Children can be given a Pflegegrad (care grade) too – what is assessed is the extra help they need compared with healthy children of the same age. In Berlin, families with a child in need of care can turn to dedicated Kinderbeauftragte (officers for children) at the Pflegestützpunkte (care support points). And there are children and young people who provide care themselves – there is help for them as well.

Details

Care within the family has two faces when children are involved: sometimes the child is the person in need of care, sometimes the child helps with the caring. Both situations are under-represented in the support system – and both have their own points of contact.

Part 1: When a child is in need of care

According to the Landespflegeplan Berlin 2025 (Berlin's state care plan), around 5.800 children up to the age of 15 in Berlin are in need of care. The same long-term care insurance benefits apply to them as to adults – but the assessment works differently, and the surroundings are different: nursery, school, early intervention, children's hospital, Eingliederungshilfe (disability support) and the Pflegekasse (long-term care insurance fund) all have to work together.

How children are assessed

The Medizinischer Dienst (the medical service that assesses care needs) compares the child with a healthy child of the same age. Only the help needed over and above what is usual for that age is taken into account. A five-year-old who is helped to get dressed is not automatically in need of care – a five-year-old who has to be supervised throughout the day and have their airways suctioned certainly is.

Special rules apply to babies and infants up to 18 months: because they depend on help in all areas anyway, they are only assessed under the age-independent modules 3 (behaviour and psychological problems) and 5 (coping with demands arising from illness and treatment); instead of the self-care module, the question is whether there are serious problems with feeding. Lower point thresholds also apply (§ 15 Abs. 7 SGB XI): Pflegegrad 2 from 12,5 points, Pflegegrad 3 from 27, Pflegegrad 4 from 47,5 and Pflegegrad 5 from 70 points. As a result, these children are usually placed one grade higher than they would be under the general scale.

Important to know: After the 18th month of life, a new assessment is carried out under the normal rules. The Pflegegrad can go down even though nothing about the child has changed. Prepare for this assessment with particular care and expect that outcome, so that it does not catch you unawares.

Which benefits are available

• Pflegegeld (cash care allowance; as at July 2026): 347 € with Pflegegrad 2, 599 € with 3, 800 € with 4 and 990 € with 5 per month.
• Pflegesachleistung (care benefits in kind) through a children's nursing service: 796 € / 1.497 € / 1.859 € / 2.299 € per month.
• Entlastungsbetrag (monthly relief amount): 131 € a month from Pflegegrad 1 – can be used for family relief services, supervision services and recognised everyday support services.
• Verhinderungspflege (respite care) and Kurzzeitpflege (short-term residential care): a joint annual amount of 3.539 € from Pflegegrad 2 (since 1 July 2025), which can be divided flexibly between the two. Verhinderungspflege is the key to relief by the hour.
• Pflegehilfsmittel zum Verbrauch (consumable care aids): up to 42 € a month from Pflegegrad 1.
• Kurzzeitwohnen für Minderjährige (short-term residential places for minors): short-term inpatient places specifically for children and young people – scarce in Berlin, so enquire early and allow for waiting times.
• Outside long-term care insurance: Kinderkrankengeld (allowance for caring for a sick child), Eingliederungshilfe, a Schwerbehindertenausweis (severe disability pass) with marker codes, early intervention, school support assistants, outpatient children's hospice and palliative services, Pflegezeit and Familienpflegezeit (statutory carer's leave and family carer's leave) for working parents.

These amounts are as at July 2026; no increase was agreed for 2026.

The Kinderbeauftragte at the Pflegestützpunkte

Berlin has a special feature that many families do not know about: in almost every district, the Pflegestützpunkte have specially trained Kinderbeauftragte (officers for children). They advise families with chronically ill or disabled children, help with applications, coordinate between the Pflegekasse, the health insurance fund, the Jugendamt (youth welfare office) and Eingliederungshilfe, and know the specialist services in the district. The advice is free and independent; home visits are possible.

Part 2: When children and young people provide care themselves

Estimates made as part of the federal family ministry's “Pausentaste” project suggest that around 500.000 children and young people in Germany share responsibility for care at home: for a parent with multiple sclerosis, cancer, an addiction or a mental illness, for grandparents, for siblings. They cook, clean, help with personal care, interpret at public offices, comfort and organise – and almost never talk about it.

