How many areas are in care
Thanks to good living conditions, a large number of people enjoy good health well into old age. However, with increasing age, the risk of serious illnesses or the need for care increases - and with it the number of those in need of care. Around 3.3 million people are currently in need of care. The demand for professional care and support in everyday life is growing accordingly due to the increasing number of people in need of care. Demographic change affects long-term care in two ways. As the population ages, so does the demand for professional care. At the same time, the potential workforce from which the need for skilled nurses can be met is falling.
Elderly care is a growth industry
Care for the elderly has been one of the fastest growing service sectors in recent years. The number of employees in outpatient care services and inpatient care facilities with around 80,000 jobs rose by around 8 percent in the period from 2013 to 2015 alone.
Almost 1.1 million people are currently employed in care services and in nursing homes. More than 85% of them are women. The majority of the staff, around 72%, work part-time. When converted to full-time equivalents, this results in a total of 764,000 full-time positions (source: Federal Statistical Office). Unoccupied positions approx. 25,000 to 30,000.
The occupational field of nursing and health professions without a license to practice medicine includes all professions in health care except medical specialists and pharmacists. Nurses and geriatric nurses were the largest group of employees in this occupational field in 2012 (microcensus) with almost 55 percent. According to this definition, nurses are people from health care and nursing, child nursing and care for the elderly. The latter differentiates again between geriatric care professionals and geriatric care assistants.
In addition, other professional groups are involved in the care of the elderly, e.g. additional carers, housekeeping support persons, administrative staff and members of other social professions.
The following notes relate to elderly care workers:
Number of current nurses in each facility
(according to the nursing statistics 2015, published 2017)
- In 2015, almost 1.1 million people were employed in outpatient care services and inpatient care facilities.
- That is around 74 percent more than in 1999.
- The number of nurses in outpatient services and inpatient facilities according to SGB XI increased by around 77 percent between 1999 and 2015
- 310,539 geriatric nurses and geriatric care assistants ensure high quality care for those in need of care in 13,300 outpatient care services and in 13,600 inpatient care facilities
- 140,639 nursing students (health care and nursing, nursing for children and the elderly) for the 2016 school year. 68,260 of them in care for the elderly.
- The number of trainees in geriatric care is increasing: In the 2016 school year, around 24,130 people began training, an increase of 518 or 2.1 percent compared to the previous year.
- More than every fourth training (here only new entrants) to become a geriatric care specialist was funded as retraining. The federal government, the federal states and associations implemented numerous measures through the "training and qualification offensive care for the elderly" in the years 2012 to 2015 with which the training, further education and training in care for the elderly is permanently strengthened.
Compensation of nurses
- Skilled workers in geriatric care earn a median of EUR 2,621 per month nationwide.
- The remuneration of skilled workers in geriatric care ranges from EUR 1,985 in Saxony-Anhalt to EUR 2,937 in Baden-Württemberg.
Skilled labor situation and forecasts
There is already a shortage of skilled workers in all nursing professions. However, there is no official information on the number of vacant positions in the nursing professions. Indications of existing bottlenecks can be found in the Federal Employment Agency's analysis of the specialist bottleneck (as of December 2017). Vacancies for qualified geriatric care specialists are therefore vacant for an average of 171 days. For every 100 registered jobs (outside of temporary work) there are only 29 unemployed.
The bottleneck analysis by the Federal Employment Agency reflects the current situation - a forecast of the development cannot be derived from it. Many of the measures taken in the last legislative period to secure skilled workers will naturally only show their effect in the next few years.
The future need for staff in the nursing professions depends on various factors such as population development and the actual frequency of care cases, the future proportion of outpatient and inpatient care in nursing, the ratio of skilled workers to auxiliary workers, replacement needs due to retirement due to reasons of age, interruption times or length of stay in the job , Development of working hours, but also the existence of alternative support offers and possible relief from medical and technical progress or digitalization. Various studies suggest that the factors mentioned can have a major impact on the actually expected staff shortage.
The prognoses of research institutes come to different results:
Assuming that the probabilities of long-term care and the staffing needs for those in need of care remain unchanged and only depend on demographic developments, demographic change alone could lead to the need for full-time care workers (both skilled workers and care assistants) by around 27 percent by 2025 compared to 2005 increases. If the employment structure is constantly updated, this could lead to a gap in trained nursing staff of around 200,000 nursing staff in 2025.
If, on the other hand, the likelihood of long-term care shifts to a later age with increasing life expectancy, the need for full-time caregivers could increase by around 20 percent by 2025. In this case, a significantly smaller gap of around 140,000 nursing staff would be expected.
A study by the Bertelsmann Foundation (2012) shows the importance of using different types of care: Assuming unchanged probabilities of care cases, an increasing rate of care in the outpatient sector and a stabilization of care for relatives can almost halve the supply gap.
In a prognosis for the year 2050, the DIW (2012) comes to the conclusion that with an increased attractiveness of the nursing profession and an increase in the number of economically active persons through immigration, the supply of nursing staff could increase from 510,000 to 930,000. A gap in demand could thus be significantly reduced or, assuming a reduced probability of long-term care cases, be avoided entirely.
A study carried out by Prognos AG (2012) for the Association of Bavarian Economy, which quantifies the different contribution margins of economic policy measures, comes to the conclusion that an increased attractiveness of the nursing profession and increased retraining of nursing assistants make a major contribution to avoiding a labor shortage can.
According to the analysis carried out by the Federal Statistical Office and the Federal Institute for Vocational Education and Training, making professions more flexible is of great importance: If unskilled and semi-skilled nurses are also taken into account, there could be a shortage of 110,000 nurses in 2025 with an unchanged probability of nursing care or around 60,000 with a reduced probability of long-term care.
Additional carers noticeably improve everyday care. Both those in need of care and the skilled workers are supported. This is also confirmed by a study carried out on behalf of the Federal Ministry of Health in 2015. The employees in the care facilities stated that the care offers had a positive effect on the vast majority of the home residents, for example in the form of greater satisfaction, a better mood or a reduction in inner restlessness.
The Nursing Strengthening Acts have made it possible for more than 60,000 women and men in inpatient care to work as additional caregivers to improve day-to-day care. This results from the current development of expenditure. In 2013 there were only around 28,000 additional carers.
The contracting parties at the federal level will develop and test a scientifically sound method by June 30, 2020 to measure the personnel requirements in outpatient and inpatient care facilities on the basis of the average care expenditure for professionally appropriate care measures and for help with housekeeping (Section 113c SGB XI). The procedure not only takes into account the understanding of care and support on the basis of the concept of long-term care that has been in force since January 1, 2017, but also the qualification requirements. Concrete benchmarks for a technically sound staffing of the care facilities can be derived from the personnel assessment procedure.
The nursing training, which was previously regulated separately in the Geriatric Care Act and the Nursing Act, has been merged in the Act to Reform the Nursing Professions. This creates the prerequisites for modern nursing training, which prepares nurses better for the changed challenges in professional practice and opens up new career and career opportunities.
The Nursing Professions Act has been in force in parts since July 2017. It creates the basis for being able to present the training and examination regulations in good time before the start of the new training. The first year of training is to begin in 2020. Nursing schools and training institutions thus have enough time to adjust to the new training.
The nursing assistant training can be credited towards the training to become a nurse.
The individual regulations can be found in the glossary article.
The care documentation is necessary for the care process and internal quality management in the facilities and also serves to ensure the quality of care for those in need of care. As part of one of the BMG
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