The Wide, you want to feel the Vastness. Anna Szymiczek put your hands firmly on the handles of the Walker and wobbles to the window. Yes, here the view stretches to the town hall. You breathe satisfied. Since the beginning of this year, the 84-Year-old lives in the center for care and Living in Fürth. “The home has become my new home,” she says, “I don’t want to go anymore.”

you will feel well-protected in your room with the emergency call button on the wall. The nurse will welcome you every Morning with a little joke, she says, the staff belong almost to the family. But she is happy that her daughter comes every day to visit. The fixed meal times of the day an order. There are concerts or festivals with homemade Pizza and the wheel of fortune to play. Back in your apartment you can imagine. Earlier, she says, she was always cheerful, never despondent, but ever since the death of her husband, everything had become different. “The Lord God has taken from me the Laugh, but here it is again a little bit back.”

So nice care in Germany can be

Ralf Krüdewagen is a strong man that is a long trip to the lake. Now he has to stay in the country, and the shoulders are broken. “I can repair a machine, but not my mother’s care,” says the 62-Year-old. That’s why he was glad his parents had managed to secure a place in the Sophienhof in Porta Westfalica. After the death of the demented father, Gudrun Krüdewagen, 89, lives there alone. Many Bay Windows bring light into the house, in the Foyer, a fountain splashing fountain.

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But one day in the summer of 2017, the mother was confused, suddenly, totally, and at the next completely clear. Had you been drinking enough? Ralf Krüdewagen, as he tells it, alerted the nurse, demanded the leadership of a drinking Protocol. When he came to visit, there were four or five glasses in the room, filled with water, unaffected. “It was a beverage storage Protocol”, he complains. The condition of the mother improved over the months correctly. Finally, you had to go to the hospital. Diagnosis: strong dehydration.

So terrible care in Germany can be

The home in Fürth, and in Porta Westfalica belong to the same operator: Korian. The group from France guides in Germany 234 nursing facilities with 21 to 500 employees. The companies reputation is important, therefore, it has opened in Fürth, the doors for the star. The case Krüdewagen in Porta Westfalica the company for privacy reasons, wants to speak only in General terms. The fluid intake will ensure that the drinking protocols. When in the room, several glasses were, then in order for the staff at each visit to have drinks.

Korian is listed on the stock exchange. So the cash has to be right. The shareholders expect a dividend. Care is a big business.

Hardly a day passes without a new headline. Investors buy homes in a frenzy. The contribution to the care insurance will increase and will no longer but in a few years. But above all: Who should do all the work? According to the estimate of 35 000 or even 100 000 nurses are missing. Three-quarters of the workers in the homes are complaining about the pressure of time, many are reducing due to Overload on part-time. “Care for the elderly, many is not clear that the System is in danger of collapsing,” says social expert Stefan Sell, Professor at the University of Koblenz.

The Overload of the system

The care is always more to a disaster area in the midst of a rich country. High 185 000 members, the needy of the Auxiliary expected to serve in – home, are on the verge of giving up. At the same time, outpatient care services, to reject, in the meantime, each year, thousands of inquiries due to staff shortages. And this is only the beginning: by the year 2050, the number of care cases will continue to grow due to the aging of the population, and 50 percent to 5.3 million.

long-term care insurance has long been regarded as a success story. A quarter of a century, it was the then Minister of social Affairs Norbert Blüm. Who was formerly the case, had a humble way. He had to dissolve its assets, and, often, in addition to the office. Two-thirds of the residents received social assistance, about 20 billion Mark, the local authorities claimed the 1994.

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The Blüm’s Reform changed the. Everyone had to – by law or private – against the care risk to insure. Who is needy, gets since then a subsidy graded according to the severity. He can withdraw money, if members care, an outpatient service or order to go home. Today, 3.7 million people received benefits, a quarter of which lives in the home. The total expenditure rose to € 38 billion.

Private providers can be rolled to the market. Everything must be efficient, cost effective, and quick. Each activity is broken down and documented: “daily help when the get Up in the Morning and going to bed in the evening, four times a week”. Or: “daily help when putting On and removing compression stockings”. Care is today an industrial process. But where is the man?

The complex System makes it hard to figure out what is a good setup. And if there are problems, you never get the feeling to race against rubber walls. As Ralf Krüdewagen.

