Asking a neighbor to hold a key feels like a small favor. In practice it is a standing arrangement with its own terms, and most of the trouble comes from terms nobody wrote down. Before you hand over anything, decide what the key is for, then check that the person you are asking can actually do that job from where they live.
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Decide what the key is for
A key used only in an emergency asks for much less than a key used to let a repair person in on a Tuesday. Write down the three most likely reasons someone would need to enter: a fall or no answer at the door, a utility or repair visit, and a routine check on the house. Each one is a different level of trust, and you may only want to share the first.
Ask the questions before the key moves
Ask the neighbor directly whether they are home most days and whether they answer calls from numbers they do not know. Ask how they would reach you if they were the one who noticed something, given that you are in another time zone and may be asleep or in a meeting. Ask whether they can get in without forcing a door or a window, and whether they would feel comfortable walking through the house. Pay attention to hesitation. A no at this stage is useful information, and it costs you nothing.
Put the agreement on one page
Write down who to call first and who to call second, what counts as an emergency, and what the neighbor should not touch. A short list works well: no moving furniture, no opening drawers or cabinets for any reason other than a check, no answering the door on your parent's behalf beyond a quick hello, and no decisions about care. Agree on how long the arrangement lasts and how the key comes back. Do not put the address on the key tag.
Test it before you rely on it
Within the first few weeks, make a test call to the neighbor at a time you choose, and ask them to report back what they saw from the outside. Ask them to confirm they can reach the second person on your list. If the test goes badly, fix the route now rather than during an emergency. The St. Louis resources on our Local Help for a St. Louis Parent page can help you find a second person who lives closer.
What to do tonight
Write the names of every person who currently has a key to the house. Then send one neighbor a short message asking whether they would be willing to talk for ten minutes this week. You do not need to decide anything tonight.
What to leave with the doctor
Ask the doctor's office who they have on file as the contact to call when your parent cannot answer the phone. Make sure the name and number match the person you have chosen, and that the office knows whether that person has a key or a plan to check in.
The public material behind this guide is listed on our Sources page.