You cannot choose between an agency and a direct hire until you know what the house needs. Both routes quote against a shape of work. If you give them a guess, the quote will be built on that guess. Spend a few days writing down what actually happens, then choose a lane.
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: Name the person and the rooms
Write the name of the person who needs help. List every room that person uses in an ordinary day. Then mark the rooms they cannot reach without someone beside them. Walk the route from bed to bathroom to kitchen to chair and note each stop where a hand is needed.
Person needing help: ____________________
Rooms used every day: ____________________
Rooms reached only with help: ____________________
Step 2: Log three ordinary days in half-hour blocks
Pick three days that are typical, not the worst day of the month. For each half hour from waking to sleep, write what the person does and what someone does for them. Use plain verbs such as got up, showered with someone standing by, ate lunch, sat alone for two hours. Do not summarize. A summary hides the gap.
Step 3: Mark who covers each block right now
Beside each block, write who is there: you, a neighbor, a sibling, or nobody. Every block marked nobody is a gap. Every block marked you is a commitment that will move if you travel, return to work, or get sick. Count both lists separately.
Gap blocks per day: ______
Blocks covered only by you: ______
Step 4: Sort the work into three piles
Sort every task into one of three piles. The first is hands-on body care, such as help with washing, dressing, toileting, and transfers. The second is household work, such as meals, laundry, dishes, and tidying. The third is presence, meaning someone in the room or within call distance who watches and responds. Total the minutes of each pile per day across your three logs.
Hands-on minutes per day: ______
Household minutes per day: ______
Presence hours per day: ______
Keep the three totals separate. They fit different people and different hours, so folding them into one number hides the problem.
Step 5: Find the peak
Circle the single hour that carries the most load. It is often the morning routine or the evening meal. A job sized to the average day will fail at the peak, so write the peak window and the work that happens inside it.
Peak window: ______ to ______
Work inside the peak: ____________________
Step 6: Fill in the size sheet
Put the numbers from Steps 3 to 5 on one sheet and keep it in the same folder as your logs.
Gap hours per day: ______
Gap hours per week: ______
Hands-on work in the peak window: ______
Household work that can wait until another day: ____________________
Hours that must be covered by the same person each day: ____________________
Step 7: Choose the lane the sheet can support
If your gaps repeat in the same blocks each day, a direct hire may fit, provided you can arrange a backup for absences. If the gaps move from day to day, or if you need someone who can step in without notice, ask an agency how it covers absences and how often the same person returns. Read the Start Here page for the five hiring steps before you call, and use the main hiring page to compare the two routes side by side.
Bring the sheet to every first call. Ask each provider to quote against your gap hours and your peak window rather than against an open-ended full-time arrangement.
Questions to ask on the first call
1. Which of my gap blocks will you staff, and how many different people will cover them in a month?
2. If the caregiver is absent, who covers the peak window, and how soon do I hear about it?
3. If the peak window moves one hour later, does the quote change, and who approves that change?
4. Can you show me which of my blocks each quoted hour covers?
What to listen for
Listen for an answer that names the blocks by time. An answer such as we will figure out the schedule once we start means you should ask again before you agree. Listen also for whether the provider asks about your peak window without being prompted. A provider who asks the question has read your sheet.
Signs to walk away
Walk away if a provider will not quote against specific blocks, or insists on a bundled full-day package without showing you what fills each hour. Walk away if the person who answers the phone cannot tell you who would work the peak window.
What to keep
Keep the three logs, the size sheet, and your list of questions together. You will need them when you compare quotes, when the first week shows a block you missed, and when the needs change, as they usually do. Start over from Step 2 whenever the routine shifts by more than an hour a day.