You will probably make this call from a phone, on a lunch break, with a list of questions that keeps getting longer. The goal of the first call is not to pick a helper. It is to learn whether the company or person can answer a handful of plain questions in plain words. If they dodge, that is an answer too.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Know who your contract is with

Ask whether the helper is employed by the agency or is an independent person you would hire directly. The difference changes who handles payroll taxes, who sends a replacement when someone calls out sick, who carries insurance if something goes wrong in the house, and who you call when you are unhappy. Ask for the exact company name that will appear on the paperwork, and for the person you will call when no one picks up.

What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).

Ask what the helper can and cannot do

Write down the tasks your mother actually needs help with: meals, bathing help, getting dressed, rides, laundry, company, walking to the mailbox. Then ask, for each one, whether it is in scope and whether it is written into the agreement. Non-medical caregivers can typically remind a person when a medicine is due and can pick up a prescription as an errand. They should not hand out, measure, sort, or manage medicine. That work stays with your family, her doctor, and her pharmacist. If an agency describes its helpers as managing her medications, ask them to explain that in writing before you go further.

Ask how they screen the people they send

Ask what they check before a helper enters the house: identity, references, and a background check, and whether any of it is repeated on a schedule. Ask whether a state license or registration applies to the work, and how you can look it up yourself rather than relying on their word. Ask who trains the helpers and what that training covers, including what the helper should do if your mother falls or seems confused.

Ask what happens when the plan breaks

Every arrangement breaks at some point. Ask how quickly they can send a replacement, whether they promise a named helper or a rotating pool, how they tell you about a change, and what happens if a helper cancels with an hour's notice. Ask for the cancellation rule and any minimum hours, and have them read those sections aloud. Ask whether a supervisor or care coordinator visits, how often, and how you reach that person when you are the one who is awake at 2 a.m.

Ask how you will hear what happened

You are the one who needs the report. Ask what the helper writes at the end of each visit, where you can read it, and whether you get a message when something unusual happens. A visit note that says the visit went fine tells you very little. Ask to see a sample of what the notes look like, with names removed.

Read the written terms before the first visit

Get everything in one document and read it slowly. Look for the rate structure, minimum hours, how time is billed, travel time, holiday rates, the notice period for ending service, any deposit, who holds keys, and whether you are allowed to hire the same person directly after the agency introduces them, since some agreements limit this. Keep the signed copy in your folder with the rest of the paperwork. If you want a starting list of St. Louis options to compare, see Local Help for a St. Louis Parent. For where we check the rules we describe, see our Sources page.

Tonight

Write down the five tasks your mother needs help with most. Pick the three questions from this list you will ask first, and put them at the top of your notes so they are the first thing you say on the call.

What to take to the doctor

Bring the list of tasks she needs help with, any falls or near-falls since her last visit, and her full medication list with doses and times as they stand now. Bring the names of the agencies or helpers you are considering so her doctor can say whether the tasks you listed match what she needs. Ask the doctor which tasks call for a licensed clinician instead of a non-medical helper. Then ask the pharmacist what authorization they need on file before someone else can pick up a prescription for her.