When you are about to hand someone the night, the price is not the first thing to settle. The first thing is the bathroom trip, the sound, and who answers when the trip goes wrong. Put these questions to the agency or the person, in this order, and write each answer down before you sign anything.
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.
1. Is the person awake for the whole shift?
Ask whether the aide stays awake from start to finish, or sleeps in a chair in another room with the door shut. Ask where they will be and how they will hear her. If the answer is that they will be asleep, find out what wakes them and how quickly. Get that answer in the care plan, not only on the phone.
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).
2. What happens in the first moments of a trip?
Walk the six stops with the aide, in the house or on paper: bed edge, first step, hallway, bathroom door, toilet, and the way back to bed. Ask them to say the order back to you. A plan they can repeat is a plan they are more likely to follow.
3. What do they do if she falls on the trip?
Ask who they call first and what they do before help arrives. Ask what the agency allows them to lift and move, and get that limit in writing. If the limit means they will not lift her from the floor, find out who is called to do it and how long that could take at 3am.
4. Who handles the medicine?
An in-home, non-medical aide can give medication reminders and pick up prescriptions as an errand. Confirm that this is the whole of the medicine job. They do not hand out, give, sort, or manage her medicine. That work stays with you, her doctor, and her pharmacist. If you are asking whether a change in her bladder, dizziness, or sleep needs attention, that question goes to her physician, not to the aide or the agency.
5. Who is the second call?
Name the person who answers your phone at 3am if the aide cannot reach you, has to leave, or needs help. Ask what happens on the night the aide is sick or does not arrive. A written backup plan matters more than a verbal promise.
What to write down before you sign
Put the answers on one sheet: the awake or asleep answer, the order of the first moments, the fall plan with the lifting limit, the medicine line, her doctor's name and phone number, the second call, and the backup for a missed shift. Sign only when every line is on that sheet. For local contacts to start with, see Local help after a fall, St. Louis.