When a family starts pricing help at home, the first question is usually the hourly figure. It is a fair question, and it is also the least complete one. The total you pay over a month depends on how the hours are packaged, how long each visit must run at minimum, how far the caregiver travels to reach her, and when those hours fall. Two arrangements with the same hourly figure can produce very different bills.
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.
The minimum shift
Many providers set a minimum length for each visit, sometimes called a minimum shift or minimum booking. A short check-in that needs two hours booked may cost more than the hours of care she actually received. Ask each provider what their minimum is, whether it applies to every visit or only to the first one of the day, and whether a visit under the minimum can be stacked with another one.
The travel clock
Some providers charge for the time it takes to reach your home, or for mileage, or both. Others absorb it. If the caregiver has to cross the city twice a day to reach her, that travel can be a larger share of the total than the time spent with her. Ask whether travel is billed, how it is measured, and whether a local provider changes the total when the same care is offered closer to her house.
Overnight, weekend, and holiday terms
Overnight coverage, weekend hours, and holiday visits are often priced differently from weekday daytime hours. Ask for each of those terms separately rather than as a single blended number. Notice whether overnight time is awake or asleep, because the terms for those two differ across providers and can change the total sharply over a month.
What pushes the total up
Common drivers include short visits that must meet a minimum, travel time billed on every trip, overnight and weekend rates, extra charges for last-minute changes, and the cost of replacing a caregiver when the regular person is away. Equipment rental and small house changes that the caregiver needs in order to work safely can also add to the total, and those belong in the comparison too.
What brings it down
Grouping visits into fewer, longer blocks can reduce the number of minimums you pay. Matching the shifts to her real daily routine, rather than to a schedule that was set before her needs changed, can cut hours that do little. Asking whether a block of hours is priced differently from the same hours booked one at a time is a question worth asking. A local provider can remove travel time that a distant one would bill.
How to compare
Write one week of her actual schedule, including every visit, the time it starts and ends, and whether it falls on a weekend or overnight. Send that same schedule to each provider and ask for the total for that week, with every charge spelled out. Compare the totals, not the hourly figures. Medication work stays with family, the doctor, and the pharmacist, so ask each provider to confirm which tasks are in the schedule and which are not.
For local providers and the questions to put to them, see the local help page. The total you can keep up for months is the number that decides whether she stays home.