Turnover is the quiet failure in home care. Nobody announces it. The name on the schedule changes, the new person does not know the routine, and the family ends up explaining the same things again and again. You can spot it early if you count.
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.
Count the names in the early weeks
Write down every caregiver name the agency sends you. Keep the list in a single place. If the list keeps growing, the agency is not holding its staff, or it is rotating people to fill gaps. Either way, the care you bought is not the care you are getting.
Ask what happens when your aide is out
Every agency will say it has backup. Ask how many people are trained on your loved one's routine, how the household is told before a switch, and whether the same faces come back. A vague answer is a finding. So is a clear answer that admits there are no spare names.
Watch the handover
A good handover leaves a written note in the home: what the person likes, what they eat, which door sticks, which chair must not be moved. Check the note. If there is no note, or it is only a few words long, ask the office for the written care plan and whether a copy is kept in the home.
Signs to act on early
Act when the same complaint returns after every switch, when the office cannot tell you who is coming next week, when visits start running late without explanation, or when your loved one stops mentioning the caregiver at all. Call the agency, ask for the supervisor by name, and put the problem in writing. If nothing changes, the answer is to move, not to wait.