When you compare in-home help, the hourly figure is only the start. The total depends on how the hours are cut into visits, what the helper is asked to do in each one, and what happens to the time that does not go to her direct care. Those are the parts that move the bill, and most of them can be read before you sign.
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.
Look at the minimum shift
Many arrangements set a minimum length for each visit. A short visit that is billed at the minimum can cost more per hour of real help than a longer visit. Ask what the shortest billable visit is, and whether a visit that runs short still bills the full block.
Count the visits per week
Four visits of two hours each and two visits of four hours each are not the same bill, even when the hours match. Write down how many separate visits the plan needs, the time each one starts, and what happens if her day runs late or early.
List what goes inside each visit
The more the helper must do, the longer the visit. A visit that includes a meal, laundry, a walk, and an errand is a different job from one that is only company and a meal. Name the tasks for each visit on one sheet, so you can see where the time really goes.
Who pays for the waiting and the driving
If the helper waits at a pharmacy, a clinic, or a delivery, ask whether that waiting is billed. A helper may pick up a prescription as an errand, and may remind her to take a dose that someone has already set out for her, but the medicine itself stays with the family, the doctor, and the pharmacist. The drive time and the wait time for that errand are part of the cost, so ask how they are counted.
Check skill, time of day, and weekends
Some arrangements price a higher skill level, an overnight stay, or a weekend visit differently from a weekday daytime visit. Ask which of these you are actually buying, and which ones you only think you need. Do not take the first total as final. Ask for the same plan priced two ways, once with the visits you need and once with a fewer-visit version, and compare what each one leaves uncovered.
Make one sheet before you compare
Write the visits per week, the length of each, the tasks inside each, the errands, the minimum shift, and who pays for the gaps. Then ask every agency to fill in the same sheet. The bill that looks lowest is often the one that leaves the most tasks unnamed.