Stop 04 of 08
Eyes on Mom: building a local circle in St. Louis from 500 miles away
You searched for someone to check on my mom in St. Louis because the phone is not enough anymore and you are not there. The answer is not one person. It is a small circle of people who each see one thing, and one rule for all of them: they call you. This page is who belongs in the circle for a house in Chesterfield, Ballwin, Eureka, Valley Park or the city, what each of them can see, and how to set it up without being in the room.
The National Institute on Aging describes the circle before it describes anything else. If you do not live close by, it says, then with the person's permission, you could contact people who see them regularly, neighbors, friends, doctors or local relatives, and ask them to call you with any concerns. Two words carry the whole plan: permission, and regularly. Get the first from her. Build the second from the list below.
If it is tonight
If the neighbor called at 2 a.m. and you cannot fly, sort tonight before you sort the circle. If you cannot reach her, nobody can get in, and you are afraid she is hurt, that is 911 for her address, not a webpage. If it is not that, but you need to know what is possible in her town right now, United Way 211 in Greater St. Louis connects you to a trained resource specialist 24 hours a day. Then call the person with the key and ask them to knock in the morning. The morning is the part you cannot cover, and it is the honest place for the paid placement on this site. New Plan Care, an independently owned non-medical in-home care company in Chesterfield, can put a caregiver in the house for the first daylight hours and call you when they are through the door. It is a client of OwnersFirm, which publishes this site, and it pays to be named here. Call (314) 405-0887, or read what it does.
Who sees what, and who calls you
A circle works because nobody in it has to see everything. The table is the whole page in one glance; the notes under it are how to set each row up from another state.
| Who | What they see | When they call you |
|---|---|---|
| The neighbor with a key | The garage door, the porch light, the newspaper on the step, the car | Anything outside looks wrong two days running |
| The parish or congregation | Whether she came Sunday, how she walked in | She misses two in a row |
| Meals on Wheels driver | The door, on delivery days, and whether she answers it | The program's own rules; ask them |
| Her hairdresser, pharmacist, bank teller | The same face, on a schedule, for years | Only with her permission and only if they agree |
| A geriatric care manager | The whole picture: doctors, paperwork, services, the plan | On the schedule you agree and pay for |
| A non-medical caregiver | The inside of the house, the fridge, the pills taken or not, her mood at 9 a.m. | After every visit, if you ask for that |
- The neighbor. Ask her, not the neighbor, first: "Is it all right if Carol calls me if the garage door is open again?" Then call Carol, thank her for last week, and give her your number under the words "call anytime." Ask her to text you a photo of the porch when something looks off, because a photo is easier to send than a judgment.
- The parish. Most congregations have someone whose job is noticing. Ask who that is. Ask them to notice her.
- Meals on Wheels and the rest of the public front door. For a house in St. Louis County, the Area Agency on Aging is Aging Ahead, which has served St. Louis, St. Charles, Franklin and Jefferson counties since 1973 for adults 60 and older, with Meals on Wheels, senior centers, caregiving services and community options consulting. Its home page lists (800) 243-6060 as the main line. For a house inside the city limits, the St. Louis Area Agency on Aging is the public office for older adults living in the City of St. Louis, and the number on its page is (314) 612-5918. The ZIP decides which one. Neither cares what state you are calling from.
- The people who already see her. The pharmacist who fills the same prescription, the teller at the branch she has used for forty years, the woman who does her hair on Fridays. You are not asking them to report. You are asking, with her blessing, whether they would mind calling you if something seems off. Some will say no. The ones who say yes are worth more than any sensor in Stop 07.
- A geriatric care manager. The NIA mentions that you might speak with a geriatric care manager to help coordinate care. A care manager is the person who holds the whole picture when you cannot: the appointments, the paperwork, the services, the plan. Ask what they charge and what a month of their time actually includes before you sign anything. This site does not name or rank them.
- A non-medical caregiver. Missouri's health department describes private duty or private pay care as aide personal care, respite or companion care paid with private funds or insurance, needing no physician order, and issued no license by the state. That is the row in the table that sees the inside of the house. Two mornings a week is a start at seeing the fridge, the pills taken or not, and her face at 9 a.m. Ask any company you consider one question before the others: will you call me after every visit?
Geriatric care manager or home care agency: which one do you actually need?
People type this as an either-or and it is not one. A care manager plans and coordinates; a home care agency sends a person into the house. If your worry is "I do not know what she needs or who to call," the care manager is the answer to that question. If your worry is "I know exactly what she needs, I need someone to be there Tuesday and Thursday mornings," the agency is. Some families hire the second and never the first and lean on the Area Agency on Aging for the coordinating. Some hire both for a season. The NIA's long-distance page lists arranging for care management or in-home care as one task, not two, and that is the right way to hold it: one job, done by whoever fits the week.
What the public system will do for the daughter, not just the mother
The Area Agencies on Aging are not only her resource. The Administration for Community Living's National Family Caregiver Support Program serves family caregivers providing care to individuals 60 years of age and older. Ask Aging Ahead what caregiver support looks like for a daughter who lives out of state. The answer may be information, a class, or help arranging a break for whoever is local. If you do not know which agency covers her ZIP, the Eldercare Locator, 1-800-677-1116, a public service of the Administration for Community Living, will tell you.
If nobody local will act
Sometimes the circle fails: the neighbor stops answering, the sibling minimizes, she refuses everyone at the door, and you are 500 miles away watching it happen. If you believe she is being harmed, or that she cannot meet her own basic needs and no one is stepping in, Missouri's Adult Abuse and Neglect Hotline is 1-800-392-0210, seven days a week from 7 a.m. to 8 p.m., and reports can also be made online. It is not a betrayal to call it. It is the state's own door for exactly the situation where a daughter far away has run out of local hands.
What to do tonight
- Ask her one permission question on the phone: is it all right if the neighbor calls you when something looks off.
- Write down the six rows of the table with a name next to each. Blank is an answer.
- Find her ZIP and decide which Area Agency on Aging covers it. County: Aging Ahead. City: SLAAA.
- If tonight is an emergency and no one can reach her, stop reading and call 911 for her address.
When to ask the care team or the doctor
The circle sees the house. It does not see what is wrong with her. A caregiver can tell you Tuesday's pills were still in the box; only her doctor can tell you what that means and whether the box itself needs to change. A neighbor can tell you she seemed confused at the mailbox; the NIA's guidance is that confusion, falls, and significant weight change are health concerns, and that significant memory problems could indicate a serious condition that requires medical attention. Every report from the circle that is about her body or her mind, rather than about the house, goes to her physician. Offer to make the appointment. Ask to be on speaker. Do not let the circle diagnose her, and do not let this page.