Personal Care Assistant

Geriatric nurse and geriatric nurses care for and look after sick or old people in the context of outpatient and home care, for example through social centers in their homes or stationary in nursing homes. Also in rehabilitation clinics, day care centers and in geriatric hospitals they are used, some are self-employed.

• 4.1 The aged care training in Germany 4.1.1 Legal basis
• 4.1.2 Admission requirements and remuneration
• 4.1.3 Structure and content of the training

• 4.2.1 training
• 4.2.2 continuing

• 5.1 The 1950s
• 5.2 The 1960s
• 5.3 The 1970s
• 5.4 The 1980s
• 5.5 The 1990s
• 5.6 The 2000s

General

The aged care places high demands on the nursing, psychological, and social skills. A geriatric nurse must be able to independently and in cooperation implement both medical treatment care and social care / psychiatric care with other professional groups. The formal requirements for planning and documentation over the years have increased sharply since 1995.

Responsibility and the type of activity differ depending on the place of care:

• Welfare centers and nursing services providing people in their own home; the nurses are there always only relatively short present.
• The people living in nursing homes often suffer from several diseases simultaneously ( multi-morbidity ), also from severe forms of dementia. The prolonged presence of trained nurses is therefore necessary.

Caregiver must document all daily care services carefully, this serves to billing and information from home and specialist physicians, other caregivers or another, involved in the therapy groups.

Vocational

In Germany, the elderly care for a long time was a secondary aspect of nursing. The staff in this area was, as far as they were not nurses or orderlies, qualified in courses or short courses. Slow and uneven, a content and time extensive training developed. Starting from the nursing, but also in contrast to her, was an independent profession and a dedicated professional ethics. The profession is predominantly a female profession, the proportion of men among trainees and examinierten has for years been fairly constant at 20 percent.

In addition to changing the assignment of the profession towards the medically-oriented care or towards social work is intensively discussed for a long time.

The care of the elderly struggling especially in contrast to nursing is an autonomous profession and another task understanding. Also, although the terminology differs only slightly but significantly. The name of the take care of people in hospital care is patient; in the elderly, these are referred to widely as inhabitants or by name. In ambulatory care, the term customer or client is gaining in importance since the seniors order individually selected and tailored to their needs nursing or care measures and pay. It is there for usually no doctor's prescription before.

Related professions are elderly care workers and in Switzerland the expert care.

Fields of activity

• See also the main article geriatric care about the extent and nature of the activities in the elderly.

In the elderly in addition to everyday tasks ( self-care ) and medically delegated tasks ( nursing) are some of the activities carried out, which set them apart from the hospital care. The biography and the habits of the patient are taken into account. This results from the necessary or desired long-term monitoring of a person in their private lives. The life care requires consideration of the principles of palliative care. Elderly care involves the social environment of a person, so first the family members in the care planning process. The consideration of geriatric psychiatry lies in the frequency and severity of age syndromes with massive personality changes.

Consideration of Biography

In the elderly, a focus on dealing with the biography of the person being cared for and the special opportunities that arise from it for the care of mental changes. ( It is sometimes also called " life history " of this basic principle of the elderly. )

Geriatric Psychiatry

Because of their special training, especially in dealing with mentally altered patients who suffer from various degrees of severity of dementia species, many geriatric nurse working in general psychiatric facilities, or in special care (see also Geriatric Psychiatry ).

Palliative Care

By common in seriously ill patients beyond 85 years multimorbidity ( presence of several diseases at the same time ) and the progression of chronic diseases is palliative care a core component of the old nursing activities. Nursing objective is no longer to cure, but the maintenance of the highest possible quality of life to enable to death. Is death foreseeable life care begins.

Training

The aged care training in Germany

Legal bases

The main legal basis for the training to the occupation of the Old carer or the care of the elderly are regulated ( AltPflAPrV ) which came into force on 1 August 2003 Elderly Care Act ( AltPflG ) and in the regulation pursuant to elder care law elder care training and examination regulation. With the adoption of elder care law elder care training was first regulated federally, after the Federal Constitutional Court had confirmed the pertinent competence of the federal legislature. The training for the profession of geriatric care, however, is regulated by state law.

