Hamm – November 05, 2026 -- Families arranging live-in care for a relative in Germany often face private costs of 3,500 to 5,000 euros a month, depending on care level and individual needs, according to care provider SILESIA Pflege- und Betreuungsdienste GmbH. Founder and managing director Sarah Lange-Pasternak argues that the employment model behind a caregiver matters as much as the person herself.
A fall, a hospital stay or advancing dementia can quickly leave a relative needing many hours of daily support, more than visits from an outpatient nursing service can cover. Many families look for care at home, but run into models where caregivers are placed by foreign agencies or posted to Germany. Reports of problematic working conditions and unclear responsibilities add to the uncertainty.
Direct employment puts responsibility with one company
Whether a caregiver is placed, posted or directly employed determines who acts as the employer. At SILESIA, care assistants are directly employed under German work contracts. The company selects, trains and supports them, so families know who is responsible throughout an assignment.
Caregivers are trained before they start, and a nurse checks in every three weeks
New staff are trained by the nursing director on relevant conditions and the demands of home care. They also complete a first-aid course in Germany and prepare for the specific household. Polish-speaking staff in personnel support and nursing management can explain key content in the caregivers' native language.
Care assistants help with basic care, housework, daily tasks, supervision and companionship. Giving medication, insulin injections and wound care stay with qualified nurses or cooperating outpatient services.
After the start, a nurse visits the home to check that care works as planned. She stays assigned to the client and returns roughly every three weeks, even without problems, advising on aids, changes to the household and how care is organized.
Personality counts as much as experience
The process starts with a phone call. It is followed by a visit from Lange-Pasternak and the nursing director and, where possible, a meeting with the person needing care. For new clients, SILESIA avoids assigning a caregiver who has only just joined the company.
Where possible, one main caregiver stays long term, with a substitute covering vacations and breaks. In some cases two caregivers alternate regularly. The company asks both the family and the caregiver whether they want to continue. If problems persist after talks with both sides, a different caregiver can be assigned.
Households need private space for the caregiver
Because the caregiver lives under the same roof, she needs a sufficiently large private retreat. Severe dementia can make the work especially demanding, requiring more frequent changes between caregivers and enough breaks. Care needs can also change after a hospital stay, and the arrangement then has to be adjusted.
Lange-Pasternak says responsible advice includes openly checking whether round-the-clock care makes sense under a family's circumstances at all.