Poverty risk also extends to family caregivers: In Bremen, around 6,000 people in need of care who are cared for at home and are affected by poverty do not receive the "assistance with care" to which they are entitled. This is shown in a recent study on the topic of care poverty in Germany, commissioned by the Paritätische Gesamtverband (Parity Welfare Association). Nationwide, this affects approximately 300,000 people.
Under-provision and hidden care poverty
According to the study, in Bremen, only 1,090 of the 7,075 eligible individuals receiving care at home actually receive state support – that's just one in six (15.4%). For the Paritätische Bremen (a social welfare organization), this is an alarming sign, indicating inadequate provision and hidden poverty in the care sector. "Poverty in the care sector is often also the poverty of the people who care for their relatives – this is far too often overlooked in the public debate," criticizes Joachim Schuster, Chairman of the Board of the Paritätische Bremen.
Good care should not depend on postcode
Those requiring care must largely deplete their assets before receiving state assistance. At the same time, many family caregivers reduce or give up their employment – with lasting consequences for their income and pensions. This creates the risk that not only those needing care, but entire families, will slip into poverty. "The 'assistance with care' must finally reach those receiving care at home more effectively – it stabilizes the care situation and relieves the burden on family members. If we look at other city-states, we see that it can be done differently. Good care should not depend on one's postal code," said Schuster.
Ignorance, shame, and complicated application procedures
The reasons for not claiming "assistance with care" are manifold: ignorance or underestimation of one's own entitlements, shame about claiming state aid, and feeling overwhelmed by the application process. Experience shows that applications for "assistance with care" at Bremen's social service centers sometimes take six months or longer to process before being approved. The Paritätische (a German welfare association) is therefore calling for greater transparency and more comprehensive and understandable information for the target groups regarding their entitlements. Furthermore, processing times at the social service centers must be significantly reduced.
Care services observe inequalities in care
The situation is exacerbated by rising costs in outpatient care, while the in-kind benefits provided by long-term care insurance remain stagnant. Home care services are also observing an increasing devaluation of care services in real terms. "People affected by poverty are more likely to forgo necessary care services or compensate for them with family members providing care themselves. This masks the de facto rationing of care services, as it is increasingly shifted into the private sphere – disproportionately burdening low-income households," explains Mario Damitz, Managing Director of Paritätische Pflegedienste Bremen gGmbH (Parity Care Services Bremen). The administrative practices regarding "assistance with care" are also problematic for home care services: "We provide the services once approvals have been granted, but payments from social welfare agencies sometimes take months," says Damitz.
Overview of figures (Bremen):
According to the Bremen State Statistical Office, a total of 47,627 people in need of care live in Bremen. Almost 90 percent of them – 88.2 percent to be exact – are cared for at home. Of these, 22 percent receive support from an outpatient care service; the majority are cared for by family members.
- 47,627 people in need of care in Bremen in 2023, care groups 1-5 (Source: Bremen in Figures 2025, p. 49)
- of these, 11.8% (5,621) were inpatients and 88.2% (42,007) were cared for on an outpatient basis or at home.
- Entitlement to home care assistance: 7,075 people (study, p. 49)
- Number of actual recipients of HzP at home: 1,090 people (study, p. 49) = 15.4%
Source: German Parity Welfare Association / Bremen State Association, press release , March 19, 2026