When you first look at the cost of keeping her home, it is tempting to ask one question: what does an hour cost? That question matters, but it rarely explains why the total moves. The total moves because her week moves.
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 shape of her week
Write out a plain week for her, the way it actually runs right now. Mark the hours when she is alone and fine, the hours when she needs a hand with one thing, and the hours when she needs someone in the room. Those three lines are the bones of every number you will be given. A helper who comes for a few hours to cook and tidy costs a different amount than one who stays through a stretch when she needs steady attention, even at the same hourly rate.
What pushes the total up
Four things tend to lift the bill: more hours, longer single visits, more than one person needed at the same time, and work that needs a second pair of hands or special equipment. Each of these can arrive quietly. A task she used to do herself starts being done for her. A visit that was an hour becomes two because the morning routine takes longer. Ask every company or helper how they count these changes, because some add a charge when a visit runs over and others build the longer visit into the plan.
What pulls the total down
The cheapest hours are the ones nobody has to buy. Family can take a regular slot, a neighbor can check in on a set day, and the house itself can do some of the work: a chair she can get out of alone, a kitchen where things are kept at a height she can reach, a bathroom set up so one helper is enough. Changes to the house often lower the bill more than adding a few hours does. Look at where most of the hours go, then ask what would take a task off the list entirely.
Ask about changes before you sign
Before you agree to any plan, ask four things: what happens to the rate if her needs rise, how extra visits are booked and billed, what notice is required to change the schedule, and who decides when a change is needed. Write the answers down. Those answers will tell you more about the real cost than the first number on the page.
When you want to see what the local options look like, the local help page is a good place to start.