[Strengthening preventive potential in care counseling]

The German system of obligatory long-term care insurance provides for several types of counseling in the Social Security Code XI (SGB XI). The counseling is mainly directed at persons in homecare arrangements and their family member caregivers. In principle, long-term care counseling according to SGB XI § 7a and § 37 par. 3, as well as the instruction according to § 45, together provide possibilities and very good access to sustainable preventive interventions for both groups, e. g. services to reduce burden and distress, provision of nursing techniques, or comprehensive case management.The objective of this contribution is to give an overview of the conditions for prevention in long-term care counseling and to strengthen the existing possibilities. It provides a comparative systematization of legal and structural aspects of long-term care counselling as well as topics with direct or indirect reference to prevention. Finally the contribution highlights the state of knowledge about the utilization of long-term care counselling as a starting point for its further development with respect to prevention.Today, long-term care counseling provides explicit preventive orientation and early access, especially for family member caregivers. In order to strengthen the preventive potential, it is necessary to improve the coordination of the different types of counseling in practice as well as to strengthen the entitlement of family member caregivers to counseling.The counseling visits according to § 37 par. 3 provide good access to preventive interventions. The instruction according to § 45 SGB XI should be strengthened as individual intervention to identify and deal with individual risks. The long-term care counseling according to § 7 a offers systematic and sustainable (preventive) support. However, concrete steps to enforce prevention in long-term care counseling must be subject to further systematic investigation using current data that allows cross-comparison.