His mother, Gudrun has placed a consultant at Care level 4, which is the second highest. 1775 Euro in the month of the care Fund, 2326 Euro you and the family pays. “That’s a lot of money,” says Ralf Krüdewagen, “for 4000 Euro, we can expect flawless performance.”

Gudrun Krüdewagen crashed several times, once you are lumbered with the wheelchair the escape down the stairs. According to the observation of Ralf Krüdewagen an emergency hatch was held up with a chair open. He turns to the Home inspection, feel put off. But they want to have “immediately” traded. Error gave it only in the case of the documentation requirements. The son looks at violations of fire protection and is addressed directly to the building authority, the decrees, then, indeed, shortcomings. Korian refers to the Dilemma that the inhabitants should retain their autonomy and mobility, but often not more properly could be assessed. Escape doors had actually been to the ventilation opened. Now, the facility management was instructed to do.

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Anna Szymiczek, 84, came as Displaced persons from upper Silesia to Fürth and worked there as a housekeeper. Today, you can no longer run alone: “Without the accompaniment I fall.”

©Jens Black

Great hopes Krüdewagen is directed to the maintenance Fund of TK. But refers it to the Supervisory authority and proposes to take a lawyer. “With this Council, Mr Krüdewagen seemed to be, however, not been satisfied,” according to the cashier. How should he? As a disgruntled son is fighting for the health of his mother. A future review of the Medical service of the health insurances (MDK) took place, according to home supervision, then, but “deficiencies in the quality of care”, even if not specifically, in the case of Gudrun Krüdewagen.

The MDK is often referred to as the “care-TÜV”. But the comparison is wrong. Because of the traffic, the controller bad homes can’t draw – but at least take a closer look.

Katja is the Age, for example. The 39-Year-old sitting opposite a friendly, older lady. Helga Barren, 87, has lived for four years in a nursing home Vitaris in the Saxon town of Torgau. On the wall of photos of dogs sticking on a chair hangover Pupfl stretches out his paws.

Regular inspections

at the Age of and her colleagues at the MDK test each year 13 300 homes and 12 800 care services, at least once. You to back with laptop and lists, stay one to three days.

here It goes: How the food tastes? Will always put a bottle of water on the bedside table? Has she complained about the care? Woman Barren sits on the bed, she answers patiently. Katja Age hesitates for a Moment: “How this works with the stools?” Woman is Barren and has no Problem with this: “My butt knows the PM, and he logs on every Morning at ten.”

The auditor is a Cabinet trade show, in the the drugs for Helga Barren. You see if the pills meet in the Tagesbox the prescribed dosage. On the Computer plan studied the Age of the treatment. How often the blood sugar was measured? Has it made an assistant or a specialist? How has the weight? Without such controls frequently changing personnel wouldn’t even notice if residents lose weight. After half an hour: Helga Barren is well maintained.

In the case of another patient is a Minor noticed something. The woman got a pain reliever, but it was not recorded which is drug and how high the dose was. A Documentation Error. Some of the criticism seems petty. However, from the Details, the examiner can often detect how well a home is organized. Here in Torgau on the whole they are very satisfied.

the people from The MDK to write detailed reports. But hardly anyone, not even the residents, family members or journalists can read. For them, there are only short versions, called transparency reports. Of All Things Transparency!

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Elisabeth Lösekow,, 87, was a sister in a religious order and has long cooked in a Hamburg sailor’s home. In September 2016, she moved into the home: “It’s good for me.”

©Jens Umbach Officially Germany’s nursing homes are in the best condition

For clarity, since 2009, published in nursing notes. Almost every institution can show a rating between 1.2 and 1.5. Where there are maintenance deficiencies, the delicious food compensate. On paper, the rays of Germany’s homes.

The Alloheim emsaue Park in Lingen, for example, a bright new building in white plaster and red brick, 2016 opened. After the MDK-examination in December 2017 was the 1.0. Best touch! Bernd Ruping, an otherwise very serene Professor of theatre education, trembles the voice, when he tells of the experiences of his mother: “In her Distress, she had stuffed the toilet paper in the crotch.” This includes permanent staffing, changing time workers, and poor nutrition. “It wasn’t the nurses,” says Ruping, “it was the organization.” After one and a half years, he found a different facility where the mother went, before her death.

