Cost moves with structure before it moves with the rate. The number of hours, the time of day, how many people are in the home at once, and whether a helper stays in the house overnight all change the total more than a single hourly figure does. A family comparing offers should compare the structure first and the figures second, because two offers with the same hourly figure can add up to very different totals.
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.
Live-in care and visit-based care
A live-in arrangement is a different kind of service from a schedule of visits. The helper lives in the home for a set stretch, which means the household provides a room and usually meals, and the terms have to say what counts as working time. Visit-based care bills the time the helper is in the home. Put the two side by side only after the household has decided which kind of presence it needs.
What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).
Ask how sleep and standby time are treated
When a helper is on site overnight, the first question is whether sleep time counts as working time, whether standby time counts, or whether only awake and active time counts. Ask for each rule in writing. Ask also how a call during the night is billed and what happens when the helper is needed beyond the planned window. These rules decide whether an overnight plan that looks lower on paper stays lower in practice.
Weekend and holiday time
Time that falls on a weekend or a holiday can be billed on different lines from a weekday visit. Read each line in the agreement and mark which lines apply to the household's usual week. A family with a schedule that concentrates care on weekends should expect the weekend lines to shape the total more than the weekday lines do.
The household's own share
A live-in helper needs a room with a door that closes, a place to store food, and time off that the household plans for. When the helper takes a day off, someone else must cover it, and that cover is part of the total. Ask who arranges the cover and whether the agreement sets a notice period for time off.
What to compare on paper
Lay two offers side by side and write four items in the same order: the hours covered, the overnight rule, the weekend and holiday rule, and the cover plan for time off. Only then compare the totals. Where few agencies serve a county, a family has fewer offers to compare, so the comparison has to start early. The guide Finding help where the supply is thinnest explains where supply is thinnest and what that means for choice.