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Home Care or Nursing Home in Germany? A Practical Guide for Families
In Germany, many families face a crucial decision when a relative requires long-term care:
Should we choose home care (häusliche Pflege) or a nursing home (Pflegeheim)?
Each option has its own advantages and challenges – especially regarding comfort, cost and financial support from long-term care insurance (Pflegeversicherung).
Here is a clear, side-by-side comparison of both options:
1. Home Care (häusliche Pflege)
Advantages
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The person in need of care remains in their familiar environment
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Stronger emotional and psychological support through contact with family
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Flexibility in choosing who provides care (relatives, ambulatory nursing service, 24-hour carers, etc.)
Typical monthly costs
| Type of service | Average monthly cost |
|---|---|
| Care by family members | Low, often unpaid |
| Daily visit by ambulatory nursing service (Pflegedienst) | approx. €1,500–2,500 |
| Live-in 24-hour caregiver | approx. €2,500–4,000 |
A part of these costs can be covered by the long-term care insurance through:
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Pflegegeld (cash benefit paid to the main caregiver, often a family member)
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Pflegesachleistungen (in-kind benefits paid directly to professional care services)
Home care usually requires:
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Reliable daily support by relatives or professional carers
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Possible adaptation of the home (accessible bathroom, medical bed, handrails, etc.)
2. Nursing Home (Pflegeheim / residential care)
Advantages
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24/7 professional care by trained nursing staff
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Ongoing presence of nurses and doctors
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Social and leisure activities with other residents
Typical monthly costs
| Component | Average monthly amount |
|---|---|
| Nursing and care costs (Pflegesatz) | depending on Pflegegrad: approx. €1,500–2,400 |
| Accommodation and meals (Unterkunft & Verpflegung) | approx. €800–1,200 |
| Investment costs (Investitionskosten) | approx. €400–600 |
| Total | approx. €2,700–4,200 |
The long-term care insurance pays a fixed amount depending on the care level (Pflegegrad).
Example: For Pflegegrad 3, the insurance pays €1,262 per month directly to the facility.
The remaining amount must be covered by the person concerned or their family.
If income and assets are not sufficient, it is possible to apply for additional support from the Sozialamt (social welfare office – Hilfe zur Pflege).
3. Quick comparison
| Aspect | Home care | Nursing home |
|---|---|---|
| Emotional well-being | High, familiar surroundings | Often lower, adjustment needed |
| Professional medical care | Limited, depends on service/family | Available around the clock |
| Monthly total cost | Usually lower | Often significantly higher |
| Support from care insurance | Flexible (combination of cash and in-kind benefits) | Fixed contribution paid to the facility |
| Family involvement | Often high, shared responsibility | Less direct hands-on care by family |
4. How to choose?
Home care is often suitable if:
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the person still has some degree of independence
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family support is available on a regular basis
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a home-based environment is clearly preferred
A nursing home is advisable if:
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the medical situation is complex
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round-the-clock care is needed
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sufficient support at home cannot be organised
5. Additional notes
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You can use Pflegeberatung – a free care counselling service provided via the long-term care insurance funds.
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Some facilities offer day-care (Tagespflege), where the person is cared for only during the day and returns home in the evening – a middle option between full home care and a permanent nursing home.
The editorial team of the website strives to provide accurate information based on thorough research and multiple sources. Nevertheless, errors or incomplete details may occur. Please treat this article as a first orientation only and always consult the competent authorities and professionals for binding and up-to-date information.
