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Topics related to Care & Support
Ambulant care services
Country Selection
As the topic varies greatly across Europe, you will find the information divided by country. You will find the information for your own country translated into your national language. By clicking on the country flag and selecting other country flags, you can also access the information for other European countries in English.
Why are ambulatory care services important?
The Italian National Health Service provides rehabilitation and functional maintenance services to individuals with complex disabilities. These services help to acquire skills or abilities never achieved or mastered, recover skills and abilities that may have been lost, or maintain residual abilities. If the person’s clinical condition and family background permit, the Local Health Authority (ASL) designs individualised rehabilitation plan to be carried out at local outpatient clinics or at home.
To obtain rehabilitation assistance, the patient or a family member can apply to the rehabilitation services of their ASL where an assessment of the clinical, physical, psychological, and socio-familial conditions will be carried out. The outcome of the assessment is an individualised rehabilitation plan setting out the rehabilitative, medical, specialist, and psychological services needed.
The following is an overview of outpatient services in Italy and a step-by-step guide on how to access them.
What outpatient services are there for people with disabilities in Italy?
The following overview lists a number of outpatient services for people with disabilities.
Casa della Salute [Houses of Health]
Houses of Health are local facilities that are easy for citizens to recognise and access, where a wide range of health needs can be met through integrated services, such as reception and care, with social service professionals.
Click on this link for more information on the service.
DAMA - Advanced medical reception for people with disabilities from birth
The DAMA project was created through collaboration between associations that deal with disabilities from birth and the Ausl of Bologna. Its aim is to create a dedicated healthcare pathway to provide suitable answers to their health problems.
Click on this link for information on this service and how to access it.
Ambulatory nursing care
In an outpatient clinic, tasks are divided according to staff’s expertise. While doctors handle the technical and diagnostic aspects, and the secretary manages the bureaucratic and management tasks, nurses collaborate with doctors in care management.
Click on this link for more information on the service.
Good practices
CAU – Centri di assistenza urgenza [Emergency Assistance Centres]
Article published in the newspaper Il Resto del Carlino.
Resources
The website of your region contains information on the health centres closest to you. Follow this link.
Article on assistance to individuals with disabilities of the Ministry of Health
Home and outpatient social and health care for people with disabilities (Art. 27, Decree of the President of the Council of Minister, 12 January 2017)
Connected topics
Who can use the care services of these ambulatory care services?
In Germany, care services for young people in need of care can be provided, financed and regulated by two different institutions: the Pflegeversicherung (Long-Term Care Insurance) (SGB/ social code XI) and the Eingliederungshilfe (Integration Services) for people with disabilities (SGB/ social code IX).
Long-Term Care Insurance is for individuals who are dependent on care due to health impairments to organise their everyday lives. Its aim is to help them regain or maintain their physical, mental and spiritual abilities. To this end, those in need of care can access various care services including ambulatory services (also called outpatient services or mobile care).
Integration Services for people with disabilities are available to citizens up to the standard retirement age (67) who face difficulties participating in social life due to a disability. The aim of these services is to promote equal participation in society.
This goal is supported through benefits for social and educational participation, integration into working life and access to medical rehabilitation. Unlike the care services provided by ambulatory services, these benefits focus more on treatment and guidance by doctors, educators, therapists and psychologists. Integration Services can range from nursing care up to support at work or university.
Therefore, there are two options to access support. In this section, however, the focus is on services provided by the care insurance, because even if the individual in need of care does not have any disability can applied for them. To claim these benefits, the person you are caring for needs an officially recognised Pflegegrad (care level). A care level can be assigned if the person you care for has health-related impairments affecting their independence or abilities and therefore requires assistance for a period of at least 6 months.
In the following section you can find out how to apply for a care level and how to find an ambulatory care service.
What national ambulatory care services exist in Germany?
There are around 17,100 ambulatory care services in Germany. Although their primary focus is on care provided by a qualified nurse, they can also offer home care and housekeeping services under the supervision of a responsible specialist who does not have to be a nurse. In most cases, a combination of both types of services is provided.
Ambulatory care services provided by non-profit organisations
Most people in Germany are supported by ambulatory care services offered by non-profit organisations, e.g., Diakonie, Caritas, Johanniter, Red Cross, Malteser.
For an initial overview, here are links to three of the largest non-profit organisations offering ambulatory care services: Link 1 | Link 2 | Link 3
Private companies
However, there are even more private companies than non-profit organisations operating in the ambulatory care sector. The market for these services is huge.
