Understanding the “Pflegegrad” System in Germany and Austria: A Guide for Caregivers

If you’re planning to work in the care sector in Germany or Austria, it’s important to understand the local care level system – “Pflegegrad” in Germany and “Pflegestufen” in Austria. In this guide, we’ll explain how this system works and what it means for caregivers.

1. What Are Pflegestufen and Pflegegrade? Basics in Austria and Germany

In Germany and Austria, there is a system of care levels that classifies how independent a person is in daily life and what kind of assistance they need.

• In Germany, since 2017, the Pflegegrad (care level) system has been in place, consisting of 5 levels based on the degree of loss of independence.
• In Austria, the Pflegestufen (care stages) system is used, comprising 7 levels, determined by the number of care hours required per month.

This classification helps to determine the type of assistance and financial support a person receives, as well as the tasks the caregiver will perform.

2. How Do Care Levels Work in Germany? Overview of the 5 “Pflegegrade”

In Germany, Pflegegrad determines how severely a person’s daily activities are restricted. The assessment is conducted by the Medizinischer Dienst (MD), which evaluates aspects such as mobility, cognitive abilities, self-care capability, and social interaction.

Care Levels (Pflegegrade) in Germany:

1️⃣ Pflegegrad 1 – Slight Loss of Independence
Minor difficulties in performing daily tasks.
Minimal need for assistance.

2️⃣ Pflegegrad 2 – Significant Loss of Independence
Requires regular help with daily activities such as dressing or meal preparation.

3️⃣ Pflegegrad 3 – High Need for Care
Ongoing support needed with mobility, hygiene, and eating.
Possible cognitive impairments, such as dementia.

4️⃣ Pflegegrad 4 – Very High Need for Care
Almost complete dependence on the caregiver in all aspects of life.

5️⃣ Pflegegrad 5 – Full Dependency
Complete reliance on care and inability to move independently.

Each level is linked to financial support from the Pflegekasse (care insurance), which helps cover caregiver and medical service costs.

3. Pflegestufen in Austria: What Do the Different Levels Mean for Caregivers?

In Austria, Pflegestufen are determined by the number of care hours required each month.

Care Levels (Pflegestufen) in Austria:

1️⃣ Pflegestufe 1 – From 65 hours of care per month.
2️⃣ Pflegestufe 2 – From 95 hours of care per month.
3️⃣ Pflegestufe 3 – From 120 hours of care per month.
4️⃣ Pflegestufe 4 – From 160 hours of care per month.
5️⃣ Pflegestufe 5 – From 180 hours of care + night care required.
6️⃣ Pflegestufe 6 – From 180 hours of care + special 24-hour care required.
7️⃣ Pflegestufe 7 – From 180 hours of care + complete dependency on the caregiver.

Just like in Germany, these levels influence the financial support and range of services available to patients.

4. Comparison of Pflegegrade and Pflegestufen: What’s the Difference?

Germany (Pflegegrad)

Austria (Pflegestufe)

Main Criteria

1 – Light Assistance

1 – From 65 hrs/month

Minimal daily support

2 – Significant Assistance

2 – From 95 hrs/month

Daily help, partial independence

3 – High Need for Care

3 – From 120 hrs/month

Daily assistance with mobility, hygiene, and eating

4 – Very High Need for Care

4 – From 160 hrs/month

Dependence on the caregiver

5 – Full Dependency

5–7 – From 180 hrs/month

Full-time care 24/7

5. What Are the Caregiver's Responsibilities at Each Care Level?

Depending on the level, the caregiver may be responsible for the following tasks:
✔ Pflegegrad 1–2 / Pflegestufe 1–2: Assistance with hygiene, meal preparation.
✔ Pflegegrad 3 / Pflegestufe 3–4: Support with mobility, help with toilet visits, feeding.
✔ Pflegegrad 4–5 / Pflegestufe 5–7: Full care, repositioning in bed, help with incontinence.

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