The first month decides whether the arrangement holds. Most problems that show up later started in a rushed intake or an unclear trial week. Run each stage on purpose, and write down who does what at every step.
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.
Stage one: the intake call and the paperwork. Before the call, write the daily routine in plain words. List the hours you need, the tasks you want done, and the tasks your family is keeping. Have a contact list ready, with the family's doctor's office and the person who will be the main contact. Health questions go to the family's doctor, so do not ask the intake person to answer them. Read every page before you sign, and keep a copy.
Stage two: the visit to the home. Whoever comes to see the home should walk the rooms the caregiver will use, the kitchen, the bathroom, and the path from the door to the living area. Show them where things are kept. Ask them to write down what the agency will and will not do in the home. If the agency sends someone who only looks at the paperwork, ask for a second visit with someone who will see the house.
Stage three: matching and the first shift. Ask who will be assigned, how far ahead you will hear, and what happens if that person cannot come. Ask for a meeting before the first shift, or at least a call. Plan to be in the home for the first shift if you can. You are teaching the routine, and the caregiver needs your words more than any handout.
Stage four: the trial week. Plan the week before it starts. Write the tasks for each day, the check-in times, and the one-line note the caregiver will leave at the end of each shift. Schedule a call on the middle day, not the last day, so problems get fixed while there is still time. Keep the notes in one place.
A sample week to plan around. Put the heaviest help on the days when the family is least able to cover. Weekday mornings usually carry the routine tasks. Put errands on a set afternoon so they do not crowd the visit. Leave a weekend window that is named, not assumed. Whatever the grid, write it out so the caregiver, the agency, and the family all see the same week.
Stage five: the review at the end of the trial. Read the notes together. Decide whether to keep the arrangement, change it, or end it. A change means a new grid and a new written routine. Ending it means you know which part failed. Either way, the decision goes in writing.
Local help in general terms. The county senior services office or the local area agency on aging can explain what help exists near you and who to call first. Ask for the local office by name and keep its number with your contact list.