Admission requirements and remuneration

Prerequisite for access to training, the average maturity, another completed ten years of elementary education or successfully completed a geriatric care exam. Here, when the grade of 2.5 or better was achieved, can be " entered " directly into the second year of training. There are also other ways to shorten the training time.

Trainees unless claims for unemployment benefits, unemployment benefit II or to a transitional payment made ​​in accordance with § 17 Section 1 AltPflG entitled to appropriate remuneration training in professional development according to the terms of the benefits for participation in the labor market regulations. In the circumstances require trainees training assistance can be obtained by the federal financial aid.

Structure and content of the training

The training lasts three years. It can also be done part-time and takes this case up to five years.

It comprises at least 2100 hours instruction and at least 2,500 hours of practical training. The lessons are given in a geriatric nursing school, which also carries the overall responsibility for the training and mentorship ensures; the practical training takes place at least 2,000 hours in a senior care facility.

While the health and nursing involves the care of the whole population, the training aims in the elderly to the care including counseling, support and care of the elderly.

The theoretical and practical instruction in the elderly is divided into four learning areas:

The learning areas are further subdivided into different learning areas (see Appendix 1 of § 1 AltPflAPrV ).

The practical training is organized as follows:

Education and training

The tasks of the Altenpfleger are changing. Education and training are anchored necessary but not a legal requirement in this profession. Responsibility for participation shall be borne initially each Caregivers for themselves. But when management task of the PDL they belong to the improvement of the structural features of the quality of care of the institution. The PDL should identify training needs and encourage participation within their budget. Response to this is in the context of staff development discussions.

In the elderly is to pay attention to the training of assistants particularly by up to 50 % high proportion of untrained personnel.

Topics comprehensive training in recent years are: care planning, quality of care / quality assurance representative, complaint management, hospice care, dealing with relatives. In addition, have the classical training, mainly financed by employers to management tasks and special care such as geriatric psychiatry continue their meaning.

Further education

Training serves to preserve the acquired through training or professional activity knowledge and skills and expand. Especially in healthcare are constantly training on the basis of new findings in medicine, and, more recently, nursing research is very important. Through training, no new accounts are purchased, it is usually only certifies successful participation.

One can distinguish the target produces various types of training:

• Expansion,
• Conservation,
• Adaptation,
• Advancement training

Another type of distinction is the classification according to the form of organization:

• In-service training
• External training

Further education

Continuing education in nursing has the objective of capacity building in order to evolve and ascend professionally. The training usually ends with an exam and leads to a new job title.

Typical developments in the elderly include:

• Teachers of Nursing ( Nursing Education, old names: teaching sister teaching sister / nurses ),
• Responsible nurse in accordance with § 80 SGB XI
• Certified specialist to lead a care and functional unit ( Middle level of operational nursing management; old - some of the more common - Designation: Station (SL) or Wohnbereichsleitung ( WBL ) )
• Certified Specialist Geriatric Psychiatry

• Compartment ( old ) for nurses ( General ) Psychiatry
• Director of Nursing ( training or study)

Similar developments often differ in the duration and cost of the events. The obligation to assume the costs must be examined in each case in detail. Employer support employees should sensibly.

There are various funding options for the cost of certain developments, such as master - federal financial aid grant from the Robert Bosch Foundation.

The requirements for participation to impart lessons Direction, required education-related internships are usually described by a state training and testing procedure or the Prospectus ( private broadcasters ).

Study

• Degree programs in nursing management, nursing education or nursing science
• Business Administrator in the social and health

History

Elderly care is a relatively new profession compared to nursing. Until the 1920s into permanent care, the elderly and people with dementia were housed in the so-called infirmary homes or in nursing homes, some of which were in terrible condition. The care in the few homes was responsible mainly people who had no professional training, but declared themselves ready for charity and other reasons, to this activity. Nurses were here to the end of the 50s, however, hardly. These were mainly engaged in the management level. A registered nurse were for the support of institutions in the traditional permanent care "too expensive" or they could not be motivated for the activities.

