Families often hire for the wrong thing. They book hours to keep an eye on the house when the real problem is that their relative has quietly stopped going out. The house is tidy, the food is in the fridge, and the calendar is empty. Nobody is missing a task. The person is missing the world outside the door.
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.
Test whether the problem is the door
Ask three questions about the last month. When did your relative last leave the house for something they chose? Which outings did they cancel, and why? Who did they talk to face to face, apart from family? If the honest answer is 'not in a long time' and the reasons are about the trip itself rather than the task list, the problem is outings.
Write the list down. Each cancelled trip is a finding. A service skipped, a friend's lunch declined, a walk around the block that stopped. Those are the hours you are really shopping for.
Compare that to a task problem
A task problem shows up as missed chores: dishes piling up, laundry that does not get done, a fridge with nothing in it. An outing problem shows up as an empty calendar while the chores still get done. You can have both. Name which one is bigger before you call anyone.
If the outing problem is bigger, a visit that only cleans will not fix it. The caregiver needs a plan for going out, such as a regular drive to a senior center program, a walk, a shopping trip the person picks, or a weekly lunch with a friend. Ask each agency whether its caregivers can drive the person, whose car would be used, and what happens if something goes wrong on the trip. Get those answers in writing.
Ask about the trip, not only the hours
Agencies that talk plainly about money also talk plainly about what a visit includes. Ask how long a trip takes door to door, whether waiting time is billed, and whether the caregiver can bring the person home if the plan changes mid-outing. A straight answer is a point in the agency's favor. A deflection is a finding.
Ask the person too. Your relative may want to choose the place, the time, and the company. Let them. If they refuse every outing, that is a different conversation, and it belongs to the whole family and the family's doctor. Health questions go to the family's doctor.
Build the first week around one outing
Pick one outing the person already wanted. Put it on the calendar for the first week. Do not add a list of new errands. One trip, on a known day, with the same caregiver if possible. If it goes well, repeat it. If it does not, the problem may be the trip itself, not the help.
Local places to look include senior center programs, faith community groups, and the older-adult programs at your public library. Your county senior services office or your area agency on aging can tell you what is open near the person's home. Ask them plainly what they offer, then match the answer to what the person said they want.