["But you often come unstuck on particularities" - Care consultants on legislation amendments and the challenges of their job: A qualitative investigation]

Abstract

Introduction: Since the implementation of long-term care insurance in 1995, various reforms have contributed to the development of the German nursing care system in order to meet the structural and financial needs of the growing number of people in need of care. The aim of this paper is to present an assessment of care consultants on past legislation, challenges encountered during their work and suggestions to improve the current care system.

Methods: 14 semi-structured, face-to-face interviews were conducted with care consultants. All interviews were transcribed verbatim and a qualitative content analysis was performed.

Results: Care consultants perceived tangible improvements with regard to the scope of benefits as a direct result of recent legislation changes. The use of these benefits, however, is limited due to an insufficient growth of care infrastructure. Particularly frequent legislation changes, unclear responsibilities and dissimilar regulations between federal states were seen as challenges.

Discussion and conclusion: Complex dependencies within the German nursing care system were identified and the necessity for a public discourse on themes such as self-responsibility, equity and a comprehensive (nationwide) care supply was underlined. A central information platform was proposed in order to concretely improve information about services available locally.

Keywords: Berater; Consultant; Content analysis; Inhaltsanalyse; Interviews; Long-term Care Strenghtening Act; Nursing care; Pflege; Pflegestärkungsgesetz.