Most long-distance daughters do not start with a clear problem. They start with a feeling, a few odd phone calls, and a list of things that might be nothing. The first job is not finding a caregiver or buying a monitor. It is deciding how big the problem is, because the size tells you which step comes first.
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.
Three sizes
Now: Someone is unsafe today. She has fallen and nobody was there to help her up, she cannot get food or water on her own, she is confused about where she is, or a doctor has said she should not be alone. If any of this is true, the first call is to someone local who can get to her today, and the second call is to her doctor.
Soon: Things are slipping but nothing is on fire. Meals are thinner, the bathroom is harder to reach, bills are getting paid late, or she has stopped going to things she used to love. You have a few weeks, not a few hours, to set up help and watch how it works.
A plan: Her days look mostly like her old days, but you can see the edges getting closer. This is the time to write down what you would want if things changed, find out who is nearby, and learn what local services exist before you need them.
How to tell which pile you are in
Ask yourself these questions and be honest about the answers. Has she been hurt, or come close to being hurt, in the past few weeks? Can she get to the bathroom, the kitchen, and the front door without holding onto furniture? Does she eat, wash, and get dressed on most days? Are her bills and her medicines being kept up with? Does someone local know what a normal day looks like for her? If you answer no to any of these, move the problem up one pile.
This is a way to organize what you already see, not a diagnosis. Her doctor is the one who can say what is causing a change.
What the size changes
In the Now pile, the work is immediate: a local person on site, a call to the doctor, and a plan for who checks in tomorrow. In the Soon pile, the work is coordination: a short list of helpers, a shared calendar that someone local updates, and a written list of the three things that would move her to Now. In the plan pile, the work is paperwork and conversation: who has which key, what she wants, and where the important papers are kept.
What to do tonight
Write the three piles on a single page. Under each one, put the specific things you have seen, each with roughly when you saw it. Do not write conclusions like she is declining. Write what happened. Then call one person who lives near her and ask what they have noticed this week. Compare their answer to your page and move anything that does not fit.
What to take to the doctor
Bring the single page with the three piles and the specific events under each. Ask the doctor which of these items matters most, how urgent it is, and what changes should be reported right away rather than at the next visit. Ask which local services the office trusts. Keep the page, and bring it back updated next time.
For the public sources behind these questions, see Sources. If you want a short starting list for the whole journey, Start Here has one. If you are looking at help in St. Louis specifically, Local Help for a St. Louis Parent explains what to ask for.