A visit length is a guess until someone walks the house. The hours on an agency's proposal should come from a walk through the home itself, not from the number of rooms or a rough feeling about the week.

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.

Walk the route before you write the hours

Start at the front door and follow the path an aide would take on a normal visit: the door, the kitchen, the bedroom, the bathroom, the laundry, and the trash. Write each stop down in order. Note every change in floor, every staircase, every door that sticks, and every place where the path doubles back. Then time the walk from the door to the farthest stop and back at a normal pace, because the route sets the floor under every task.

Count the floors and the far rooms

A two-story home adds a trip for every task that ends on another level. A basement laundry adds the stairs twice for each load, and a bathroom at the far end of a long hall adds minutes to every personal care visit. Ask the agency to show that movement in its own visit plan. If the plan lists tasks but no time between floors or rooms, the hours are short.

Match the tasks to the rooms

Make a short list of what happens in each room during an ordinary day: meals, dishes, linens, sweeping, clothes, a bath, and a bedside check-in. Put each task beside the room where it happens. Then sort the list into tasks that must happen on the visit day and tasks that can wait for another day. Compare the agencies against this list, not against their own descriptions of what they do.

Set the block length from the walk

Add the walk time, the time for each task, and a buffer for the things that always take longer than expected, such as a stuck door or a full laundry basket. Then round up to the nearest block the agency offers, and keep the walk inside that block. A visit that covers a bath on the upper floor and a load of laundry in the basement needs a different block than a visit that stays in the kitchen and living room.

Questions to put to each agency

  • Does your visit plan count the walk between floors and rooms, and where on the plan is that shown?
  • Will the aide carry laundry, groceries, or trash up or down stairs, and is that task written into the scope?
  • What does the agency do when a visit needs help on the stairs, and will you have that answer in writing? Health questions go to the family's doctor.
  • If the household changes its layout, such as a bedroom moved to the ground floor, who revises the visit block, and how soon?
  • Which rooms may the aide enter and use, and who decides when a room is off limits?

Check the plan after the first full week

Walk the route again with the aide's notes from the first full week in hand. Compare the time on paper with the time each visit actually took. If the gap repeats, the block is short. Take the question back to the agency and record the change in writing for the family. The county supply pages show how many agencies serve each county, which helps a family judge how hard a switch would be if the block cannot be fixed. For the method behind those pages, see How to read a caregiver-supply map for your county.