In short and in plain language
Some people are very ill. They will not get well again. Many of them want to stay at home. There is care at home for this. It is called palliative care.
A doctor has to order this care. This is called a prescription. Some people need a lot of help. Then a special team joins in. It is called an SAPV team.
Many people help. The family doctor, the care service, the SAPV team and the hospice service. They talk to each other.
A care service can explain this on its website. The page says whom to call. It also says what happens next.
The care service must not promise that someone will get well. It can say that it eases pain and other problems. We help build this page.
When an illness can no longer be cured and the family wants the person to stay at home, the search often starts with a few words: "palliative care at home". Behind them lies a web of GP practice, home care service, specialized palliative team and hospice service that relatives in this situation rarely know. Legally, the path is clearer than it looks from outside: insured persons with an incurable, progressive and far advanced illness and a limited life expectancy who need particularly complex care are entitled to specialized outpatient palliative care (SGB V). The service must be prescribed by a contracted physician or a hospital doctor (SGB V). For all other cases there is general palliative care as part of home nursing care. This article shows how a home care service explains this path on a guide page: which form of care applies when, who in the network does what, how the prescription comes about and how the page stays calm and makes no promise of cure.
Key takeaways
- Under Section 37b SGB V, insured persons with an incurable, far advanced illness and limited life expectancy are entitled to specialized outpatient palliative care if they need particularly complex care (SGB V).
- General palliative care runs through home nursing care: symptom control under no. 24a is prescribed for up to 14 days per initial and follow-up prescription (home nursing care guideline), follow-ups also beyond the original prognosis.
- An SAPV prescription has to reach the health insurer by the third working day after it is issued; the insurer then covers the costs until it decides (SAPV guideline). At discharge, the hospital usually prescribes for no more than 7 days.
- The guide page shows the network of GP practice, home care service, SAPV team and hospice service, names partners only by agreement and describes the service's own availability exactly as the roster supports it.
- Cure and certain success do not belong on the page: advertising is misleading if it falsely suggests that success can be expected with certainty (Section 3 HWG). The goal of SAPV is to relieve symptoms and suffering (SAPV guideline).
- Employees whose employer normally has more than 15 staff can take up to three months of leave to accompany a dying relative (Care Leave Act); in outpatient palliative care, the shortened care level assessment by the fifth working day applies (SGB XI).
Why families search for palliative care at home
The trigger is often a turning point: a discharge from hospital, a conversation at the oncology practice, a condition that has worsened over weeks. Relatives are then not looking for statutes but for answers to three questions. Who helps us now? What do we have to do so that help arrives? And whom do we reach if things get worse at night? A care website that answers these questions is more than advertising at that moment. It is orientation in a situation where nobody has time for detours.
The structures exist nationwide. Germany has around 1,500 community hospice services (DHPV), and there are more than 400 specialized outpatient palliative care teams (National Association of Statutory Health Insurance Physicians, via DHPV). Even so, the offer often stays invisible to families because each party only describes its own part: the practice its office hours, the palliative team its admission criteria, the hospice service its volunteers. The home care service is often the one that spends the most time in the household and knows the other parties. That is why its website is the right place for the page that brings it all together.
This is not a bereavement page and not a donation page, but a guide and service page: what do we provide in palliative care, whom do we work with, how does care get started? If your website for a home care service is already organized by services, add this one page and link to it from the home page, the service overview and the frequently asked questions. Hospice services with volunteers and fundraising have different priorities; they are covered in the article on the hospice service website for volunteers and donations.
Telling general and specialized palliative care apart
The most important explanation on the page is the difference between two forms of care that relatives rarely know. The first is general outpatient palliative care. Legally it is part of home nursing care, because home nursing care expressly includes outpatient palliative care (SGB V). The guideline of the Federal Joint Committee on prescribing home nursing care lists a dedicated service for it, number 24a, symptom control for palliative patients. It covers, for example, pain, nausea, vomiting, pulmonary or cardiac symptoms, the care of ulcerating wounds and crisis intervention, always in close coordination with the prescribing doctor (home nursing care guideline).
The initial prescription and follow-up prescriptions for number 24a each run for up to 14 days (home nursing care guideline); follow-up prescriptions are possible as needed, even beyond the original life expectancy prognosis (home nursing care guideline). One detail that reassures families is in the statute itself. Home nursing care that avoids or shortens a hospital stay is otherwise limited to up to four weeks per case of illness (SGB V). For outpatient palliative care, however, a justified exception is generally to be assumed (SGB V), so the health insurer can approve care beyond that period.
