Most of a lost week comes from calling three kinds of businesses as if they were the same thing. They are not. An agency employs the caregiver and sends them to you. A direct hire makes you the employer. A referral service finds names and then steps out. Pick the lane first, and the phone calls get shorter.

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.

Step 1: Write down who the caregiver answers to

Fill in this line before you call anyone:

If the shift goes wrong, I call ______________________.

If the answer is a company, you want an agency or a company that supervises its own staff. If the answer is you or a family member, you are taking on the employer role, and you need to know that before the first shift.

Step 2: Ask every provider the same five questions

  1. Who is the employer of record for this caregiver, and whose name is on the pay record?
  2. If the caregiver cannot come, who finds a replacement, and how quickly must that happen?
  3. Who sets the schedule, and who approves a change to it?
  4. Who carries insurance for the caregiver while they are working in the home, and will the company put that in writing? Check the answer with your own insurer as well.
  5. What happens if the family ends the arrangement, and is any notice period written down?

Write each answer on the line below its question, with the name of the person who gave it and the date you heard it.

Listen for a named person, a stated time limit, or a written policy you can keep. Walk away from any answer that is only a promise to see how things go, or any answer that the company will not put on paper.

Step 3: Compare the answers, not the sales talk

Set the three lanes side by side on one page. Write each answer under its question. A blank cell means that lane is not ready to serve your household yet, and you should not treat it as a small detail to fix later.

The public sources behind these descriptions are listed on the Sources page, and the agency and direct choice is laid out side by side on the Hire a Caregiver in St. Louis: Agency or Direct page. Use both to check your own notes against.

Step 4: Decide the lane before you name the caregiver

Once every cell on the page is filled, choose one lane. Do not start a second lane while you wait for the first one to answer. Mixing lanes is how two companies end up sending two different people to the same door.