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At the end of 1994, an Infratest carried out a representative survey in Germany of the life situation of people with disabilities who live in a institution. According to the results, about 660,000 people presently live in homes for the elderly and about 140,000 in homes for the handicapped. Impaired mobility is a characteristic feature for the inhabitants of homes for the elderly. However, only two of three inhabitants (63%) have "need of care". That means that at least every third inhabitant will not receive benefits from the new long term care insurance. 47% of the inhabitants rsp. 60% of those with need of care show mental disorders, which points to dementia. The living and life situation itself show that in Western Germany only 39% and in Eastern Germany only 29% of the inhabitants of the geriatric units of homes for the elderly are able to live in a single-bed room. The typical daily life normally shows routines, e.g., meal times are preset firmly. Restrictions such as no own room or front-door keys or no possibilities to keep pets are common. Therefore, quality control must be directed towards the extension of the living and lifestyle options of the inhabitants in addition to the problems of care giving. The individuality and the needs of the inhabitants must be the guiding rules for the options and procedures in institutions.

In two representative infratest-surveys, needs for care were systematically assessed regarding 24 basic activities of daily living (hygiene, mobility, communication, etc.). About 1.2 million persons in private homes and .5 million in homes for the elderly or handicaped were found to need care at least once a day. Impaired mobility was a persisting characteristic, partly due to physical disability, partly due to cognitive deficits. Being unable to phone or to orientate oneself outside the home, for instance, points to dementia. For the future, an increase in the number of persons who are dependent on care to 1.32 million in private homes and 900,000 who probably will live in homes for elderly, can be calculated for the year 2040 as a consequence of the demographic impact. Nevertheless, also in the future nearly one out of two elderly will be able to live independently without any need of care or help. Self-maintenance can be identified as the essential problem, because people with need of care will increasingly live alone without any relatives.