Someone needs to walk your mother's route from bed to toilet with a tape measure, a flashlight, and your night log in hand. That person might be an occupational therapist, a home modification contractor, or an independent home evaluator. The job is the same in each case, so the choice comes down to three things: who will look at all six stops, who signs the written report, and whether that person profits from what they recommend.
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.
Before you book anyone
Start with your mother's physician. Ask whether a therapy referral fits what you have written in the night log, and ask whether the visit would be covered under her plan or by the referral. Get that answer in writing or on the referral form. Clinical questions about her balance, her medicines, or her bladder go to the physician, not to the evaluator.
At 3am you do not book anyone. You write down where she stopped, what she was holding, and what the floor looked like, then you call the physician's office in the morning.
Four questions for every candidate
Ask each candidate the same four questions, and write the answers in the same order so you can compare them later.
First, what license or certification do you hold, and can I confirm it myself with the issuing board or registry? Write down the name of the board. A confident manner is not a credential.
Second, will you visit at the hour my mother actually makes the trip? A bedroom seen at noon does not show the hallway at 3am. If they cannot come at night, ask them to use your log of the night trips and to note the lighting and the distances at each stop.
Third, will you walk all six stops in order, from the bed edge to the toilet and back, and name each stop in your report? If the report offers only a summary such as 'bathroom safety,' ask for the stop-by-stop version before you agree to anything.
Fourth, do you sell or install the equipment you recommend? An evaluator who also installs grab bars, rails, or a new toilet may be entirely honest and still have a reason to find a problem that needs their product. Ask whether they are paid for any recommendation, and whether you may take the written list to another installer for a quote.
Compare the written reports
When two reports arrive, put them next to each other and check the same things in each. Does every stop have a measured distance or height? Does each recommendation say what is wrong, what the fix is, and who does it? Does the report separate the items your family changes, the items the physician should weigh in on, and the items that need a licensed trade? A single mixed list is harder to act on.
Look for the trip back. A visit that checks only the way out leaves the return route unseen, and the return is where many night trips break down. If the return route is missing from the report, ask for it to be added before you pay.
What to write down
Keep one page for each provider. Record the name, the license and where you confirmed it, the date and hour of the visit, whether all six stops were walked, and which recommendations depend on the physician's sign-off. File the pages with the night log so that anyone who reads the file later sees the whole story in one place.
If you are not sure where to start in St. Louis County, the local help page is the place to begin. The sources page lists where each fact in these guides comes from, so you can check any claim before you act on it.