Live-in care in Germany
Live-in care explained simply
What it is, how it works day to day, who employs the caregiver, what the law says and what it costs. For anyone looking into it for the first time.
The essentials in brief
A caregiver moves in with your relative for an agreed period and supports them in daily life, so they can stay in their familiar surroundings.
Lives in the household
For the agreed period the caregiver lives with your relative and is by their side through the day.
Help in everyday life
Cooking, shopping, personal care and good company: everything that is hard to manage alone.
Clear hours and breaks
The name 24h describes the living arrangement, not constant work. Working hours and rest periods are agreed in advance.
The nursing service stays involved
Medical treatment care such as wound care stays with qualified nurses. Having both is the normal case.
Live-in care, 24-hour care and 24h nursing mean the same thing in everyday use: a caregiver lives in the household of the person who needs support for an agreed period. The German federal government considers the term "24-hour" misleading, because it suggests round-the-clock care by a single person. That is not legally possible.
Who is live-in care meant for?
It fits when someone needs help in daily life but wants to stay in their own home.
What speaks for it
- The person needs support every day, but not constant medical care.
- They want to stay in familiar surroundings.
- There is a room of its own in the house for the caregiver.
- Relatives cannot be there permanently.
What comes with it or speaks against it
- Medical treatment care, for example wound care, is handled by an outpatient care service (Pflegedienst).
- The caregiver has working hours, breaks and a day off. You need a solution for those times.
- If the person regularly needs help at night, a single caregiver is often not enough.
- A stranger moves in. That takes space and trust.
What the caregiver takes over, and what not
She moves into the household and is there in everyday life. These three areas are part of it.
Household and everyday life
- Cooking and preparing meals
- Shopping and errands
- Laundry and ironing
- Keeping the home clean and tidy
- Company on appointments and outings
Basic care
- Help with washing and personal hygiene
- Support with dressing and undressing
- Company on the way to the toilet
- Help getting up, lying down and moving about
- Reminders to take medication
Company and daily structure
- Conversation and a listening ear
- Walks in the fresh air
- Games, reading aloud and shared hobbies
- A steady rhythm to the day
- Patient support with dementia
And what a nursing service takes on
Medical treatment care such as wound care, injections or preparing medication stays with qualified nurses. An outpatient nursing service handles that. The two together are the normal case for 24-hour care, and if you do not have a nursing service yet, your Pflegekasse will help you find one.
The alternatives at a glance
Live-in care is one of several options. They are often combined.
Live-in care
One person lives in the household and helps in daily life. Care at home remains possible.
Outpatient care service
Qualified nurses come to the home at fixed times, for example for personal care or medical treatment. Between the visits, nobody is there.
Day care
The person spends the day in a facility and sleeps at home. This relieves relatives during the day.
Nursing home
The person moves out and is cared for there around the clock. On 1 July 2026, the average own contribution in the first year of stay was €3,364 per month.
What a week looks like
The caregiver lives in the household but does not work around the clock. Here you can see what a working day can look like and how the day off is arranged.
One week: care on up to six days, plus one day off. Alternatively there are two half days off. You agree together which day is free.
A typical working day
There is no rigid duty roster. The work follows the rhythm of the person in care and is usually spread over several blocks between 7 am and 8 pm. In between come breaks and free time.
Morning
Getting up, personal care, dressing and breakfast, at the pace of the person being cared for.
Late morning
Housework, shopping, cooking, appointments or a walk.
Midday
A meal together, then a break. While the person being cared for rests at midday, the caregiver has free time.
Afternoon
Conversation, games, exercise in the fresh air and company.
Evening
Dinner, evening routine and getting to bed. After that the working day is over.
Night
There is no duty to work at night. Only in an unforeseeable single case, for example after a fall, does the caregiver help. That counts as working time and is compensated with time off.
The key points
- On average 40 hours per week is usual, spread over up to six days
- Breaks and free time fall between the work blocks
- One day off per week or two half days off
- A long rest period lies between two working days
- At night the caregiver is in the house but not on duty
How much is worked is set out in the contract. A single caregiver cannot work around the clock.
Who is the employer? The options at a glance
There is no separate law for live-in care. The general rules of labour, social, tax and criminal law apply. The federal government's working group distinguishes several arrangements. Placement agencies are involved in almost all of them.
Employer model
- Who is the contract partner
- The household employs the caregiver directly
- Who is responsible for taxes and social insurance
- The household. German labour and social law applies, with minimum wage, maximum working hours and leave.
Posting (Entsendung)
- Who is the contract partner
- A company in another EU country that employs the caregiver
- Who is responsible for taxes and social insurance
- The posting company. With the A1 certificate, social insurance stays in the home country, for 24 months at most.
