[Preventive Home Visits for Elderly People: A Systematic Appraisal of Current Application in Germany]

Preventive home visits (PHV) are a measure for promoting the health of elderly people. A study of these measures used over the past 40 years in many countries across the globe revealed a very diverse picture regarding targeted groups, applied structures and intervention contents. So far, there has been no clear evidence of their effectiveness on outcomes such as mortality, need for care, hospital or nursing home admissions. However, a steady increase in PHV programmes in Germany warrants an examination of the current national practice.

PHV programmes in Germany were identified in the course of Internet-based research (January 2018) and systematically compared by means of nine criteria that were defined beforehand.

38 PHV programmes were included: 26 currently implemented, and 12 that have been terminated. These showed a considerable variety in terms of their programme components. Medicine-oriented and social environment-oriented programmes (n=8 vs. n=24) could be differentiated. Relevant differentiation criteria were sponsorship, profession of home visitors and intervention contents. Thus, the practice in Germany is characterised as follows: municipal sponsorship, social workers conducting home visits, and guidance by consulting services disregarding integrated case management. Programmes of this type mainly emerged only in the current decade.

PHV for elderly people evolved from initially medicine-oriented into rather social environment-oriented programmes of municipal public service. They target elderly people with unclear need for support who, at the same time, are confronted with barriers to accessing suitable services. The anticipated main effect of PHV relates to the safeguarding of social participation. However, evidence for their effectiveness, still pending, should be made available before a broad or even legally anchored application is envisaged.