In the 60s a training took place in non-state- regulated courses or short courses. By and by individual federal states enacted training regulations and curricula for first year, later up to three year programs. It was a very inconsistent training landscape. By the year 2003 there were in the 16 states, 17 different training arrangements (national elder care laws).

The 1950s

In the 1950s, there were relatively few elderly and infirm homes. Elderly care was almost exclusively family care. The capacities ranged soon no longer sufficient, because there are always more elderly and disabled people were in the course of the postwar years and the economic miracle, the family wanted to take care not or could. Both world wars and the Industrial Revolution had many places destroyed the earlier family structures. The heads of these homes now were desperately new employees. Nurses there were not enough and also these were relatively expensive. For the care of the elderly esp. female labor was sought as assistants. These were easier to finance and were rumored to worry because all of the " typical female qualities " even without training to old people. End of the 50s began some religious denominations to perform in-house training for their Carer. Because the social needs of older people and thus also the number of homes continues to increase, emerged first confessional and later municipal schools. The course duration was a few weeks up to 6 months.

The 1960s

In the 60s, the care of the elderly was first a political issue and at the country level, there was the late 60s for the first time examination regulations for this new, socially -oriented profession of nursing elderly caregiver.

The 1970s

In Baden- Württemberg and other countries there were in the 1970s, a nationwide scheme to a 1.5 - year training. Part of this time was work / internship without classes, the so-called recognition internship. The professional understanding of the care of the elderly was formed at that time a mixture of lifetime support, medical care, housekeeping, hotel service and individual customer care.

In the 70s, inter alia, as a professional association of the DBVA ( German professional association for the elderly) was founded and published the first designs for a professional image.

The 1980s

The training course in almost all provinces was extended to two years and extended from the content here.

From DBVA a professional image for State Altenpfleger was formulated and the training concept extended. Since the late 80s, the payment of Carer has enforced according to BAT, as in the health and nurses. The great part of private homes as an employer depends on the basis of the market situation ( lack of staff ) also ( in large parts ) thereafter.

The 1990s

In Baden- Württemberg and other countries are now at least 2890 practice hours and 1760 lessons in the subjects of religious doctrine, German, professional and legal studies, gerontology, health and pathology, pharmacology, psychiatry, dietetics, nursing and medical care, enablement and rehabilitation practice in the elderly and possibly other electives or working groups ( eg data processing, senior dance ) mandatory. Prescribed internships constitute the bulk of the " apprenticeship ", which is very similar to the dual system. Most internships are completed in nursing homes, more in nursing homes, in the open and ambulatory elderly ( eg, welfare center, counseling center ) and in the hospital and in mental health care. In Baden- Württemberg there are about 6000 students in 1997. Was it before 1980 per year among 300 participants, the number of students increased steadily thereafter.

Only in the late 90s, it is nationwide to enforce the three-year training and to the fact that elderly caregivers such as health and nurses can perform medical treatment care in the physician order ( injection, etc. ). Also in welfare centers three-year trained geriatric nurses are now set.

Through the secured by the long-term care financing many outpatient services to be re- established since 1995. You need professionals to provide the contractually agreed with the insurance benefits. Also available are illegally employed foreigners (mainly from the eastern neighboring countries ) since a new field of elderly care; In addition to the existing institutions will be paid a round- the-clock care on behalf of the relatives at home as a kind of Aupairleistung (accommodation in the household). These are committed to the cash amount of the long-term care as pocket money ( wage replacement ). These women from Poland and the Czech Republic usually work without training and without standardized quality norms and without the protection of a verifiable treaty. In relatively few cases, there is the - slightly more expensive - way of working legally ( mediated by the Federal Employment Agency) used (Foreign Domestic Helper ). In nursing homes, there is a change in the disease severity of newly admitted nursing home residents. The nursing stations serve now to a large extent (70-80 %) of dementia ill old people, without being equipped as a psychiatric nursing home.

The 2000s

The old nursing education was regulated federally by the elderly care law on 17 November 2000 in the version published on 25 August 2003 and is counted legally to the "other" healing professions. The training period was extended from two to three years. The practical training can be performed in both the inpatient and outpatient environments. The development of the teaching staff and the management staff (see Care Management ) is not federally, improved by the establishment of higher education programs.