Care and Support

The need to care for and support elderly people is no longer the exception today, and has become a central issue in Austrian social policy.

Not only people in need of care, but also their caregiving families and relatives require support, because they are taking on a great burden and making an extremely valuable contribution to society. Caring for someone at home is undoubtedly a great challenge for all those involved.

Depending on the health, living and family circumstances of the person, every care situation is different. In addition, financial conditions and the housing situation play an important role.

In order to obtain deeper insights into the everyday lives of caregiving relatives, particularly in care at home, but also in residential homes, the Institute of Nursing Sciences in cooperation with the Institute of Sociology of the University of Vienna were commissioned to carry out the study Care Provided by Family Members in Austria. On the basis of this study, it can be assumed that around 801,000 persons are involved in the informal care and support of a person in need of care at home, while 146,000 carry out such informal care work in residential long-term care settings. These figures include the main carer, but also other persons from among the families and friends of the person being cared for. These 947,000 represent around ten percent of the Austrian population.

The Report on Long-term Care in Austria informs its readers about fundamental facts, but also about new developments in the field of long-term care.

Information on the range of residential and care homes available can be viewed on the website of the Infoservice of the Ministry of Social Affairs.

The Council Recommendation on access to affordable and quality long-term care is part of the European long-term care strategy. It contributes to the implementation of the European Pillar of Social Rights.

The aim of the Implementation report on the "Council Recommendation on access to affordable high-quality long-term care" (PDF, 857 KB) is to present Austria's long-term care system with regard to the recommendations.

Long-term care allowance

In Austria, around 500,000 people are entitled to long-term care allowance. Due to demographic trends, the need for long-term care has developed from an individual marginal phenomenon into a challenge for society as a whole. Austria was one of the first countries to face up to this problem and, after extensive preparations, created a uniform long-term care system in 1993.

The long-term care allowance is an earmarked benefit that is independent of income and is intended to cover additional care-related expenses only and is therefore not designed to create a general increase in income. Since the actual costs of care exceed the long-term care allowance in most cases, the long-term care allowance should be regarded as a lumpsum contribution to the costs of the care required. It enables people in need of care to enjoy a certain degree of independence and to remain at home (for longer). The long-term care allowance is financed exclusively from the federal budget.

The amount of the long-term care allowance is determined exclusively by the specific need for care and assistance. The permanent need for care due to a physical or mental disability, learning disability or sensory disability must have lasted for at least six months and amount to more than 65 hours per month on average. The granting of a long-term care allowance is independent of the cause of the need for care and the income, assets and age of the person concerned. Even though the long-term care allowance can be paid from birth, the majority of recipients are older people.

If the requirements are met, there is a legal entitlement. The rejection of an application can be contested at the Labour and Social Court.

Due to the structural reform of the Austrian social security system, there will be the following three decision-makers from 2020:

• Social Insurance Institution for the Self-Employed (SVS)
• Insurance Institution for Public Employees, Railways and Mining (BVAEB)
• Pension Insurance Institution (PVA)

Since 2020, the annual valorisation of the long-term care allowance has been based on the respective pension adjustment factor. The resulting amounts are determined annually by a regulation of the Ministry of Social Affairs.

The long-term care allowance is available at seven levels. The decisive factor is the determined care expenditure in hours per month.

The long-term care allowance – overview

The extraordinary care requirements at long-term care allowance level 5 are present in particular if the permanent readiness, but not the permanent presence of a caregiver or regular checking up on the patient by a caregiver in relatively short time intervals is required. At least one follow-up visit must be required during night hours. Or more than 5 care units are required, including one during the night hours (between 10 p.m. and 6 a.m.).

Classification at level 6 is assigned if a predefined care plan cannot be adhered to and thus the care must be provided immediately. The long-term care allowance is paid at this level also when a caregiver must be present at all times, for example to prevent aggressive acts.

Long-term care allowance level 7 requires that no purposeful movements can be performed with the 4 extremities. A comparable condition exists, for example, if the person in need of care is dependent on the help of vital technical aids (e.g. a ventilator).

The detailed provisions for assessing the need for care are set out in the classification regulation of the Federal Long-term care allowance Act (Einstufungsverordnung zum Bundespflegegeldgesetz) (PDF, 128 KB). The classification regulation contains definitions of care and assistance and estimated times for individual activities, e.g. for dressing and undressing, personal hygiene, preparing and taking meals, and mobility assistance.

A separate children’s assessment regulation (PDF, 156 KB) was issued for the uniform assessment of the need for care for children and adolescents up to the age of 15.

The basis for the award of long-term care allowance is an expert medical opinion. Qualified nurses can also be consulted as experts for the assessment of long-term care allowance. As a rule, the assessments are carried out in the form of home visits. Upon personal request, the presence and opinion of a trusted person (e.g. the caregiver) who can provide information on the specific care situation must also be facilitated during the assessment.

The special needs of people with learning and mental disabilities are taken into account by assigning the same importance to guidance and supervision as to care and assistance and by including an estimated time for a motivational interview. Hardship supplements were laid down as fixed values. This is intended to take into account factors that make care more difficult:

• for children with severe disabilities and adolescents up to the age of seven, 50 hours per month, and up to the age of 15, 75 hours per month;
• for persons with severe learning disabilities or mental disabilities and persons suffering from dementia from the age of 15, 45 hours per month (from 2023).

Individual groups have very typical, largely similar care needs because of a particular disability. Therefore, certain long-term care allowance levels are assigned to these disabilities.

1. Visual impairment

• severely visually impaired people: level 3
• blind people: level 4
• deafblind people: level 5

2. Wheelchairs as mobility aids

A fixed assignment to one of the long-term care allowance levels is also provided for persons who are reliant on the independent use of a mechanical or electric wheelchair. This applies to people who are at least 14 years old and can overcome their limited mobility and move around independently by using a wheelchair.

If independent use of a wheelchair is necessary because of paraplegia, bilateral leg amputation, genetic muscular dystrophy, multiple sclerosis, or infantile cerebral palsy, a level 3 long-term care allowance is provided.

If there is also faecal/urinary incontinence or bladder/bowel paralysis and no restrictions on the upper extremities, a diagnosis-related minimum classification of long-term care allowance at level 4 is possible. A functional restriction of the upper extremities (independenttransfer to and from the wheelchair is not possible) justifies a level 5 long-term care allowance.

How to get care allowance

People in need must apply for care allowance, although members of their family or members of the household can also apply. If living in a home and part of the costs are borne by the social assistance or the minimum income provider, these institutions are also entitled to apply. Recipients of a pension submit the application for care allowance to the competent insurance institution. Medical certificates or findings from a hospital regarding the current state of health can be enclosed with the application.

Persons who are

• working,

• co-insured relatives (for example, as a housewife or child),

• recipients of a minimum income scheme can apply for the care allowance at the pension insurance institution.

The application for care allowance can be submitted informally. Subsequently, the applicant will be visited at home by medical staff or a qualified health and nursing professional. This home visit is announced in advance. The expert determines the applicant‘s care needs. It is recommend to have a trusted person on hand for this assessment, for example the carer, who can provide information on the specific care situation. If the applicant is cared for by staff of a social service, the medical expert will take the existing care documentation into account when assessing the need for care. Living in a home, the information provided by the nursing staff must be taken into account in addition to the nursing documentation.

On the basis of the expert opinion, the competent authority will decide whether the applcant will receive care allowance and, if so, to what amount, and will inform of this in the form of a decision. Recipients will receive the care allowance retroactively from the month following the application.