Self-employed caregiver
- Who is the contract partner
- The caregiver works on the basis of a service or freelance contract
- Who is responsible for taxes and social insurance
- The caregiver personally, with a registered business
Placement agency
- Who is the contract partner
- Depending on the model, the household, the caregiver or a company
- Who is responsible for taxes and social insurance
- An agency arranges the care but is not always the contract partner. Placement agencies do not need an official licence.
Without registration it counts as undeclared work
If the caregiver is not registered and there is no employer, this is legally undeclared work. Which model fits your situation depends on the individual case. Legal or tax advice can help you with that.
What the law says
These rules apply regardless of who arranges the care.
Minimum wage
The statutory minimum wage is €13.90 per hour, and €14.60 from 1 January 2027. In 2021, the Federal Labour Court ruled that posted caregivers in private households are entitled to the minimum wage for standby time as well.
Working hours
Even someone who lives in the household does not work without limits. There are rules on maximum working hours, breaks and rest periods. A single caregiver may not work around the clock.
No separate law
The 2021 coalition agreement promised a legally secure basis for 24-hour care. The federal government's working group presented its final report in November 2024. The draft of the Pflegeneuordnungsgesetz (care reorganisation act) contains no rules for live-in caregivers.
Providers do not need a licence
There are no statutory minimum requirements for placement agencies. Providers show quality through voluntary certificates, memberships and reviews.
The figures, sources and court rulings are in the report "24-Stunden-Betreuung Report 2026".
To the reportHealth insurance, A1 and other papers
These proofs are part of legally secure care. Who takes care of them depends on the model.
Health insurance
The caregiver needs health insurance cover. For caregivers from other EU countries, this is often proven by the European Health Insurance Card (EHIC).
A1 certificate
It shows that a posted caregiver stays socially insured in their home country and pays no contributions in Germany. It is valid for 24 months at most.
Business registration
Self-employed caregivers need a registered business and arrange their own health, pension and accident insurance.
Liability insurance
Liability insurance covers damage the caregiver causes in the household. Ask whether the provider has one and what it covers.
Invoice
You also need a proper invoice for the tax relief. Whether VAT is shown depends on where your contract partner is based.
What does live-in care cost?
The monthly price depends mainly on the caregiver's German language skills. The following figures come from an analysis of the published prices of 56 providers from October 2026.
Entry prices
Half of the published entry prices lie between €2,550 and €2,860 per month, with a median of €2,700.
Check the prices
A monthly price includes wages, contributions, placement and travel. At the statutory minimum wage, a caregiver working 40 hours a week costs around €2,409 gross per month in wages alone. If a price is lower than that, ask: How many hours a week does it cover, how is the caregiver paid and registered, and what is included in the price?
German language skills
Better German skills cost €200 to €1,000 more per month, depending on the provider.
Additional costs
Travel costs, placement fees and flat fees are often not included in the monthly price. Only the total costs over a period can be compared.
Board and lodging
The caregiver's room and meals come on top. One provider puts them at around 150 € to 200 € per month.
Why prices differ so much
The scope of services, working time assumptions and employment model differ from provider to provider. Prices can therefore only be compared with the scope of services in mind.
All prices are provider figures before deducting Pflegegeld and tax relief. They have not been checked and are not binding offers.
All prices in the reportWhat the care insurance and the tax office contribute
These benefits reduce what you pay yourself.
Pflegegeld
It is paid when care is organised privately, for example €599 per month at Pflegegrad 3.
Joint annual budget
€3,539 per year is available for Verhinderungspflege and short-term care.
Tax relief
Under § 35a of the Income Tax Act (Einkommensteuergesetz) you can deduct 20 % of labour costs, up to €4,000 per year.
Care reform 2027
On 30 September 2026, the federal cabinet approved the draft of a Pflegeneuordnungsgesetz. It is not yet law.
What to look out for when choosing
Consumer advice centres and care support centres name these points to check.
Who is the contract partner
Does the contract say who you are signing it with, and whether there are two contracts?
Total costs
Are the monthly price, placement fee, travel and changeover costs itemised?
Termination
How short is the notice period, and how long does the contract run at a minimum?
Replacement if the caregiver drops out
Who provides a replacement if the caregiver falls ill or is not a good fit, and within what time?
Sample contract
Do you get the contract in advance to read?
Quality seals
Who checked, what was checked and how long is it valid?
Live-in care at CAIR
CAIR arranges live-in care and shows you before booking who your contract partner is and what the care costs in total. How exactly that works is explained in the detailed explanation.
Still have questions? We will clear them up with you.
CAIR advises you on your situation in a free needs consultation. The conversation does not commit you to anything.
This page gives general explanations and does not replace legal, tax or care advice.