She wants to stay in her own bed, and a home health agency may be part of how that happens. The brochure will show you the visits. What decides whether the house holds is what happens in the hours between them.
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.
Start with the empty hours
Put the proposed visit schedule for each agency on one page. Then mark every hour she will be alone: each night, each weekend, each stretch between a morning and an afternoon visit. Those are the hours when a change in her breathing, a fall, or a confused morning will actually land. The schedule tells you when someone comes. The empty hours tell you what you will be carrying.
Ask the after-hours question three ways
Ask each agency for its after-hours number, and ask who answers it. Then ask whether that person is a nurse, a dispatcher, or a message service. Ask what happens to a message after it is taken, and how long it usually takes for someone with clinical judgment to call back. Ask whether the answer changes on weekends and holidays. Write each answer down in the agency's own words, and ask for the same answer in writing before you choose.
Compare what each one will check, and what it will not
Ask each agency to list the services it will provide: skilled nursing visits, therapy, aide visits, and any other help. For each one, ask how often it happens, how long a visit runs, and who decides when the schedule changes. Ask who writes her plan of care, who reviews it, how often, and who tells you when she needs more than the plan covers. An agency that cannot say who makes that call has not yet shown you how the house will be watched.
Medicine stays with the family, the doctor, and the pharmacist
Ask whether a nurse reviews her medicine list at a visit and what the nurse does with what they find. Then ask the agency to name the things it will check, not the things it will handle. The medicines themselves stay with you, her doctor, and her pharmacist. Write that down so no one assumes otherwise on a difficult morning.
Find out who will actually come through the door
Ask how many different people usually visit her in a typical week, and whether the same person comes most days. Ask what the agency does when the usual person is out. Ask whether you will be told before a visit changes, and how. Her comfort depends on familiar faces, and so does your ability to notice when something is off.
Put the answers side by side
Build a simple sheet with three columns: the question, the answer in writing, and the name of the person who gave it. Mark anything that was only said on the phone. Then compare the agencies on the empty hours, not on the visit count. The one that answers clearly about the night is usually the one that will hold the house when it matters.
If you want a starting list of St. Louis options before you make these calls, see Local help for keeping her home. For how these guides are written and checked, see How we write.