The aim of this service is to secure medical treatment at home for dying people with a palliative care need that does not require the specialized palliative medical and palliative nursing care provided within specialized outpatient palliative care (SAPV) under Section 37b SGB V.
The second form is specialized outpatient palliative care, known by its German abbreviation SAPV, under Section 37b SGB V. It covers medical and nursing services including their coordination, in particular pain therapy and symptom control, and is meant to make care possible in the familiar setting of home or family (SGB V). When care counts as "particularly complex" is described in the SAPV guideline: an indication is a complex pattern of symptoms, such as severe pain or severe neurological, respiratory or cardiac symptoms (SAPV guideline). SAPV is provided by service providers under Section 132d SGB V that are organized in an interdisciplinary structure of qualified doctors and nurses (SAPV guideline).
| Feature | General palliative care | Specialized palliative care (SAPV) |
|---|---|---|
| Legal basis | Section 37(2b) SGB V, home nursing care guideline no. 24a | Section 37b SGB V, SAPV guideline |
| Who prescribes | the treating practice, for example the GP practice | contracted physician or hospital doctor; at discharge usually for no more than 7 days |
| Who provides care | the home care service in coordination with the practice | team of doctors and nurses under Section 132d SGB V |
| When | if symptom control keeps the person at home and other services are not enough | for particularly complex care, such as a complex pattern of symptoms |
| Prescription period | initial and follow-up prescription up to 14 days each | period stated on the agreed form |
| Availability | as the home care service commits to it in its contract and roster | on-call, emergency and crisis intervention service around the clock |
The two forms do not generally exclude each other. SAPV can be provided as advice, as coordination of care, as additional supporting partial care or as full care (SAPV guideline). Number 24a can only not be prescribed if full SAPV care is in place or partial care in which the SAPV team takes over palliative nursing completely (home nursing care guideline). In many situations the familiar home care service therefore stays in the household even when a palliative team joins. This sentence belongs on the page, because the worry of losing their own care service can keep families from asking about SAPV at all.
The network around the family
Palliative care at home is cooperation across organizational boundaries. The SAPV guideline requires the parties to coordinate their measures and expressly names the community hospice service as a cooperation partner that is involved at the patient's request (SAPV guideline). In general palliative care under no. 24a, too, patients who wish it should be supported in organizing additional psychosocial support, for example from a community hospice service (home nursing care guideline). For the guide page this means describing not only your own service but the roles of everyone involved, so that relatives understand whom to contact for what.
GP practice
Issues the prescription for home nursing care and, where the conditions are met, for SAPV, and usually remains the family's medical point of contact. The page should say that the practice is the first contact for the prescription.
Home care service
Provides day-to-day nursing and symptom control under no. 24a, observes changes and reports them to the practice. For relatives it is often the first contact. The page should cover services, service area and availability.
SAPV team
Doctors and nurses with palliative qualifications advise, coordinate or take over care when needs are particularly complex, and can be reached around the clock (SAPV guideline). The page should say which team works in the region.
Hospice service
Qualified volunteers accompany dying people and their families at home, coordinated by professionals; the health insurers fund this work (SGB V). The page should mention that this support is possible in addition to nursing care.
A fifth party is missing from many descriptions: the health insurer. Insured persons are entitled to individual advice and support from their health insurer on hospice and palliative care services (SGB V). This includes an overview of contacts for the advice and care services available in the region, and at the patient's request relatives take part in the advice (SGB V). A sentence about this on the guide page takes nothing away from the home care service. It shows that the service knows the whole field and does not want to keep families within its own offer.
Names call for care. An SAPV team, a practice or a hospice service should only be named on the page if the cooperation actually exists and the partner has agreed to be named. A cooperation that does not exist would be a misleading statement. Without fixed partners the page stays general: "SAPV teams and community hospice services work in our region. We will help you get in touch." Hospice services that need a website of their own will find a suitable structure under website for hospice and palliative services. The legal limits of self-presentation are summarized in the article on the legally compliant care website with imprint and HWG.
