Good life

Health care planning for the last phase of life (in accordance with Section 132g SGB V) in nursing homes: implementation to date, barriers and recommendations for further development

 

 

Project logo consisting of an abstract tree with a green crown and light brown trunk; on the left side of the trunk is the word good in blue capital letters and on the right side of the trunk is the word live in red capital letters.

Background

In Germany, Section 132g SGB V (Health Care Planning for the Last Phase of Life) came into force in 2018, allowing nursing homes and Facilities or Institutions for Integration Assistance to provide services based on the concept of "Advance Care Planning" and charge them to statutory health insurance.

To date, no structured and published information is available on the implementation of health care planning (in accordance with Section 132g SGB V) or on the actual design and organization of consultation processes in nursing homes.

 

Aims

The aim of the project is to provide a comprehensive picture of the current design of the options for health care planning for the last phase of life in the nursing home setting created by law in 2018 in Section 132g SGB V on the basis of empirical data. Possible barriers to implementation are identified, discussion processes are examined in more detail and relevant contextual factors at home and resident level are identified that need to be taken into account for further development. Finally, recommendations for the further development of Section 132g SGB V are derived.


A woman in a white coat-possibly a physician-sits at a table with an older woman and two older men. She shows one man a progression curve on a piece of paper and explains something. The other two people listen attentively.
Copyright: Robert Kneschke/stock.adobe.com /Institute ofGeneral Medicine and Palliative Medicine/MHH

Methods

The explorative project is divided into five different work packages which, in addition to the consultation process, also examine the contextual factors of the home and residents and continuously involve care practice and other stakeholders. The results of the individual sub-projects are incorporated into the further development of the framework conditions.

 

Relevance of the expected results

The results of our project allow for a quick, direct and Germany-wide transfer and an associated optimization of care in nursing homes. Many of our findings are also likely to be relevant and transferable to Facilities or Institutions for Integration Assistance. In addition, it would also be possible to extend the project in the future to people in need of care who are cared for in their own homes or in other forms of accommodation, for which the results could also be useful.

 

Funding

The project is funded by the Innovation Fund of the Joint Federal Committee for the area of care research (funding reference 01VSF21040) for 36 months.

 

Publications

Stiel* S, Brütt* AL, Stahmeyer JT, Bockelmann AWE, Schleef T, Völkel A, Hoffmann F. Implementation, barriers, and recommendations for further development of advance care planning for the last phase of life in nursing homes in Germany (Gut-Leben): protocol for a mixed-methods study. BMC Pall Care 2023 Mar 24;22(1):27 doi: 10.1186/s12904-023-01147-y.

Jacobs H, Brütt AL, Völkel A, Stiel S, Schleef T, Schütte S, Burger B, Stahmeyer JT, Hoffmann F. Feasibility testing and analyses of proofs of achievement for health care planning according to § 132g SGB V in nursing homes - results of the project "Gut-Leben". Z Evid Fortbild Qual Gesundhwes. 2024 Dec;190-191:84-91 doi: 10.1016/j.zefq.2024.10.006.

Czwikla J, Schmiemann G, Schleef T, Stiel S, Hoffmann F. Indwelling urinary catheter changes in male nursing home residents: Results from a nationwide cross-sectional survey in Germany. Urol Int. 2024 Nov 18:1-7 doi: 10.1159/000542430.

Berloge C, Völkel A, Jacobs H, Burger B, Jona T Stahmeyer JT, Brütt AL, Hoffmann F, Schleef T*, Stiel S*. Provision of hospice and palliative care and implementation of advance care planning for residents in German nursing homes - A cross-sectional study. BMC Geriatr 2024;24:999 doi: 10.1186/s12877-024-05578-x.

Wandscher K, Jacobs H, Völkel A, Schleef T, Stahmeyer JT, Burger B, Brütt AL, Stiel S, Hoffmann F. Trends in end-of-life hospitalizations of nursing home residents between 2011 and 2020: analyses of German health insurance data. J Am Med Dir Assoc 2025 May;26(5):105540 doi: 10.1016/j.jamda.2025.105540.

Jacobs H, Stiel S, Völkel A, Schleef T, Burger B, Stahmeyer JT, Wandscher K, Brütt AL, Hoffmann F. Change over time in characteristics and survival of residents newly admitted to nursing homes - an analyses of health insurance claims data from 2011 to 2022 in Germany. Eur J Ageing 2025 Jul 21;22(1):34. doi: 10.1007/s10433-025-00871-z.


Consortium and cooperation partners

Consortium management

  • Prof. Dr. PH Falk Hoffmann, MPH; Carl von Ossietzky University Oldenburg, Department of Health Services Research, Department of Outpatient Care and Pharmacoepidemiology

Consortium partners

  • Prof. Dr. rer. medic. Stephanie Stiel; Hannover Medical School (MHH), Institute ofGeneral Medicine and Palliative Medicine
  • PD Dr. phil. Anna Levke Brütt; Carl von Ossietzky University of Oldenburg, Department of Health Services Research, Junior Research Group Rehabilitation Research

Cooperation partner

  • AOK Lower Saxony (Dr. PH Jona Stahmeyer)
Map of the MHH
Copyright: MHH

Gut-Leben - Team:

Prof. Dr. Dr. Stephanie Stiel (Project Manager)

  • Phone: +49 511 532-4548

Dipl. Med. Päd. Tanja Schleef, MPH (research assistant)

  • Phone: +49 511 532-4991

 

Address

Hannover Medical School

Institute ofGeneral Medicine and Palliative Medicine

Carl-Neuberg-Strasse 1

30625 Hanover