Hourly rates get the attention. The number underneath every rate is the staffing plan: how many people, doing what, for how long. A plain rate can hide a quote that is far bigger than it looks. Physical help is a common reason.
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.
Where the extra weight comes from
Some tasks need more than a single caregiver. Helping someone out of a bed, up from a low chair, or in and out of a car can need two people for safety. Some agencies send a single caregiver and bill for a single visit. Others send a pair and bill for both. Ask which one you are buying.
Other drivers push the staffing up too. Heavy housework, long stretches of lifting, or a client who needs help most of the day rather than a few minutes at a time all add staff time. Each driver should appear on the quote as a line, not as a surprise later.
What can bring the price down
Good planning lowers the total honestly. Schedule the heavy tasks for the hours when a second person is already in the house, such as a family visit. Group errands into a single trip. Keep the caregiver's time focused on hands-on help, and do the light chores yourself or on another day.
What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).
Ask each agency to price two versions of the plan: a version with a single caregiver and a version with a pair for the transfer tasks. Compare them side by side. If an agency cannot price the second version, record that as a finding.
What to ask before you sign
Ask how many caregivers are assigned to each visit and whether the quote shows that count. Ask whether the second person is billed at the same rate or a different one. Ask what happens when that person is late or unable to come. Ask who decides when a visit needs a pair and who pays for the change.
Ask for the staffing plan in writing before you agree to it. A quote without a staffing plan leaves the most important line blank, and you end up filling it in yourself.
Plan for change, not just the start
Needs shift. A visit that takes a single person in one season may take a pair by the next. Set a review date and ask the agency how it reprices a change. For the longer view of what a year of care adds up to, see Budgeting a Year of Home Care.