The path to a prescription, step by step
Relatives need the process as a sequence of actions, not as a legal position. Three stations carry the page: prescription, first visit, care. Before them there is often a question to the GP practice, after them the ongoing coordination in the network. Each station gets one sentence on the page that says what needs to happen now and who does it.
- Initiate the prescription: the family talks to the GP practice or, before a discharge, to the hospital. SAPV must be prescribed by a contracted physician or a hospital doctor (SGB V); symptom control under no. 24a is prescribed by the treating practice as home nursing care.
- Send the prescription to the health insurer: a short deadline applies to SAPV. If the prescription is submitted by the third working day after it is issued, the health insurer covers the costs of the services provided until it decides (SAPV guideline).
- First visit at home: the home care service and, if involved, the SAPV team come to the house and discuss wishes, symptoms, medication, aids and availability. Relatives take part if the person who is ill wants them to.
- Care in the network: the parties coordinate. Follow-up prescriptions for number 24a each run for up to 14 days (home nursing care guideline) and are requested from the practice in good time.
One special case deserves its own paragraph: discharge from hospital. If the hospital considers discharge possible and SAPV is necessary from a medical point of view, the hospital doctor can issue the prescription, but usually for no more than 7 days (SAPV guideline). The hospital informs the practice that continues treatment early enough for seamless follow-up care to be possible (SAPV guideline). For families this results in one simple action: contact the GP practice during the first days at home. How a guide page explains hospital discharge as a whole is shown in the article After hospital: the advice page on discharge, and the basics of prescribing home nursing care in the article on doctor-prescribed home nursing care.
A short list of what relatives should have ready for the first call is helpful. It saves time in the conversation and eases the fear of forgetting something important:
- prescription or discharge letter, if already available
- current medication plan
- name and phone number of the GP practice
- care level or date of the application to the long-term care insurer
- advance directive or lasting power of attorney, if there is one
- phone numbers of the relatives who want to be reachable
Describing the first visit and availability honestly
The most frequent question after the prescription is: whom do we call if things get worse at night? SAPV includes an on-call, emergency and crisis intervention service around the clock for the patients it cares for (SAPV guideline). For the home care service, what its contract and roster allow applies. The guide page has to keep the two apart. A sentence like "We are there for you around the clock" only fits if the service actually provides it. Otherwise it creates an expectation that is disappointed on the hardest night of all.
A concrete statement in three parts works better: the hours when the office can be reached, the on-call service of the home care service with its hours, and a note on who is responsible outside those hours, such as the SAPV team when SAPV is in place or the out-of-hours medical service. The comparison below shows typical sentences and a plain alternative that only belongs on the page if it is true for your own service.
| Better avoid | Better, if it is true |
|---|---|
| "We are there for you around the clock." | "You can reach our on-call service daily at the hours shown. When SAPV is in place, the SAPV team is your contact at night." |
| "We will come right away." | "After your call we usually get back to you on the same working day to arrange the first visit." |
| "Pain-free to the very end." | "We work with your GP practice to relieve pain and other symptoms." |
| "We take all your worries away." | "We explain every step and tell you whom to reach and when." |
The first visit itself can be described just as plainly: who comes, roughly how long it takes, what is discussed and that relatives can be present. A time estimate only belongs on the page if it matches your own practice. The callback route below asks for name, phone number, place of residence and preferred callback time, not for the diagnosis. Health data belongs in the phone call, not in a form field. How forms on care websites keep data to a minimum is described on the page on privacy on the care website.
Calm language with no promise of cure
The German Therapeutic Products Advertising Act (HWG) does not only apply to medicines. It also covers advertising for procedures and treatments insofar as the advertising statement relates to the detection, elimination or relief of illnesses or suffering (HWG). A service page on palliative care that speaks of relieving symptoms can fall under it. Misleading advertising is prohibited, and it is misleading in particular if it falsely suggests that success can be expected with certainty (HWG).
Palliative care itself sets the right tone. The SAPV guideline describes its goal as maintaining, promoting and improving the quality of life and self-determination of seriously ill people; instead of a curative approach, the focus is on relieving symptoms and suffering in a way that suits each individual case (SAPV guideline). Relieve, accompany, coordinate, explain: these are the verbs of the page. Cure and commitments about the course of the illness do not belong on it, not even in negated form.
