Entwicklung von Pflege-Wohngemeinschaften für Menschen mit Demenz und deren Perspektiven im Hinblick auf den demographischen Wandel

Abstract

Mitte der 1990er Jahre wurde die erste Pflege-Wohngemeinschaft für Menschen mit Demenz (MmD) in Berlin gegründet. Seither sind in Deutschland zahlreiche Pflege-Wohngemeinschaften entstanden, im vierstelligen Bereich, etwa zwischen 3.500 und 4.000, selbst ohne spezielle Ausrichtung. Diese Entwicklung wurde insbesondere durch das Pflege-Neuausrichtungsgesetz (PNG) im Jahr 2012 maßgeblich beschleunigt. Aufgrund des demographischen Wandels, mit der Verrentung der geburtenstarken Jahrgänge und der gleichzeitig ansteigenden pflegebedürftigen Gesellschaft ist die Sicherstellung der Gesundheitsversorgung als eine große gesellschaftliche Herausforderung der nächsten Jahre zu sehen. Gleichsam verändern sich Familienstrukturen, so dass die häusliche Pflege durch An- und Zugehörige nicht mehr als fester Bestandteil der Betreuungs- und Sorgearbeit angenommen werden kann. Das Konzept der Pflege-Wohngemeinschaften scheint zusätzlich stimmig zu sein mit den Vorstellungen von Pflege und Wohnen im Alter der neuen alternden Generation, da Individualität, Autonomie und Selbstbestimmung im Vordergrund stehen.

Abstract The first residential care community for people with dementia was founded in Berlin in the mid-1990s. Since then, numerous residential care communities have been established in Germany, even without a special focus, in the four-digit range between 3,500 and 4,000. In particular, this development was significantly accelerated by the Care Reorganisation Act (PNG) in 2012. Due to demographic change, with the retirement of the baby boomers and the simultaneous rise in the number of people requiring care, securing healthcare provision must be seen as a major social challenge in the coming years. At the same time, family structures are changing, so that home care by relatives can no longer be accepted as an integral part of caring work. The concept of residential care communities also appears to be consistent with the ideas of care and living in old age of the new ageing generation, as individuality, autonomy and self-determination are at the forefront. Research question This dissertation examines the current development of residential care communities for people with dementia and their perspective in the context of demographic change. However, it is only partially possible to fully answer the underlying question. The lack of transparency regarding the number and specific orientation of residential care communities makes it difficult to clearly identify trends at state and national level. Methodological approach An extensive literature review was conducted on the topic, the results of which are analysed in detail. Results and findings Due to considerable differences in the distribution of small-scale residential care arrangements at a national level and the lack of valid data, it is currently not possible to make concrete statements about current developments or the future prospects of outpatient residential communities. The identification of dementia residential communities in particular poses a major challenge, as people with dementia can also live in residential care communities, although these do not have to be explicitly designated as dementia residential communities. In addition, the availability of coordination and advice centres for shared care homes is not guaranteed in every federal state, which makes start-up projects more difficult and underlines the above-mentioned lack of transparency. Within the analysis, this results in four recommendations for action relating to security of supply, planning security, sustainability, and counselling structures. If the recommendations for action are observed and taken into account, a structured supply and demand management system can be derived that strengthens a further branch of care that will certainly be needed in the future alongside the established structures of outpatient and inpatient long-term care.