An in-home care agreement is the paper that decides what a non-medical caregiver does during the night hours and what happens when something goes wrong. The rate matters, but the scope, the incident steps, and the ending terms matter more when she is on the bathroom trip alone.
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.
Read the scope line by line
Find the list of tasks. A non-medical caregiver may give medication reminders and may pick up prescriptions as an errand. Check that the agreement lists these, and check that it says medicine handling itself stays with the family, her physician, and her pharmacist. If the scope is vague, ask the agency to write the exact errands in plain words before you sign.
Find the incident clause
Look for what the agreement says happens if she falls during a shift. Check who the caregiver calls first, in what order, and whether the caregiver writes an incident note. Ask where the note goes and who receives a copy. A clause that says only 'follow standard procedure' leaves the order of calls to memory at 3am, so ask for the steps in writing.
Check the night hours
Confirm which hours are listed as on-shift and which are on-call. Ask whether she can call the caregiver from the bathroom or bedroom, and whether the caregiver is expected to walk the trip with her or wait outside the door. The agreement should match what you actually need on the night route, not a general phrase like 'overnight support.'
Look at the replacement and absence terms
Find what happens when the caregiver is sick or cannot come. Check who arranges a substitute, how much notice the agency must give, and whether the substitute must meet the same written scope. Replacement terms are the part families most often find out about only after the first missed shift.
Read how it ends
Look for the notice period, who has to give it, and what is owed for hours already worked. Note whether the agreement allows a shorter notice in a hospital stay. These terms decide how you can change plans if her needs change.
Compare on these lines, not the rate
If you are comparing two agreements, put them side by side on scope, incident steps, night hours, replacement, and ending terms. Do not compare on the rate alone, because a lower rate can sit beside a narrower scope.
For who to call in St. Louis after a fall, see Local help after a fall, St. Louis. Keep the signed copy with the route notes so the scope and the incident steps are in the same place as the night plan.