How to recognise young carers

• frequent absence or lateness at school or in training, a sudden drop in performance
• tiredness, headaches and stomach aches, withdrawal from friends
• striking maturity and willingness to take responsibility, little free time of their own
• evasive answers to questions about the family, shame about the situation at home
• fear that “something might happen” if they are not at home

Helping out is not a bad thing – it can strengthen a sense of self-efficacy and family cohesion. It becomes a problem when the responsibility rests on a child, when tasks are inappropriate for their age (personal care of a parent, medical procedures) or when school, friendships and sleep suffer as a result.

What helps young carers

• Being allowed to talk – anonymously, without an authority being called in straight away. That is exactly what the advice line Nummer gegen Kummer is there for.
• Relief for the family, so that the child can be a child again: a care service, Verhinderungspflege, the Entlastungsbetrag, home help.
• Allies at school: a teacher they trust, school social work, a guidance teacher. One informed adult at school often changes more than any formal measure.
• Peers: groups and holiday activities for young carers – the experience of not being the only one brings great relief.
• Clear agreements about which tasks the child takes on and which they expressly do not.

What to do?

If your child is in need of care

1. Apply for a Pflegegrad – informally with the Pflegekasse, and make a note of the date. Benefits are paid from the month in which the application is made.
2. Contact the Kinderbeauftragte: ring the Pflegestützpunkt in your district and ask expressly for the officer for children.
3. Prepare for the assessment: keep a Pflegetagebuch (care diary), have reports from the hospital, early intervention, therapy and nursery or school to hand, and describe concretely the extra help needed compared with children of the same age.
4. Plan for relief before your strength runs out: use Verhinderungspflege by the hour, ask about family relief services, and put short-term residential places on the list early.
5. Check other sources of support: Schwerbehindertenausweis, Eingliederungshilfe, a school support assistant, Kinderkrankengeld, Pflegezeit for parents.
6. Note the reassessment after the 18th month of life in your calendar and prepare for it just as carefully as for the first one.
7. Think of the siblings too – they often stand by quietly and take on responsibility unnoticed.

If a child in the family helps with the caring

1. Raise it without blame. “You do a lot at home. How are you coping with that?” – and be prepared for the first answer to be “it's fine”.
2. Offer anonymous advice: Nummer gegen Kummer (the German children's helpline), 116 111, free of charge and anonymous if wished, Monday to Saturday from 14:00 to 20:00; there is also chat and e-mail counselling via the pausentaste.de portal.
3. Organise adult support: care advice at the Pflegestützpunkt, a care service, the Entlastungsbetrag, Verhinderungspflege – every hour of professional help is an hour less of burden for the child.
4. Inform the school, if the child agrees. Allowances and flexible deadlines for handing in work are possible.
5. Set free time firmly: fixed times for sport, friends and sleep – not as a reward, but as a rule.
6. Feel responsible as a professional: teachers, paediatricians, care services and advisers are often the only people who notice young carers at all.

Where to find help

• Kinderbeauftragte at the Pflegestützpunkte (Berlin, almost all districts) – free and independent advice for families with children in need of care. Locations via Directory, service type “Beratungsstelle / Pflegestützpunkt” (advice centre / care support point). In Brandenburg, advice is given by the Pflegestützpunkte of the districts and independent cities.
• Nummer gegen Kummer: 116 111 – free and anonymous for children and young people, Monday to Saturday 14:00–20:00. Chat and e-mail counselling as well as accounts from young carers via the portal of the “Pausentaste” project.
• Outpatient children's hospice and palliative services, self-help groups and family relief services in Berlin and Brandenburg: via Directory, service types “Hospiz & Palliativ”, “Selbsthilfegruppe” and “Unterstützung im Alltag”.
• Groups for relatives, care courses and family activities: Events.
• The basics of applying: Applying for a Pflegegrad: step by step and Checklist: preparing well for the MD assessment.

If it all becomes too much and nobody knows what to do next: advice at the Pflegestützpunkt is also available at short notice and by telephone – and it costs nothing.