Caregiver Guidance
Alone Like a Migratory Bird: The Invisible Burden of the Care Process
In a small Anatolian town, Ayşe, who looks after her elderly father with devotion, thinks mostly about expenses as she starts her day. Her father, diagnosed with dementia, is restless at night. During the day, his care demands more responsibility each passing day. Perhaps you too feel as lonely as Ayşe. The burdens on your shoulders are not only emotional but also quite financial.
Care expenses are a significant source of stress for families and caregivers, especially with chronic conditions like brain health disorders. So, what does the government and the private sector offer to those seeking support in care services? Is it possible to breathe easier financially? In this guide, you’ll find evidence-based answers to these questions.
The Scope of Care Expenses and the Situation in Turkey
Brain health often requires long-term and regular care. For illnesses such as Alzheimer's, Parkinson's, dementia, or post-stroke care, different care services may be needed depending on the severity of the case:
Home care: Involves receiving health and daily living support in the person’s own home.
Institutional care: Living in institutions like nursing homes or rehabilitation centers.
Part-time care: Daycare centers or temporary care services.
According to Turkey Population and Health Survey 2021, 13.7% of individuals over 65 need daily living support. The aging population in Turkey is increasing; TURKSTAT data shows that the elderly population increased by 1.2 million from 2019 to 2022. This rise intensifies the overall burden of care on society.
Why Are Care Expenses High?
The care of paralytic disorders affecting brain health, Alzheimer's, stroke, or advanced dementia requires not just meeting basic needs but also professional support, 24-hour supervision, medical equipment, medications, and psychosocial support, all of which generate extra expenses. According to the Alzheimer’s Association, the average annual care cost for an Alzheimer’s patient in the U.S. is around $57,000. Although no specific statistics exist for Turkey, daily home care fees are between 400-800 TRY as of 2024. In institutional care homes, fees are over 15,000 TRY per month depending on the service package. These sums are realistically hard to afford for a minimum-wage family.
Small Solutions to a Big Problem: State Support
The government of the Republic of Turkey runs several main support programs to help citizens in need of care.
1. Home Care Allowance
What is provided? As of 2024, a monthly cash assistance of 7,608 TRY is paid by social service centers and the Ministry of Family and Social Services to individuals providing home care for a fully dependent disabled relative.
Who is eligible? First-degree relatives (mostly family members) of individuals who cannot care for themselves and who have a “fully dependent” disability report. Income criteria apply (households with less than 2/3 of the minimum wage per capita).
Application: Can be made in person to the Provincial Directorate of Family and Social Services, via e-government, or at a Social Services Center.
Note: With this support, Ayşe was able to catch her breath, even if just a little, while caring for her father. Application requirements, documentation, and reporting processes may take time. However, being persistent in following the process has helped many families cover essential costs.
2. Disability Pension (Law No. 2022)
Social assistance for those over 65 and for the disabled: In 2024, monthly payments of 1,874 TRY (40-69% disabled), and 2,811 TRY (70% and above disabled), depending on disability rate.
Application: Applications can be made at district governorates, social assistance directorates, or via e-Government. Required documentation: disability board report and income test results.
3. Old Age Pension
Individuals aged 65 or older, who are in need, have no social security, and meet the income criteria, receive a payment of 2,348 TRY per month (2024).
Application address: Social Assistance and Solidarity Foundations.
4. Daycare Centers and Municipal Services
Daycare services, elderly-friendly centers, and “mobile health” initiatives provided by metropolitan and district municipalities (e.g., Darülaceze in Istanbul, 100th Anniversary Elderly Center in Ankara).
Fees generally depend on income tests and most of the time are free or charged at a nominal rate.
5. Chronic Disease Assistance
Medical devices, medications, and supplies used in the care of mental illness, dementia, and post-stroke are covered by Social Security (SGK). (e.g., wheelchairs, adult diapers, bed pads).
Can be provided by the state or municipalities with a prescription from a family doctor or specialist.
Insurance Options for Care Services
When care expenses are not fully covered by the state, a secondary option for additional financing is private insurance products. In Turkey, there are two main options for those who wish to benefit from such services:
1. Supplementary Health Insurance and Home Care Coverage
These are products offered by private insurance companies (e.g., Anadolu Sigorta, Allianz, Acıbadem, Mapfre).