In this article you can find the name of the 10 largest ambulatory care services in Germany.
By far the largest company is Home Instead GmbH & Co. KG: Link.
The ZQP (Zentrum für Qualität in der Pflege/ Centre for Quality in Care) provides a brochure with general information on how to choose good outpatient care services: Link
Compass Private Pflegeberatung (Compass Private Care Advice)
How can I receive care benefits from an ambulatory care service?
To avoid having to pay for ambulatory services yourself, the person you are caring for needs a Pflegegrad (care level) recognised by the care insurance. You can find out how to apply for it below:
An application for a care level can be submitted informally or by using the appropriate forms provided by the person’s health insurance provider. Care insurance funds are affiliated with the health insurance funds.
You can also find private companies on the Internet that assist with the initial application free of charge and bill the care insurance fund for this service.
On the website of the Sozialverband Deutschland/ VdK (German Social Association) you will find independent information about the care insurance
Once a care level has been applied for, the assessment is carried out by the Medizinischer Dienst (Medical Service) of the German health insurance funds during a home visit. The impairment related to independence or abilities is assessed by the Medical Service using a points system based on the severity of the condition. People in need of care are then assigned one of 5 care levels. A maximum of 100 points can be achieved, with a minimum of 12.5 points to qualify for a care level.
Tip. Before the assessment by the Medical Service, keep a care diary so that you can show exactly where you provide/receive support and where help is needed. If you are a caregiver, be present when the medical service visits. Four eyes see more than two!
On the VdK website you will find a free self-assessment form with a care level calculator to see if you are likely to obtain a level before the visit of the Medical Service.
After the visit from the Medical Service, the Health or Long-Term Care Insurance fund will write back to the applicants and inform them of a care level.
If you believe that the care insurance fund’s assessment is too low or you have not been awarded a care level at all, and you disagree with the decision, you can file an appeal within a one month. Your appeal should include well-reasoned arguments and explain which aspects you would assess differently based on the results you received from the Medical Service. The appeal must be submitted in writing. An e-mail is not sufficient in this case.
Further information and a free sample letter can be found on the website of the consumer advice centre.
The person in need of care is now entitled to Long-Term Care Insurance benefits. The amount of Long-Term Care Insurance benefits is limited because the insurance only covers a fixed, limited portion of the costs, known as the base. Remaining costs must be paid by the people in need of care.
Starting from care level 2, those in need of care receive Pflegegeld (Care Allowance), to be used to organise appropriate care involving relatives or close friends. As a carer, you many benefit from this allowance financially as a form of income support.
Instead of the Care Allowance, you can opt for Pflegesachleistungen (Care Benefits in Kind), which include physical and nursing care as well as assistance with housekeeping tasks. These services are usually provided by ambulatory care services and can support you as a carer at home. The costs for the services provided by the ambulatory service are settled directly with the care insurance up to their applicable maximum amount.
If the full amount of care benefit in kind is not used, you may be entitled to a proportionate Care Allowance, known as Kombinationsleistung (combination benefit). This allows outpatient care to be combined with home care.
In addition to these basic benefits from the care insurance, there are other supplementary benefits for home care that are not often used, such as Verhinderungspflege (respite care), Tages- und Nachtpflege (day or night care) in semi-residential facilities, Kurzzeitpflege (short-term care) in full inpatient facilities (Respite Care), or subsidies for measures to improve the living environment (Barrier-free Housing).
You can find more local information at the nationwide Pflegestützpunkte (Care Support Centres) where you can receive free advice on care services, financing, local assistance and support services. However, you will not be referred directly to an outpatient service; you will have to find one yourself.
The chosen ambulatory care service then bills the services to the care insurance itself up to the maximum amount.
People with care level 1 do not receive any of the above-mentioned basic benefits (Care Allowance and/or Care Benefits in Kind). They can only claim care aids, measures to improve the living environment, and a small Entlastungsbetrag (support allowance) per month. The support allowance can be used for day or night care in semi-inpatient facilities and full inpatient short-term care. It is mainly used for some services provided by authorised ambulatory care services that are intended to relieve the burden on relatives and support those in need of care with their everyday tasks.
TIP. If the total amount of the support allowance is not used by the end of December, it can be carried over to the following year up to the 30th of June!
Further information and a free sample letter can be found on the website of the consumer advice centre.
Good practices
Home nursing care provided by the statutory health insurance
In some federal states, neighbourhood helpers are recognised as low-threshold relief services. In Hessen, for example, people can register as neighbourhood helpers after submitting a certificate of good conduct and attending a first aid course.
