A two-floor house splits your parent's day in half. The bed and bathroom may be upstairs while the kitchen, mail table and phone sit downstairs. A helper who visits only the kitchen will miss the part of the day you are most worried about. Before you choose visit lengths or times, walk the house the way your parent walks it. For the St. Louis side of this, see Local Help for a St. Louis Parent.
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.
Map the route your parent takes
Sketch the path from bed to bathroom, bathroom to kitchen, and kitchen to the front door. Mark every step, every rail, and every light switch on that path. Ask your parent to describe the route on a call, or ask a neighbor who has seen it. The helper's first visit should follow the route your parent uses in the morning, not the one that looks tidy on paper.
Set the visit where the day starts
A morning visit that starts upstairs tells you about the night and the start of the day: whether the bed was made, whether the bathroom is in order, whether clothes for the day are out. An afternoon visit that starts in the kitchen tells you about food, mail and the basics. Pick one of those for the regular schedule and use the other for the trial week. Check how long the stairs take your parent before you set the visit length, because a visit that is too short gets spent on the stairs.
Put the phone where the stairs do not block it
Find out where the phone lives and whether your parent can reach it from the bed and the bathroom without going down the stairs. If not, ask whether a second handset upstairs is practical. Ask the helper to confirm the phone works from the spot where your parent usually sits when tired.
Ask the helper how they handle the stairs
Ask whether the helper will go up and down the stairs on each visit, whether they will carry anything, and what they do if your parent is on the stairs when they arrive. A helper's role is to watch and help with errands, not to lift or steady your parent on steps. If the stairs are a safety concern, that question belongs with the doctor or with a qualified person who can look at the house.
What to do tonight
Sketch the route and mark the stair rails, switches and phone spot. Decide which visit should start upstairs and which should start downstairs. Send the sketch to the helper before the first visit.
What to leave with the doctor
Bring a note on how your parent manages the stairs on a normal day and whether that has changed over the weeks you have been noticing it. Ask the doctor whether stair use should be limited, and what should be watched and reported. Ask whether the house needs a home safety look from someone trained to do one.