Alloheim acknowledges that “our high quality had not been complied with standards at the facility in the past temporarily in all respects”. Now, was the perfect remedy. The personnel requirements were even exceeded.

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the differences in the homes are much larger, as the notes reveal, also shows the “care-Report to 2018” by AOK, the Charité and the University of Fulda. The scientists studied on the basis of six criteria, such as those in need of care are cared for. In a poor home, you get three times as many pressure ulcers as in good, you have two and a half times that is so often a urinary tract infection, are stuffed with dementia with antipsychotics, though often unnecessarily. After all, the policy has come to realise how blind the care notes. “Care-TÜV, today almost every home is a “very good”, not worthy of its name”, says the Minister of health, Jens Spahn (CDU). But what is a new, differentiated System, is completely open.

In the case of the Alloheim Lingen, the home supervision of the town was still active. What authority, exactly, is responsible for control, is not uniformly regulated. Since the federalism reform of 2006, each state had its own law, rügen critics.

The Home inspection you may not think of as special operations command. First, the operator is advised only if suggestions are ignored, there are planning procedures.

the organisation of Care through the Alloheim, managing Director of the home oversight in Lingen was not satisfied, and imposed fines. Now the judicial system deals with the defects. For this Wednesday, a process scheduled another process. Alloheim does not want to comment on the request of the star.

With 196 inpatient facilities, 72 facilities with assisted Living, 25 patient care service and 17 500 employees, the group ranks among the three largest private providers in Germany. With many million, he buys a smaller nursing home chains in series. Impeller of international financial investors, which have discovered the business with the needy in times of low interest rates as a new Bonanza. On average, just under five percent of sales, income and manageable risk. Alloheim itself was passed within a decade twice over to other Private Equity funds. Last Nordic Capital paid 1.1 billion euros. The Fund sits on the tax-favorable channel island of Jersey.

The state wanted private money

so far scientists have found no evidence that it is in private homes, poor gepflis egt than in the non-profit Caritas or the Red cross. With the introduction of the care insurance, the policy had opened up the market, because the state for the investment in new home places the money is missing. In retrospect, however, the General public construction and maintenance is paid, but only in Installments over the care set.

That a means is closed, is the absolute exception. The nursing care funds may terminate the contract. A little more frequently, that the home supervision imposed a recording stop until deficiencies are rectified. In Alloheim in Bremen, it came up several times. The operations in the care center Marcus Avenue also employ the judiciary. A young woman had discovered a year ago in her father’s deep, partly purulent wounds, pressure ulcers, grade 4. In an interview with Radio Bremen, you said: “Now I know how death smells like.” You presented a criminal complaint for assault. According to the state’s attorney’s investigation is ongoing, Alloheim, a specialist opinion be relieved. The supervision of prescribed nursing center quality management.

The social worker and book author Claus Fussek know the signs of poor care. At the very top of his list, the bedsores, the professionals refer to as pressure ulcers. No other topic lend itself so well to the defects in the System – and the 66-Year-old thinks is enormous. He says the monstrous sentence: “You make poor care more than with good.” It works like this: If a patient’s pressure sore worsened, he needs to be OP to the hospital, comes back with a higher nursing degree and is now for the home more lucrative. If, however, employees heal with great commitment on the wounds, then the demotion, even threatening. The result: less money. Care is a paradox.

Nobody works badly on purpose. However, if you simply do not have enough people on the Station, then the tasks are not creating. The nurses suffer often including up and down Hiking. From the outpatient services to the homes of the poor to the better-run facilities. More attractive employer, more recently, Intensive-care-WGs.

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Liselotte Dommach, 96, places a lot of value on a neat Appearance. The bright red lipstick is important to her. They are not complains, but if she feels comfortable?

