Many families never decide to hire a caregiver. They notice a gap, cover it with phone calls and favors, and keep covering it until the covering costs more than the help would. This guide is for the point where you need to state the gap on paper before you talk to anyone who sells care. For the full sequence, see Start Here: Five Steps to Hiring.

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 the gap in one sentence

Fill in the blanks by hand. Do not use the word help.

Between ____ and ____ on ____ days, no one is in the house to ____.

If you cannot fill the blanks, you have a worry, not yet a hiring problem. Keep working through the steps below until you can.

Step 2: List the tasks that fail

Write the tasks that actually go undone, not the ones you would like done. Common ones include meals, fluids, bathing, dressing, laundry, transport to appointments, reminders about the day's plan, and simple company. For each one, write who covers it today.

Task 1: ____ Covered by: ____

Task 2: ____ Covered by: ____

Task 3: ____ Covered by: ____

Step 3: Ask the person in care

Ask what they think is missing. Write their answer word for word, even if it contradicts what you expect. Do not argue with it on the page. The point is to record it.

Their answer: ____________________________________________

Step 4: Ask someone who sees them regularly

Ask a neighbor, a member of their faith community, a pharmacy counter worker, an adult day program staff member, or the doctor's office what they have noticed. Ask only what they actually observed, and write the date of each observation next to it.

Observer: ____ What they saw: ____

Step 5: Check the signs

You have a real problem if several of these are true:

  1. Calls go unanswered for longer than your usual gap, and you learn about it second-hand.
  2. Meals or fluids happen only when you bring them.
  3. Mail, bills, or appointment notices are piling up.
  4. You have made the same unplanned trip twice in one month.
  5. Someone reports a fall, a near fall, or an injury nobody can explain. Take that report to the doctor's office. This guide does not diagnose anything.
  6. The person says they are fine, but the house shows otherwise.
  7. Your own week now bends around this gap more than around your work or family.

Step 6: Ask the three questions that set the timeline

Answer each one in writing.

If I am unreachable for 24 hours, who checks on them? ____

Which task fails first when a gap opens? ____

How many hours a week is the gap, roughly? ____

Step 7: Name who handles the medicine now

If medicine is part of the gap, write down who handles it today. A hired non-medical caregiver may give medication reminders and pick up prescriptions as an errand. Sorting, handing out, and managing medicine stay with the family, the doctor, and the pharmacist. Write that split on the page so it is settled before the first call.

Medicine currently handled by: ____ Reminder needed at: ____

When the gap is not a hiring problem

If the gap is one short, known errand that ends soon, you may not need an in-home caregiver. Write the end date. If you cannot write one, the gap is probably ongoing, and the steps above still apply. For how to check the claims behind each step, see the Sources page.

Your next move

Take the finished sentence, the task list, and the signs you checked to the first call. Do not start with price. Start by reading the gap back to the caller and asking whether their service covers every task on your list.