When families talk about hiring help, they often start with the number of hours. A better starting point is the list of tasks. Every task in a household belongs to one of three hands: the family, a hired helper, or the care team. The mistake most families make is assuming that anything that is not hard can go to a helper, and anything that is hard must stay with them. The line is actually drawn by the kind of judgment a task requires, not by how difficult it looks.
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.
This article gives you a way to sort the tasks and a way to test each pile before you commit to anyone's schedule. It does not tell you what care she needs. That is for her doctor and the care team to decide with her.
Write every task on its own line
Make a list of everything that happens in her day and in the house across a typical week. Include the obvious items such as meals, bathing, laundry, rides, and cleaning, and the less obvious ones such as calling about a bill, noticing a change in her mood, restocking supplies, and answering the door at night. Write each one on its own line. Lists that group tasks together hide the parts that take the most judgment.
Sort into three piles
Family keeps the decisions and the judgment. That includes choices about money, conversations about her wishes, deciding when to call the doctor, and any task where someone has to notice that something is off and decide what to do. It also includes sorting or managing her medicine. A non-medical helper may give medication reminders and pick up prescriptions as an errand. Filling a pill organizer, deciding which doses to give, or keeping track of what is in the cabinet stays with the family, the doctor, and the pharmacist.
A hired helper can take the repeatable errands and the companionship. Rides to appointments, groceries, laundry, light housekeeping, meal preparation, errands to the pharmacy to collect a prescription, and reminders that the day's plan is in place. These tasks can be scheduled, written down, and checked from week to week.
The care team holds anything that touches her health needs, any change in what she can do safely, and the planning for nights and emergencies. If a task requires a clinical assessment, a change in her treatment, or a decision about whether her needs have grown beyond what the house and the helpers can cover, it belongs with the care team.
Test each pile before you hire
For each task in the helper pile, ask whether it can be described in a sentence a stranger could follow on their first day. If the description needs a lot of unwritten knowledge, the task is not ready to hand off yet. Write it down first, with the steps and the places where a decision might come up. For each family task, ask whether anyone else has ever been given the decision. If not, that is a gap to fix with a conversation before a crisis forces it.
Then ask the hardest question: which of these tasks, if it fell back on you alone, would make you give up your own work or sleep? Those tasks need a hand, even if the hand is not the one you expected. Bring that list to the care team and ask which of them they can help you plan for.
If you want to see what local help is commonly available for these tasks, the local help page is a useful place to start the search.