When the bill for help around a parent's house jumps, the hourly rate is rarely the whole story. Two households can pay very different totals for the same kind of cleaning, because the total is built from the size of the job, how often it happens, and how much of the work is heavy. Settle those before you compare anyone's rate.
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.
Write the job list first
Walk the house in your head or on a video call and list what actually gets done: kitchen surfaces, bathroom, floors, laundry, dusting, the fridge, the windows. Mark each item as routine or occasional. A weekly wipe-down and a deep clean every few months are two different jobs, and a provider who quotes one will quote the other differently. Ask your parent what the house looks like on a bad week, because that is the week the helper has to plan for.
The five things that move the total
Visit length matters because a short visit that covers the same floor plan costs more per hour of actual work. Frequency matters because a regular schedule usually gets a better total than one-off visits booked on short notice. Heavy tasks such as moving furniture, scrubbing ovens, or stripping beds are often priced separately or left out, so find out which ones are in. Supplies matter because some providers bring them and bill for them, while others expect the house to be stocked. Access and timing matter too: keys, parking, pets, and whether anyone has to be home for the visit.
Ask every provider the same questions
Give each one the same job list and the same frequency, then ask what is included, what counts as extra, what triggers an extra charge, and what happens when a visit runs long. Ask how a missed visit or a cancellation is handled, and whether the same person comes each time. A written estimate that names each task is worth more than a verbal range. If you want a local person to walk the house with you, the Local Help for a St. Louis Parent page lays out how to start.
Tonight
Open a shared note and write the job list. Ask your parent which tasks they still do themselves and which have quietly stopped. That gap is the real scope of the work.
What to leave with the doctor
Ask whether any limits on lifting, climbing, bending, or standing mean certain tasks should never go to a helper, such as ladders, high shelves, or reaching into the oven. Ask for the answer in writing if you can, and send it to whoever writes the job list.