An adult day program takes your parent for set hours on set days, usually with meals, activities, and staff who watch the room. It can carry part of the week while you stay 500 miles away. But a program that looks good on a tour can fail on an ordinary Tuesday if the van is late or the schedule doesn't match the days your parent is home alone.

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.

Start with the hours and the pickup

Ask for the exact opening and closing times, which days they offer, and whether you can book two days a week or only full weeks. Then ask how pickup works. Does the driver come to the door or stop at the curb? What happens if your parent isn't ready? Write down the pickup window. A program twenty minutes from the house and an hour from the pharmacy changes the rest of the week, so compare drive times as carefully as you compare fees.

Ask how an ordinary day is run

Ask for a description of a normal day, not the brochure version. Ask how many staff are in the room at once and what they do when a guest needs help walking, using the bathroom, or eating. Ask how they handle a guest who becomes upset, and whether they call family right away or after the moment has passed. You are comparing how the program handles the ordinary hours, not its best moment.

Get the medicine answer in writing

Ask how the program handles any medicine your parent takes during the day. Ask them to put the answer in writing. In most families the doctor, the pharmacist, and the family keep the job of managing the medicine list, and the program should tell you clearly what its staff will do and what they will not do. Compare the answers from two or three programs side by side. A vague answer is a reason to keep looking.

Ask what happens on a bad day

Ask what the program does if your parent gets sick in the middle of the day, if the van doesn't come, or if the center closes for a holiday or a sudden illness on its staff. Ask whose number they call first and how fast you will hear. Ask about the exit terms: how much notice they need if you stop attending, and whether a missed day is still charged. Ask whether they keep a sign-in and sign-out log you can see.

Tonight

Pick the three programs you are considering and send each the same five questions by email, so the answers are in writing when you compare them. Include the medicine question and the exit terms in the same message. Then look at what your parent's week would have to look like on the days they go, and check whether a neighbor or a local helper can cover the first pickup if something goes wrong.

What to leave with the doctor

Bring a plain summary of what your parent can do without help, what they need help with, and which hours of the day are hardest. The program will ask for much of the same information, and having it written once saves you from repeating it on every call. Keep a copy for yourself.

If you want someone in St. Louis to visit the programs in person and report back, the local help page explains how to start.