Most families who hire in-home help end up on one of three routes: an agency that employs and schedules the caregiver, a direct hire where the family is the employer, or a referral list where you find the person yourself and an outside party handles only part of the work. Each route sends the paperwork, the scheduling, and the missed-shift calls to a different place. Pick the lane first, because every later question depends on it. For a broader comparison of the two main routes, see Hire a Caregiver in St. Louis: Agency or Direct.

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 does what on each lane

Take one sheet and draw three columns, one for each route you are considering. Under each column, write the answers to these questions:

  1. Who is the employer of the caregiver?
  2. Who do I call when the caregiver cannot come?
  3. Who holds the schedule and changes it?
  4. Who pays the caregiver, and who sends me the bill?

Leave a blank where the answer is unknown. Do not move on until each column has no blanks you cannot explain.

Lane 1: ______________________________

Lane 2: ______________________________

Lane 3: ______________________________

Step 2: Build a short call list

Write no more than five names on the lane you chose. Next to each name, write the one thing that made you put it on the list. If you cannot write a reason, cross the name off.

Step 3: Ask every provider the same first questions

Use the same four questions on every call so the answers can be compared side by side:

  1. What is the earliest start date you can staff?
  2. How many hours per week will you commit to in writing?
  3. Do you visit the house before a plan is written? When?
  4. Who is the first person I call if a shift is missed?

Listen for a specific date, a specific number of hours, a named visit step, and a named person. Walk away from any answer that depends on what the family says later, or that leaves the missed-shift route as a general promise.

Step 4: Hold the in-home visit and the written plan

The provider should see the house, the daily routine, and the places where help is needed before a plan goes on paper. Ask for the plan in writing before you agree to a start. The written plan is the document you will check against later, so keep a copy.

Step 5: Set the first shift and the first-hour check

Before the first shift, write down the arrival time, the family contact for the day, and who will be in the house for the first hour. The caregiver should know the same names and numbers you wrote down.

Signs to stop the process

  • The provider says you must decide today.
  • No one can tell you who employs the caregiver.
  • The missed-shift route is a shared inbox or a general phone line with no named person.

If you want a sequence with the same order in one place, the Five Steps to Hiring page follows the same route. Write the start date on your sheet as the last line, and do not let the calendar set the start before the lane is chosen.

Start date: ______________________