Resources
Home nursing care provided by the statutory health insurance
In addition to nursing services, many people in need of care are also dependent on medical support, such as injections or a ventilator. These medical treatments can be covered by statutory health insurance, whose benefits are not capped, unlike those of Long-Term Care Insurance. You should therefore try to obtain a doctor’s prescription for all home nursing services provided by your outpatient nursing service so that these costs do not have to be deducted from the monthly nursing care benefits.
Persönliche Assistenz (Personal assistance)
If the person you care for is disabled, you can also receive benefits under the Bundesteilhabegesetz (Federal Participation Act). You can apply for personal assistance to be helped with all daily tasks: from errands to round-the-clock care. More details about the Persönliche Assistenz (Personal Assistance) and further information for people with disabilities and their families can be found on the family guide by Aktion Mensch. The offer is free of advertising and commercial interests.
Pflegesachleistungen (care benefits in kind)
Find general information on Care Benefits in Kind including support services here. Adittional info.
Benefit entitlements from long-term care insurance
You can find the current level of benefit entitlements from Long-Term Care Insurance in the title link.
Connected topics
What national ambulatory care services are available?
Young adults with care needs and disabilities face barriers accessing services such as limited availability of specialised care, bureaucratic challenges, and financial constraints. They require comprehensive care that addresses not only their physical and mental health but also promotes social interaction and emotional well-being. In this learning unit, you will discover care options available at health facilities, home-based services, and other programmes that facilitate the social and emotional rehabilitation of care receivers. You will also learn how to access these services, which is particularly important in cases where professional help is required due to the pathology.
In the following overview, you will discover available ambulatory care services in Portugal. You will also be provided with the necessary links to learn how care recipients can access them, if eligible.
What national ambulatory care services are available?
The services listed encompass a range of support options tailored to meet various needs of the young adult with care needs and disabilities. They include outpatient support, home care services, transport services, centres providing comprehensive care and social rehabilitation, and occupational and training centres focussing on skill development and inclusion, to prepare individuals for active participation in society.
Apoio em Regime Ambulatório [Outpatient support]
A social initiative aimed at carrying out assessments, providing counselling as well as therapeutic and socio-educational intervention activities to people with disabilities from the age of 7.
Click here to learn more about the service and its eligibility requirements.
To request the service, learn more about it, or have your questions answered, check the following links:
- Segurança Social (to book a face-to-face appointment)
- Balcão da Inclusão (for appointments related to disability and incapacity)
- Carta social (to find the nearest IPSSs offering the service. You can find their contact information and addresses, and reach out to them by phone or visit in person).
Serviço de apoio domiciliário (SAD) [Home care services]
A social support service that provides home care and services to families and/or individuals experiencing physical and/or psychological dependency. These people are unable to temporarily or permanently meet their basic needs or perform essential activities of daily living, without family support. Entities providing this type of care can be private companies or Private Social Solidarity Institutions (IPSS) offering such services on the basis of a cooperation agreement with the national social security system.
According to a 2019 study by DECO Proteste, private companies offering 4 hours of daily home care from Monday to Friday can cost between €450 and €880 per month. Costs for IPSS may vary between entities and are also dependent on the user’s income and household circumstances.
To request the service, learn more about it, or have your questions answered, check the following links:
- Segurança Social (to book a face-to-face appointment)
- Balcão da Inclusão (for appointments related to disability and incapacity)
- Carta social (to find the nearest IPSSs offering the service. You can find their contact information and addresses, and reach out to them by phone or visit in person).
Equipa de Apoio Domiciliário (EAD) de Cuidados Continuados Integrados (CCI) em Saúde Mental [Home care Services for Home Support Team for Integrated Continuing Care in Mental Health]
The Home Support Service (EAD) carries out necessary activities to maximise the autonomy of individuals with psychosocial disabilities and to strengthen their social support network by promoting meaningful interpersonal relationships. The EAD also aims to improve their social integration and access to community resources, in order to prevent hospitalisations and admissions to residential units, and support the participation of families and other caregivers in providing home care.
Click here to learn more about the service and its eligibility requirements.
To request the service, learn more about it, or have your questions answered, check the following links:
- Segurança Social (to book a face-to-face appointment)
- Balcão da Inclusão (for appointments related to disability and incapacity)
- Carta social (locates the nearest IPSSs offering the service. You can find their contact information and address, and reach out to them by phone or visit in person).