©Jens Umbach

From the hustle and bustle and lack of time is felt in München-Feldmoching. Nurse Karina is sitting at the large dining table, and painted a resident of the nails. Next door a small group of the heaviest squats of the sick and is not playing along with supervisors Ludo!, some have your mobile ventilation machine. Seven people in need of care living in this delightful new building of about 400 square meters. Around 50 000 critically ill patients are now cared for outside of hospitals. With student stalls you have nothing in common. Rather, they are similar to small hospital wards. Karina has been working for one and a half years here. Previously she was in several of the classic old homes. She says it’s a difference like day and night. In the intensive care of a specialist is, on average, two and a half patients. “In the normal facilities, it is common that you will need to provide a second 30 people.” Karina remembers that she used to be as the only specialist in a home with 109 people on the spot. Although she had numerous care assistants to support, but were not allowed to do many things. So Karina had to race all day through the four-storey house. She wore a step counter into the bag. At the end of the shift he was nine kilometers and 42 floors.

Karina is working in Feldmoching so, as she has always wanted. “You don’t want to spend time with the people, not just the wash fire up and the drugs spread,” she says.

Between 13 000 and 16 000 euros for a single place in a care costs-rent per month. The market is considered to be highly lucrative. Three billion euros in sales, and the trend continues rapidly upward. The AKB-care service, the care of the facility in Feldmoching, belongs to the German specialist care group – recently bought by the US company Advent International.

nursing staff searched desperately

managing Director Elke Dodenhoff could provide in Feldmoching even more clients, but five of the twelve WG-rooms are empty, as well as the entire first floor. Dodenhoff is not enough staff. “The market is empty,” she says. In the case of the Federal employment Agency 23 862 open care for the elderly are reported. An average 183 days until a suitable candidate is found a peak value.

the poor pay is to blame? “No, that’s nonsense,” says Elke Dodenhoff. There is also no shortage of hairdressers, and would be paid much worse. Here the employees start with 3200 to 3500 Euro. With the supplements, experienced staff will come to around 4200 Euro per month. Christoph Jaschke, marketing Manager and spokesman for the German specialist care group, looks rather poor Image of the profession as the cause. “The Service of the people has in Germany simply a low social recognition,” he says. And the few that opted for a training, would be overwhelmed to the beginning total.

The staffing in the homes is so great that even the apprentices are used in the first year of the apprenticeship, often as full-fledged professionals. “The young people will be saddled with a responsibility that you overloaded completely,” says Jaschke, “if at the end of a third makes the conclusion, which is much. This is in comparison to other training a catastrophic rate.”

It is not so, that the policy would not have recognized the seriousness at all. Every home should now get a caregiver in addition, the payment will rise and a “Concerted action” training to make it more attractive.

But all this is hardly enough. After a quarter of a century, care insurance it would be a good time to make remedy. In the law the principle of “outpatient before inpatient” , but in reality, the number of homes increases, and the carers feel let down. The home care is not only humane, but also cheaper.

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Günter Stöhr, 83, lives in zehna years, together with his wife Babette in the nursing home. They celebrated here, even the diamond anniversary. The daughter comes in to visit every day.

©Jens Black

The self-interests of the residents explode meanwhile, in the average, it is 1830 euros. In a third of cases, must now step in, but again, the Department of social services. Not only in the CDU will be discussed, therefore, from the grant Fund a full – cost insurance with a quite high, but predictable Self -involvement. Others, such as the social expert Sell, demand to put more tax money into the System – because it was fairer, than to burden the contributors.

Above all, the excessive bureaucracy would have to be contained. If the documentation lasts soon longer than the actual care, it is absurd. Today, people Affected between providers of Care and health insurance as well as various authorities are wrong. To prevent the search for Yield, stop, it needed a strong body which regulates the market.

But all this time

Ralf Krüdewagen need not want to wait. A move he and his mother did not want to expect. In his frustration he turned to the nursing critics Claus Fussek, who introduced him to the Korian-Central. And lo and behold, after a few phone calls: The quality management system was turned on, the new staff moved in, the old forces have been re-trained. “All of a sudden it no longer smelled on the Station to have a pee, but after the flower shop. It’s so different!”

But until then, it’s been a long fight.

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Teodora Torrendo is an investigative journalist and is a correspondent for European Union. She is based in Zurich in Switzerland and her field of work include covering human rights violations which take place in the various countries in and outside Europe. She also reports about the political situation in European Union. She has worked with some reputed companies in Europe and is currently contributing to USA News as a freelance journalist. As someone who has a Masters’ degree in Human Rights she also delivers lectures on Intercultural Management to students of Human Rights. She is also an authority on the Arab world politics and their diversity.

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