Most families arranging help at home start with the question of how many hours to buy. A quieter list often settles the answer first: the routine upkeep checks inside the house that nobody writes down until something stops working. Sort that list before you request any schedule. It shows which tasks a hired non-medical aide can take on, which stay with the family, and which belong to a licensed trade that a home care agency should not be expected to cover.

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.

Build the list from the house, not from memory

Walk each room, the entry, and the basement or utility space with a notepad. Write down every check that repeats on a fixed cycle: replacing light bulbs, changing a furnace or air filter, testing smoke and carbon monoxide detectors, checking the gauge on a fire extinguisher, resetting a tripped breaker, clearing a dryer vent, watering the yard, and checking the water heater temperature setting. Add any task that has an owner only because one person happens to do it. The list is the working document. A check with no name beside it is the one that fails first.

Sort every line into one of three columns

Use three columns. The first is family: tasks that need a relative's judgment, a key holder, or a decision about money or property. Testing a detector and confirming that it works belongs here, because a family member should see the result, not only learn that someone touched the device. The second is hired aide: simple, repeatable tasks within easy reach, such as replacing a bulb at floor level, swapping a filter in a tray that opens without tools, wiping a detector cover, or setting out the trash. The third is licensed trade: anything involving a ladder, an electrical panel, a gas line, a furnace or water heater repair, or any wiring. Keep the trade column separate even when the family assumes an aide could handle the job.

Put the aide column to the agency in writing

Do not assume an agency will accept the aide column as you have drawn it. Ask the office for its written list of household tasks an aide will and will not perform, and compare that list line by line with your own. Ask specifically whether aides reach above the shoulder, use a step stool, change items in the entry, handle a key or lockbox, or reset equipment. Ask who decides when a task moves from one column to another. The answer belongs in the service agreement or the written care plan, not only in a phone call.

Questions to ask before you book

Put these questions to the intake coordinator and write down the answers:

  • Which upkeep tasks are on your standard list, and which need a written addition?
  • Can an aide reach a bulb or filter without a ladder, and what does the agreement say when the task needs one?
  • Who supplies replacement bulbs and filters, and who buys them?
  • If a detector chirps or a breaker trips between visits, who is called first, and how fast does the office respond?
  • Will the aide record a failed check in writing, and who receives that record?
  • Who holds a key or lockbox, and how is it returned if service ends?

Plan one week around the three columns

Lay out seven days in a grid. Place family tasks on the days a relative can check them, hired aide tasks on the days the aide is scheduled, and trade tasks on appointments booked in advance. A weekly check that lands on a day with no coverage is a gap, so mark every row that has no owner on a given day. Review the grid after the first full week and move any line that failed or ran late. Repeat the review after any change in the household, such as a new visit window or a family member who starts traveling.

Where local supply shapes the choice

In a thinly supplied area, fewer agencies may have aides available for the hours you need, so the aide column can shrink in practice even when a contract lists it. Check the supply picture for your area before you assume the aide column will hold. The guide to reading a caregiver-supply map for your county and the page on finding help where supply is thinnest explain how to read that picture for a specific county, using How to read a caregiver-supply map for your county and Finding help where the supply is thinnest.