terms with their own physical and psychological changes. People who are starting to receive care often experience feelings of grief and loss in relation to their role in the world. Take small steps and celebrate small successes.
7. Find solutions together
Try not only to see your own ideas but also to consider the thoughts of the person who is in need of care. It could be that parents who are receiving care have other concerns and see problems in a proposed solution. When discussing a move to a retirement home, for example, they might be afraid of no longer being able to play the role of host or have the grandchildren over to stay. Work together to come up with ideas and solutions.
8. Accept rejection
Sometimes you can't find a solution because change is not (yet) wanted. Think back to the time when it was the other way around – for example, when your parents had to accept your behaviour: your job, your life partner, your travels. Communicate in an understanding way, showing that you accept the decision of the person who is in need of care but are open to further discussion. For example, you could say something like "I understand that you don't want to change this now. I’m still concerned, but I accept your decision. Remember to let me know if you change your mind about anything."

What can carers do for themselves?

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Take time for yourself and maintain boundaries
We can only help other people if we do not lose sight of our own needs. Give yourself permission to care for yourself as well and never neglect your own health or lose sight of what you want. Make decisions that are not only good for the person being cared for but also for you.
a speech bubble says help
Build up a support network
Build up a support network in plenty of time so that you can fall back on it when the need for help increases. There is German legislation that provides for the financing of domestic assistance or hourly care.
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Transfer responsibility to skilled personnel
Possibilities exist for transferring the responsibility for care to specialist staff – for example, in the form of temporary care provision. This way, you know that your relative is in good hands even when you are taking a bit of time off, are on holiday or are ill.
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Share your experiences with others
Many carers are in a similar situation. Talking to people who are going through similar things - for example, by attending a self-help group – can help you to understand your own situation better. You could also meet like-minded people at a Kur, or recuperation holiday, for people who are caring for relatives.

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