The tone matters just as much. Relatives often read this page late in the evening, tired and worried. Short sentences, clear terms, no images of paths and light, no religious interpretations that not every family shares. Technical terms such as SAPV are explained the first time they appear. Photos, if any, show your own team or calm everyday scenes with consent, no people in their last phase of life and no stock images that stage grief. The page earns trust through clarity, not through sentiment.
No success stories
Supporting relatives: leave, assessment, advice
A guide page that only describes nursing care leaves relatives alone with their own questions. Three notes therefore belong on it, each with its legal reference and without individual advice.
First, leave from work. Employees must be released from work in full or in part to accompany a close relative who suffers from a progressive, far advanced illness for which a cure is ruled out, palliative medical treatment is necessary and only a life expectancy of weeks or a few months can be expected (Care Leave Act). This leave lasts no more than three months per close relative (Care Leave Act). It is proven with a medical certificate and must be announced in text form at least ten working days before it starts (Care Leave Act). The entitlement does not apply to employers with normally 15 or fewer employees (Care Leave Act); employees of such businesses can, however, apply for an agreement on the leave, and a refusal must be justified (Care Leave Act). For an acute care situation and the care support allowance, the page refers to a separate explanation, as described in the article on the care support allowance guide page.
Second, the care level. If someone does not have one yet, it is best to apply early. If a person receives outpatient palliative care, the shortened assessment deadline applies to them as well (SGB XI): the assessment must then be carried out by the fifth working day after the long-term care insurer receives the application (SGB XI). In these cases the long-term care insurer decides without delay once the recommendation of the Medical Service has arrived (SGB XI). The note on palliative care therefore belongs in the application itself, and the guide page may say so.
Third, advice. In addition to hospice and palliative care advice, the health insurer informs its insured persons in general terms about personal arrangements for the last phase of life, in particular advance directives, lasting powers of attorney and care directives (SGB V). The guide page does not have to explain these topics itself. One sentence with a referral is enough, and the first visit asks whether such documents exist.
Guidance, not legal advice
How the guide page is structured
The previous sections add up to a structure that can be implemented on any care website. The order follows the questions relatives ask, not the system of social law.
- Page header: what the service provides in palliative care, service area, phone number and availability in one sentence.
- Two forms of care, briefly explained: general palliative care through home nursing care, specialized care under Section 37b SGB V.
- The path in three steps: prescription, first visit, care, each with the action that is due now.
- The network: GP practice, home care service, SAPV team, hospice service and health insurer; partners named only by agreement.
- For relatives: leave from work, shortened assessment, advice from the health insurer.
- Frequently asked questions: worded the way families speak and marked up as FAQ.
- Callback route: name, phone number, place of residence, preferred callback time, no diagnosis fields.
- Status and sources: date of the last review and the legal provisions the page relies on.
The page is found through the terms families search for: "palliative care at home", "palliative care" with the name of the town, "SAPV" with the region. A dedicated address and a heading that carries the term help more than a sub-item in the service list. How local references in title, text and business profile work together is described on the page on local SEO for care services.
Because many readers are older or reading under strain, the rules of an accessible care website matter all the more here: adequate font size, clear contrast, headings that structure the page, and a phone number that can be dialed with a single tap.
Finally, maintaining the page. The SAPV guideline was last amended on September 15, 2022 (SAPV guideline), the home nursing care guideline on October 16, 2025 (home nursing care guideline). Reviewing the page once a year and after every change to these foundations, and showing the review date, demonstrates care without having to claim it.
What has to be in place behind the page
A guide page promises nothing the organization cannot deliver, but it shows how the service works. Before it goes live, the nursing manager settles a few points that appear on the page in just one sentence but require organization behind them.
- Which nurses take on symptom control under no. 24a and how cover is arranged
- At what times the service's on-call duty is available and who covers it
- Which practices, SAPV teams and hospice services the service works with and whether the partners want to be named
- How changes are reported to the prescribing practice and who is the first contact while SAPV is in place
- Who handles requests from the callback form on the same day
- Who approves the page professionally and when it will next be reviewed
It also needs to be clear what the service offers beyond what the insurers pay for, such as additional hours of support or night watches. If such services are paid privately, price and terms belong in a separate place; how to do that transparently is shown in the article on private-pay care services.
If you would rather not set up the page alone, you can develop the structure, texts and callback route together with us. A first step is an inquiry with the key facts about your service. The page fits into an existing care website and is linked from there, so that families reach it from the home page and the service overview.
Sources and legal texts
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