Transporte de pessoas [People transport]
Personalised transport and accompaniment service for people with disabilities, regardless of age available in the districts of Lisbon and Porto. This service guarantees access to rehabilitation and health services, and supports the integration of people with disabilities.
Click here to learn more about the service and its eligibility requirements.
To request the service, learn more about it, or have your questions answered, check the following links:
- Segurança Social (to book a face-to-face appointment)
- Balcão da Inclusão (for appointments related to disability and incapacity)
- Carta social (locates the nearest IPSSs offering the service. You can find their contact information and address, and reach out to them by phone or visit in person).
Centro de atendimento, acompanhamento e reabilitação social (CAARPD) [Centre for care, monitoring and social rehabilitation]
The Centre provides social support and assistance in order to prevent and resolve social issues. It also offers social rehabilitation to help individuals with disabilities and incapacities acquire personal and social skills for greater autonomy and social participation. This can be done at a facility, at home, or in the community. Additionally, it offers training and support services to families and informal caregivers.
Click here to learn more about the service and its eligibility requirements.
To request the service, learn more about it, or have your questions answered, check the following links:
- Segurança Social (to book a face-to-face appointment)
- Balcão da Inclusão (for appointments related to disability and incapacity)
- Carta social (locates the nearest IPSSs offering the service. You can find their contact information and addresses, and reach out to them by phone or visit in person).
Centro de Atividades Ocupacionais ou Centro de Atividades e Capacitação para a Inclusão (CAO/CACI) - Occupational Activity Centre or Activity and Training Centre for Inclusion
A social initiative designed to support young people and adults aged 16 and over with severe disabilities. It promotes activities that develop self-esteem and personal and social autonomy, while facilitating the transition to socio-professional integration programmes when applicable.
Click here to learn more about the service and its eligibility requirements.
To request the service, learn more about it, or have your questions answered, check the following links:
- Segurança Social (to book a face-to-face appointment)
- Balcão da Inclusão (for appointments related to disability and incapacity)
- Carta social (locates the nearest IPSSs offering the service. You can find their contact information and addresses, and reach out to them by phone or visit in person).
Unidade Socio Ocupacional (USO) de Cuidados Continuados Integrados em Saúde Mental [Socio-Occupational Unit (USO) for Integrated Continuing Care in Mental Health]
The Socio-Occupational Unit is located within the community, in its own dedicated space. It is designed for individuals with moderate to low levels of psychosocial disability who are clinically stable but experience difficulties in relational, occupational, and social integration areas.
Click here to learn more about the service and its eligibility requirements.
To request the service, learn more about it, or have your questions answered, you can check the following links:
- Segurança Social (to book a face-to-face appointment)
- Balcão da Inclusão (for appointments related to disability and incapacity)
- Carta social (to find the nearest IPSSs offering the service. You can find their contact information and addresses, and reach out to them by phone or visit in person).
Good practices
The Porto Cerebral Palsy Association (APPC) has organised a talk on ‘Sexuality and Disability’ with residents of the residential unit and subject matter experts. This initiative aims to enhance the autonomy and self-determination of APPC clients, empowering them to make independent decisions about their life.
Resources
This is a practical guide to the rights of people with disabilities in Portugal. It provides a framework for people with disabilities, informing them about what to do if they have a disability, what their rights are, social protection, social and tax benefits, etc. This guide aims to help people looking for answers in this area, to know where to turn to and what to do if they have any questions or difficulties.
Biblioteca Digital Careceiver [Careceiver Digital Library]
Materials on the general practical care, breathing, nutrition, elimination, hygiene care, mobility, monitoring, and other areas of interest.
Connected topics
What are ambulance care services and why should you consider using them?
Ambulatory care, with home visits and community-based services, ensures access without difficulty. Services can be customised based on specific needs, enhancing quality and outcomes by delivering care in comfortable environments.
Your unique healthcare needs, including preventive measures and chronic condition management, are addressed through regular screenings and interventions, promoting overall well-being.
Ambulatory care promotes autonomy by allowing people with care needs and disabilities to receive care at home and maintaining control over their health decisions.
By providing comprehensive care outside institutions, such as long-term facilities, ambulatory services enable you to stay in your communities, preserving social connections and quality of life.
Providers advocate for patients, helping navigate the healthcare system and access resources, empowering individuals to take control over their health.
This section contains information about ambulatory care services for people with care needs and disabilities.
What ambulatory care services are available in Lithuania?
