“Care very actively” creates more freedom in care

Model project "Care very actively" More freedom in outpatient care Status: November 12th, 2026 • 4:46 p.m

A model project in Rhineland-Palatinate enables outpatient care based on individual time budgets instead of rigid guidelines. Initial results are promising. Could this be what the future of nursing looks like?

Michaela Salziger is a nursing specialist at Caritas Lahnstein. Today she is with Ute Pusse. She has 45 minutes to do this. The 78-year-old has needed her help for a year. The patient decides for herself at each visit what form of care she offers.

"I often help her shower. But a few weeks ago she greeted me with the words: I'm in a bad mood today. Then we talked to each other. I showed her what we've achieved so far and what she can do on her own. Afterwards we laughed so hard. Then the bad mood went away again," says Michaela Salzinger. Ute Pusse sits next to her, smiling.

German Care Day: Companies specifically recruit skilled workers abroad Jacqeline Piwon, RBB, tagesschau, Das Erste, November 12, 2026 • 2:00 p.m. Maintaining people's independence Being able to move independently within their own four walls again was unthinkable last fall. The 78-year-old suffered an epileptic seizure and fell badly. The cause was an undetected tumor. “Then the next shock came. When I was allowed to get out of bed for the first time and I realized that nothing was working anymore,” she says.

Today she can move around independently in her own apartment again with the help of a walker. Thanks to care in which there is time to guide and support the patient instead of routinely carrying out procedures and under time pressure.

Nursing specialist Michaela Salziger says: "In the normal catalog of services, I wouldn't have been able to provide the support on site here. I would have taken over all the personal care and left because that would have been my job."

Instead of billing per minute for predefined individual tasks such as washing or helping with dressing, the nursing service in the model project is paid a time budget. The service provided during this time is based entirely on the needs and wishes of the person being cared for. They get back a piece of their independence, which for many people was taken away by illness, as was the case with Ute Pusse.

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Activating the patients themselves and achieving further goals in small steps is the core of the model project “Care in a very active way”. Relatives and the environment are also involved and resources are mobilized that may not have been used before.

The nurses work in small, self-organized teams with flat hierarchies. Stefanie Krones from the Caritas Association Westerwald-Rhein-Lahn designed the 2022 care model in cooperation with the AOK Rhineland-Palatinate/Saarland.

Word of the success has gotten around, says Krones, including among nursing professionals. "We have such a high level of employee satisfaction. We have hardly any fluctuation. People come to us and apply to us because they want to work like that. I think that's the biggest indicator of how successful the model is."

And Michaela Salziger agrees: "The holistic view is what I learned. And being able to do that again now gives me something and something for the patients. It's a win-win situation, being able to provide satisfied care. And also getting young people excited about care again."

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Success can also be measured in the progress of therapy. In the beginning, Ute Pusse needed daily help with personal hygiene, but today she is so independent that the nurse only comes once a week.

The next hurdle has now been overcome for a nationwide introduction of the “Nursing Very Active” project: starting in December, the model project will be scientifically evaluated for two years with the aim of “permanently” it, as it is officially called. Then other care facilities could also work according to the model and even more patients like Ute Pusse could benefit from “care very actively”.

This topic in the program: tagesschau.de | Care model project from the Westerwald | 11/12/2026 | 06:33 amThe First | daily news | 11/12/2026 | 2:00 p.m