Families usually spot the change in the kitchen, the laundry, or the stairs, and miss the car. A car that stays in the driveway for a long stretch is a planning signal. Trips that once happened on the older adult's own schedule now depend on another person's calendar, and that person is often a relative with a job, a house across the county line, or both.
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.
Write the trip list first
Before any agency call, write down every regular trip from the last ordinary stretch of life. Keep the list plain: the grocery store, the bank branch, the post office, the place of worship, a standing lunch with friends, the barber or salon, the library, and the appointment calendar kept on the refrigerator. Next to each trip record the usual day, the usual hour, the place it sits on a map, and who drove the last time it happened.
Then sort the trips by geography. A home in St. Charles County may have most trips inside one town, while a home in west St. Louis County may have trips that cross several municipalities in a single afternoon. Group the trips that share a corridor, and mark which groups fall outside the reach of the family members who are free on weekdays. The groups with no named driver are the gap.
How to tell the trips have stopped
The signs are usually small and repeated. The car has not moved for a stretch the family can name. The older adult turns down outings that used to be accepted without thought, or stops mentioning them at all. A relative begins driving to the same store every week without being asked. Errands once done in person are now done by phone, by mail, or not at all. Any two of these, held for more than a few weeks, is enough reason to start the trip list.
Compare the gap by county
Use a single table with four columns: the trip, the direction of the drive, the time one way at the hour the trip usually happens, and the name of the person who is free. Read the table once for the trips with no name, and once for the trips with a name but a long drive. The second group often breaks first, because the named driver is carrying more than one trip at a time.
The desk's supply pages can help you judge whether the county has enough non-medical help nearby to share the driving. For a county view, see how to read a caregiver-supply map for your county.
What to check or ask
Ask whether the older adult still wants to make each trip, because a list full of trips they no longer care about will make the gap look bigger than it is. Ask whether a hired helper is expected to drive the older adult's own car, or only to ride along in the helper's car, and get the answer in writing. Ask whether the agency can send the same person for each ride, or whether rides change with the schedule. Ask who keeps the trip list current after the first few weeks.
Ask the family what happens on the day the usual driver is unavailable. Every trip that depends on one person has a failure point, and the list should name a second person for each of them.