Ambulance care services are available throughout the country. If you or your relative need ambulatory care, you should first contact your family doctor. The information below will help you better understand the purpose of ambulatory care and how to access it.
Ambulatorinės slaugos paslaugos namuose (Ambulatory home nursing services)
Ambulatory home nursing services are healthcare services provided in the patient’s home to ensure continuity of care, meet the patient’s care needs at home, and promote self-care. These services must be provided by all healthcare facilities providing primary outpatient personal care services to the subscribing population.
These services are provided on referral by a family doctor to patients who meet certain criteria. Working-age people with disabilities may access these services if they have a level of independence and a need for permanent nursing care.
If you would like to know more about ambulatory home nursing services, please visit this links: Link 1 | Link 2 | Link 3
Good practices
Daycare services at a person’s home
Korys is an organisation that provides a set of social and health day care services for people with disabilities and care needs in their homes.
Connected topics
What are ambulatory care services?
Ambulatory care, or extramural care, refers to treatments from specialists for a short period of time without the need to stay overnight. Examples are psychiatric, psychological, and outpatient care. Ambulatory care can take place in a clinic or hospital but can also be arranged at home. The difference between home care and ambulatory home care is that home care is focussed on everyday activities, such as help with eating, dressing, and cleaning (see also home care), whereas ambulatory home care is support provided weekly, bi-weekly, or monthly, for medical checks, social support, administrative tasks, treatments, etc.
The benefit of ambulatory care is that it enables people with care needs and disabilities to continue living in their own homes. As a result, this type of care is strongly supported by the Dutch government. Knowing how to arrange and finance ambulatory care can be difficult, though. This module will explain how to do it.
What ambulatory care services are there in the Netherlands?
Arranging care services and financing options can be a difficult and time-consuming task. This step-by-step guide can help you to find and receive the support that you need.
Ambulatory care focusses on personal care needs and is always customised. The main goal of ambulatory care is to assist people to be as independent as possible.
There are many different types of support available, including:
Help with organising and managing personal administration
Offering a listening ear
Help in maintaining order and structure in life
Support with making and attending important appointments
- Help in finding meaningful everyday activities or accommodation
- Learning to deal with limitations
- Support in maintaining healthy relationships
- Expanding one’s social network
- Receiving medical checks, mental help, or therapy
An ambulatory care professional is a social worker who is often experienced in various life areas related to people with different types of impairment.
Nevertheless, different organisations may specialise in different areas of expertise, especially when medical or psychological assistance is needed. If you are unsure about the possibilities or what ambulatory care could do for you, you can schedule a confidential conversation with an organisation that offers the type of care you are looking for. You can find available service providers in your region using ZorgkaartNederland (link below).
Alternatively, if you are unsure about the organisation to contact, you can ask the Wmo point of your municipality (see the next step).
Click here for more information on ambulatory care / extramural care.
Click here to connect to a search engine for care providers in the Netherlands.
Ambulatory care is arranged through the Wmo (see also legal frameworks for an overview of the different laws). In order to receive this type of care via the Wmo, a care assessment is needed. You can request a Wmo assessment at your municipality. Consult their website or google WMO plus the name of your municipality.
Once you have requested an assessment, a so-called ‘kitchen table conversation’ will be scheduled, usually at your own home, during which your (loved-one’s) care needs are discussed. The municipality will inform you about the various available care options, and advice you on which services best suit your (loved one’s) needs.
If both you and the municipality see the value in ambulatory care you can choose a care organisation that offers the type of care that you need (see links above to find an organisation in your region).
You can also contact an ambulatory care organisation beforehand and discuss your needs. You can then contact the municipality together which can help you articulate your support requirements (see previous step). Furthermore, with a Wlz assessment, you can receive assistance at home with daily activities, household tasks or medical issues.
Visit our home care section for more information on extramural care through the Wlz.
Support under the Wmo is financed and arranged by the municipality. In most cases, a co-payment is required. The amount of the co-payment depends on your income, the municipality you live in, and the type of care you receive. In 2025 the maximum co-payment is €21,00 per month. These payments are arranged through the CAK (Central Administrative Office).
You can find more information on the Wmo co-payment in the leaflet below.
Good practices
Alles zelf (Everything by yourself)
‘Alles zelf’ is an online platform where informal carers, care providers, family members, and older citizens can find and compare different Dutch care services. Care options can be easily found and filtered through category, price range, and location.
Resources
A tool to calculate co-payment for care services
‘I need care, what should I know and how can I arrange it?’
A questionnaire and informative video to help people with care needs finding and contacting the right services.