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Germany's long-term care costs hit families harder at home than in nursing facilities

Staying at home for care in Germany can cost families thousands more per month than nursing facilities. Why does the system penalize those who avoid institutional care?

,   and  Administrator
2 min read
The image shows an elderly woman laying in a hospital bed with a nurse standing beside her. The bed...
The image shows an elderly woman laying in a hospital bed with a nurse standing beside her. The bed is covered with a white sheet and a pillow, and there is a window with curtains in the background.

Germany's long-term care costs hit families harder at home than in nursing facilities

The cost of long-term care in Germany varies sharply depending on where people receive support. While most care-dependent individuals stay at home, expenses for home-based care can climb far higher than those in nursing facilities. A recent analysis highlights significant financial burdens, with out-of-pocket payments often exceeding thousands of euros each month.

Official figures show that 85.9% of those needing care in Germany live at home, often relying on relatives. Over half—54.5%—are looked after exclusively by family members. The country's social welfare policy, outlined in Section 3 of the Eleventh Book of the Social Code (SGB XI), prioritises home-based care over residential options.

Costs for home care vary widely, ranging from €340 to €7,441 per month, with a median of €2,085. Unlike nursing homes, these expenses do not decrease over time. For individuals with severe care needs, personal contributions can surpass €7,000 monthly. None of these costs are covered by long-term care insurance. In contrast, nursing home residents face high initial payments, averaging over €3,200 per month in the first year. However, supplements later reduce these out-of-pocket expenses. Historical comparisons remain difficult, as cost records only date back to 2025. The Federal Association of Family Caregivers, *wir pflegen* e.V., has criticised the system for its 'scandalous imbalance' between home and institutional care costs. Meanwhile, the federal government plans to finalise a care reform by the end of 2026, aiming to improve affordability and sustainability.

Germany's care system currently places a heavier financial load on those receiving support at home. With only 14.1% of care-dependent individuals living in full-time residential facilities, the majority must navigate steep and unchanging costs. The upcoming reform seeks to address these disparities and ease the burden on families and caregivers.

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