Home Age & Care Need for care – the causes

Need for care – the causes

by Josephine Andrews
Published: Last Updated on 166 views

According to the law, the need for long-term care is given when someone is unable to carry out everyday tasks, activities and obligations for at least six months due to physical or mental problems or limitations and needs help to do so. Above all, chronic illnesses (e.g. cardiac insufficiency, rheumatism, dementia) and sudden events such as a stroke or a fall are frequent reasons for the need for care.

Six disease groups

There are six major disease groups that are responsible for the majority of all nursing cases:

  • diseases of the circulatory system
  • Mental and behavioral disorders
  • diseases of the nervous system
  • diseases of the musculoskeletal system
  • cancers
  • Senility and other non-specific symptoms

diseases of the circulatory system

Diseases of the circulatory system are a very common reason for applying for care services in both men and women. Heart failure ( heart failure ) and stroke are the most common triggers for the need for care. The reason: the heart and brain are very sensitive organs that react most quickly and sensitively to changes in the blood vessels supplying them (such as arteriosclerosis ).


A stroke occurs either as a result of an acute reduction in blood flow in the brain (ischemic stroke) or as a result of cerebral hemorrhage (hemorrhagic stroke). The consequences can include unsteady gait, paralysis, speech disorders, clumsiness in handling cutlery and tools and reduced mental performance. If permanent limitations remain after the healing phase of the stroke, the patient needs specific help. These can be simple tools such as thicker cutlery handles or a non-slip cutting board. However, the stroke can also cause bed rest and require all-round care.

heart failure

After a heart attack, heart muscle inflammation or long-term alcohol consumption, the pumping capacity of the heart muscle can be so severely restricted that many physical activities are no longer possible. This heart muscle weakness means that various body tissues no longer receive sufficient blood – and thus oxygen and nutrients. Even the slightest physical exertion manifests itself in shortness of breath and muscle weakness. People with severe heart failure need help even with normal activities such as shaving or getting to the living room.

Mental and behavioral disorders

Slowly progressing degradation processes in the brain are primarily responsible for the need for care in old age, mostly summarized under the term dementia . Alzheimer’s disease is the most common , followed by vascular dementia . Both are – just like frontotemporal dementia (Pick’s disease) – independent diseases (primary dementias).

Rarely is dementia the result of other diseases or health disorders, such as Parkinson’s , HIV or chronic alcohol abuse. This is then referred to as secondary dementia .

Since the introduction of the new definition of the need for long-term care in 2017, people with dementia have had access to all long-term care insurance benefits, just like people with physical disabilities.

diseases of the nervous system

Inflammation and breakdown processes in the nervous system can restrict the range of motion to such an extent that chronically ill people are completely dependent on the help of others. Mental impairments do not have to be present.

An example of such a neurological condition leading to the need for care is multiple sclerosis. It can lead to disabilities at a young age. In older people, it is mainly Parkinson’s disease that leads to limitations in everyday life. The neurological consequences of diabetes are on the rise, especially diabetic polyneuropathy : First, toes and feet become numb and numb, later walking becomes increasingly unsteady. Finally, paralysis sets in so that the patients can no longer move around without assistance.

diseases of the musculoskeletal system

Signs of joint wear and tear ( arthrosis ) and rheumatic diseases cause pain and unsteady gait. There is a risk of falls, in which those affected can injure themselves, so that they are often further restricted as a result. If hands and fingers are also affected, it can severely impair dexterity in general and the ability to perform everyday activities such as tying shoelaces, holding onto a banister or eating.


It is often not the cancer itself that leads to comprehensive helplessness, but the consequences of the tumor. Severe pain, unstable bones due to secondary tumors (metastases), severe digestive disorders or impairment of brain function in the case of brain tumors are the reasons for the increased need for help in the last phase of the disease.

Senility and other non-specific symptoms

Possible causes of the need for care include illnesses in which mental abilities and physical resilience decrease.

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