Psychological situation of home care patients in the Federal Republic of Germany

The demographic development, advances in medicine and also the increase in AIDS and paraplegia at an early age means that we must assume approximately two million people in Germany requiring care and attention or nursing on a longterm basis. Object of the explorative pilot-study is to analyse the conditions for mental well-being in the case of homecare patients and the influence on behaviour, enjoyment of life and the quality of their hopes for the future. In the study two comparable random surveys have been examined in all their demographic and medical characteristics: (1) homecare patients (n = 60) and (2) patients in old people's or nursing homes (n = 30); in so far as they can be compared, another random survey of younger homecare patients (n = 33) will be taken into consideration in some of the questions. Under examination is the hypothesis that the well-being of people requiring nursing is considerably dependent upon (1) the quality, activity and diversity of their social network (social assistance), (2) the extent of their own competence and deficiences (subjective level of performance), (3) the history of illness and the subjective health status (subjective health status), (4) the way in which they interpret and cope with their own illness (situative positioning), (5) their domestic surroundings, the sociodemographic situation and the subjective creative freedom (ecology), (6) the person's lifestyle and the quality of his prophylactic behaviour (biographical behavioural manner), (7) their ideas, opinions and convictions relating to the alternatives homecare and old people's or nursing home. General findings to be emphasized in the case of homecare patients--compared with patients in old people's or nursing homes--are that: homecare facilitates and/or encourages (1) greater personal freedom, own control over the environment, familiarity, security, variety, challenge, individuality, good care and attention, activation of needs, appetite, future orientation (well-being). (2) a higher level of active social contacts (ringing other people; visiting friends, neighbours, family; writing letters, holidays) and passive social contacts (visits, telephone calls and mail from friends, relatives, etc.) Instead of resignedly conforming to the situation, they are receptive for stimulation, learning, positive interpretation of the situation. (3) more possibilities for social contacts, communication, social stimulation: everyday pleasures are experienced more frequently.(ABSTRACT TRUNCATED AT 400 WORDS)