Most families ask about the hourly rate first, and that is a fair place to start. But the base line rarely tells the whole story. Over a few months, the total is shaped by what the caregiver is asked to do, what the household ends up buying, and how often the schedule shifts. Your job is to find each of those lines before you sign, so that the first bill does not come as a surprise.
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.
Ask which tasks change the rate
Some agencies price every task the same. Others add a charge for hands-on help such as transfers from bed to chair, bathing assistance, or help with toileting. Some charge more when two people are needed for a single task. Ask the agency to list, in writing, which tasks are included in the base rate, which carry an add-on, and which need a second caregiver. Then ask how each add-on is billed.
Count the supplies the family will buy
Estimates often leave out the things that keep a day running: gloves, wipes, incontinence products, meal ingredients, and small household items a caregiver uses on the job. Ask who is responsible for buying each one, and whether the agency keeps a supply on hand or expects you to provide it. Write the monthly supplies on your worksheet as a separate line so they are visible.
Count the errands and their costs
A caregiver can pick up a prescription as an errand and can give medication reminders, but the medicine itself stays with your mother, her doctor, and the pharmacist. Errands carry their own costs: mileage if the caregiver drives their own car, parking, and the time spent waiting at a counter. Ask whether those minutes are billed, whether a trip to the pharmacy counts as part of a shift, and whether a longer errand changes the total for that visit.
Plan for visits that move
A late call, a sick caregiver, or a family appointment can change what you pay. Ask what happens when a visit is cancelled on short notice, when a replacement arrives, and when an extra visit is added for a day that needs more help. The answers belong in the written agreement, not only in a conversation.
Build a three-month worksheet
Write down the base line, each task add-on, the monthly supplies, the expected errands, and a line for changed visits. Then run the same worksheet against a few typical weeks, including a week with an appointment and a week with a sick day. The number that comes out of that exercise is far more useful than the number on the first estimate. For more on how we work through questions like this, see our how we write page.
What to bring back to the table
When you meet the agency, bring the worksheet and ask them to mark each line as included, add-on, or family-provided. If they cannot fill it in, ask them to explain why. A clear answer now is worth more than a quick estimate that leaves the important lines blank.