'I can't let my mother die of thirst'

"Drink another little sip," Frank Schulz tells his mother as he puts his arm around her shoulder. He holds up a cup of tea to her lips and she drinks. "You did great," he says.

Schulz says his mother, Inge, often gets too little to drink. One Sunday in April she was utterly apathetic, the corners of her mouth falling into a deep frown. Nursing staff refused to call a doctor. "Your mother is tired," they said.

It wasn't until hours later that an emergency physician was notified. The doctor said Inge was suffering from dehydration. According to nursing records she had been administered enough liquids, but the doctor said that was impossible. His report backed the assumption: her bladder was almost empty.

Read more: Germany's aging population desperate for more nurses

A health care industry union representative who wishes to remain anonymous says: "It's not enough to put a cup of fluids in front of a helpless individual, you have to administer it." The representative is well aware of personnel shortages in the industry in Germany — some 22,000 more geriatric nurses and assistants are needed. Nevertheless, the representative says: "The excuse 'I don't have time,' or 'we are understaffed' no longer applies, because maintaining hydration is the most important thing in life."

Answering nature's call on the floor

Frank Schulz hugs his mother and asks if she needs to go to the bathroom. She gives a clear answer: "Yes." He gets her up on her feet and leads her away: "Hang on to me." Schulz says his mother is not incontinent, but that she is often forced to wear diapers because the staff at her facility take her to the toilet far too seldom. "It is utterly shameful that in our society people are made incontinent because they are forced to urinate and defecate in diapers," he says.    

Schulz says he once saw a nurse deal with a woman in the hallway who smelled of feces. He says the man simply sprayed a fog of air freshener around the woman and walked away rather than cleaning her.

Read more: 'Who will look after us?' — Germany's ailing elderly care system

Data on nursing home abuse, which includes physical and psychological abuse as well as neglect, is hard to come by. Yet a poll of nursing staff at care facilities in Hesse found that 72 percent of those questioned said they had abused or neglected someone at least once over the past year.

Schulz and his brothers have repeatedly written to the operators of their mother's facility as well as launched complaints with Bavaria's home supervisory authority and the Medical Service of the Health Funds (MDK), which is responsible for auditing nursing homes. Schulz says that his mother was especially well cared for on the day the MDK carried out its inspection.

If you don't like it, leave

Inge Schulz's sons had expected that home operators would eventually be interested in talking to them, perhaps to even offer an apology. Instead, the family was informed that they should look for another home for their mother if they were not satisfied with the care she was getting.

Read more: Germany to recruit more elderly care workers abroad

Frank Schulz says the nursing home director reacted to his criticism very aggressively, screaming at him in his mother's room, prohibiting him from entering the home in the future and then calling the police. The entry ban was quickly rescinded. Then police questioned family members and opened an investigation into the nursing home. Schulz says the case is currently in state prosecutors' hands, but that the office is drowning under its caseload.

The Schulz family says it does not want to choose another home. Germany's most famous nursing home critic and author, Claus Fussek, told DW that things are not necessarily any better at other homes in the area.

In December 2017, some 3.4 million people were in need of nursing care across Germany and that number is on the rise. Two-thirds of those in need of help are cared for at home, the other third — those with the greatest need — are put in nursing homes.