Germany's elderly care crisis: Families bear the financial and emotional burden

Most people needing long-term care in Germany rely on family support rather than residential facilities. New figures show that 85.9% are cared for at home, with over half receiving help exclusively from relatives. Yet, the financial burden on these families remains heavy, with out-of-pocket costs ranging from hundreds to thousands of euros each month.

Under German law, the principle of 'outpatient before inpatient' guides care decisions. This means home-based support is prioritised over full-time residential care, which only 14.1% of care-dependent individuals currently use. Families often take on the responsibility, with caregivers providing an average of 49 hours of care per week. A quarter even dedicate 57 hours or more.

Costs for home-based care vary widely. Monthly expenses for families can start at €340 but climb as high as €7,441, with a median of €2,085. For those with severe care needs, personal contributions may exceed €7,000 per month. By comparison, nursing home residents paid an average of over €3,200 per month in their first year as of January 2026. The Federal Association of Family Caregivers, *wir pflegen* e.V., has criticised the current system. They describe a 'scandalous imbalance' where home-based care is financially disadvantaged, especially for those with high needs. While exact data on private expenses for those cared for solely by relatives in 2024 remains unavailable, existing figures highlight the strain on households.

Germany's care system offers choices—residential facilities, professional home care, or family support. But the financial gap between institutional and home-based care remains stark. With most care-dependent individuals relying on relatives, the pressure on families, both in time and money, continues to grow.