Some policies cover at-home nursing care, physiotherapy, preventive follow-up visits, and psychological counseling services.
Premiums vary by age, risk factors, and coverage. For example, annual premiums for care-inclusive policies range from 7,000 to 15,000 TRY.
It is essential to check whether the policy includes "care coverage." Most basic health policies do not; it is usually available with additional packages only.
2. Long-Term Care Insurance
This type of insurance, common in Western countries, is very new in Turkey. However, some companies pay a monthly sum within a predetermined limit to insured persons once they turn 60.
Covers care expenses for chronic illnesses like brain health disorders.
Premiums may be high; policies taken at a younger age provide security against old age risks in the long run.
Pension Funds and Individual Opportunities
The Individual Pension System (BES) and private health insurance can be sources of savings for future care needs, especially for those who invest from an early age. The 30% government match for BES provides a significant long-term advantage (Source).
BES funds can be withdrawn as a lump sum or in monthly payments as needed.
Private and supplementary health insurance policies are more costly at older ages but having them from a younger age reduces premiums.
A Brief Scientific Perspective: The Impact of Care Burden on Families
With brain health disorders, the care burden is not limited to financial strains. According to a World Health Organization report, 60% of family caregivers report high levels of stress, depression and exhaustion. Therefore, financial support for care also contributes to mental health preservation.
Many studies have shown that caregivers’ daily routines, social lives, and work are affected; economic difficulties and care expenses may increase feelings of guilt, inadequacy, and hopelessness (source).
Practical Application Guide
Consult a professional if needed: Social workers, municipal advisors, and hospital social services can guide you through applications.
In home care allowance, accurately report all household members and income for the means test.
For support requiring a disability report, a health report from a fully equipped state hospital is mandatory; check the validity period of the report.
For municipal services, apply to local social services units; some services are seasonally available.
For private insurance applications, always inquire about coverage limits and age/illness risks. Obtain written information from insurance agencies.
Challenges and Solution Proposals Regarding Care Expenses in Turkey
Insufficient Income: Care allowances must be updated according to minimum living standards. Beneficiaries frequently face means tests, and assistance should be re-adjusted in parallel with minimum wage increases.
Lack of Registered Workforce: Finding trained staff for home care services is difficult. In the long term, it is safer to prefer official institutions and organizations.
Eligibility Criteria: The dependency level in the health report for those in need of care must be correctly stated.
When reviewing private insurance products, especially pay attention to "waiting period," "pre-existing conditions excluded from coverage," and "age limit" rules.
Practices Abroad: A Short Comparison with Turkey
In European Union countries, care insurance is mandatorily implemented under state guarantee. For example, in Germany, long-term care insurance is funded by a 2-3% deduction from salaries and almost all elderly care costs are covered (Source). In the Netherlands, customized support columns are created for each person in nursing homes. These implementations reduce the financial burden while playing an important role in improving peace and quality. In Turkey, however, the system relies more on social aid programs, with a narrower scope.
Ways to Reduce Care Costs in Brain Health
Early diagnosis reduces care costs in the long run. Try to plan appropriately before the disease progresses.
Attending public agency seminars on home care training may reduce the need for hiring professional caregivers.
Make use of free or low-cost care support services provided by municipalities or NGOs.
With regular health check-ups, it may be possible to slow the progression of the disease and thus postpone the need for inpatient or intensive care (Source).
The Caregiver’s Voice: Staying Balanced Financially and Mentally
Sometimes being a caregiver can make one feel the deepest loneliness. However, remember that the support provided touches not only your finances but also your soul. Seek as much support as possible. Prioritizing your own psychological health enables you to provide better care and experience less burnout for your loved one.
Conclusion: Dignified Care Is Possible Through Solidarity and Knowledge
Every care story is an emotional, social, and financial journey. Thousands of caregivers like Ayşe can somewhat ease their hardships through state support and private insurance. The key is to stay up to date with the latest information, diligently follow application procedures, and get as much expert help as possible. Although no form of support can relieve you of all burdens, getting started is the first step toward healing.
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