When families ask what it costs to keep a parent at home, they are usually picturing the day. The day has a clear shape: a morning visit, a lunch, someone back by supper. The night has no such shape, and it is where the number tends to surprise people. Before you compare any two offers, pull the overnight hours out of the total and price them on their own line.
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.
Why the night is a separate question
Overnight coverage is often billed on different terms than daytime hours. Some providers charge a set rate for a sleeping shift. Some bill every hour in the block at the same figure. Some charge a higher rate when the caregiver is expected to get up and help. Those are three different bills for what sounds like the same job, and you cannot compare them until you know which one you are being quoted.
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).
What to ask before you compare
Ask the agency or the private caregiver these questions in writing, and keep the answers with the rest of your paperwork. Is the night rate the same as the day rate, or is it a separate figure? Does a sleeping shift count as full hours, or only the hours when someone is awake and working? If she wakes and needs help getting to the bathroom or a drink, is that billed as extra time, or is it already included? What is the handoff time in the morning, and does the day caregiver arrive early enough that there is no gap? If the night caregiver is sick or does not come, who covers, and does that change what you pay?
Count the hours she is actually awake
For one week, write down when she gets up at night, how long she stays up, and what she asks for when she is up. A trip to the bathroom, a question about where she is, a request for water. Each of those belongs in the written scope. A quiet week does not tell you what a restless week will need, so the scope should describe the bad night as well as the good one. The bad night is the one you will be paying for.
Read the reminder line
A non-medical caregiver can give a medication reminder and can pick up a prescription as an errand. If you want a bedtime reminder included, put it in the written scope so the price reflects it. The medicine itself stays with the family, her doctor and her pharmacist. If a night plan assumes anyone else will handle her medicine, settle that assumption in the conversation before anyone signs.
Build the overnight plan on its own sheet
Make a short sheet with the day hours in one column and the night hours in the other. Total each column. Then add a third line for what you would need if the night plan fails: a family member who can be reached, a second caregiver who has been introduced to her, and a call system that reaches the bed. Look at the three totals side by side. The night line is often the one that decides whether the house can hold the promise, and it is easy to miss when the day line looks reasonable.
When to take it to the care team
If her nights change faster than the plan can follow, the question is no longer only about the bill. A change in how often she gets up, how confused she is when she wakes, or how much help she needs to get back to sleep is something to raise with her care team, not a reason to stretch the same hours further. Bring them your week of notes. Bring the sheet with the three totals on it too, so the conversation starts from what the house actually needs at night.
For people who can help you work through this list with a local eye, see local help for keeping her home.