Families rarely decide they need help all at once. The first sign is usually a task that stopped getting done, then another, until one person is covering a list that nobody wrote down. This guide reads the household as a record: what has slipped, who has been absorbing it, and what the gap looks like on paper before anyone calls an agency.
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.
Read the house for stopped tasks
Walk through the home and the mail with a list. Look for bills left open on the counter and not yet sent, mail that has not been opened for a while, a refrigerator running low before the week is out, laundry that has moved from one chair to a stack, a car that sits more than it runs, and appointments on the calendar that were moved more than once. Each one is a line on the record. None of them is a health finding. They say the household is short of hands.
Sort each task by who can take it
Make three columns: tasks the person can still do, tasks a family member can do, and tasks that need someone outside the family or someone who lives far away. Write the name of the family member beside each task they can reliably do, and write the hours they actually have, not the hours they wish they had. A task with no name beside it is the gap.
Write the week
Lay out one ordinary week in the same plain columns. Put every errand, meal, ride, appointment, and check-in on its day. Mark which items fall to the same person more than once. Count the open items at the end of the week. That count is the working record of how much the family is covering alone, and it is more useful than a general sense that things are getting harder.
Decide what the gap is for
Some gaps are errands a non-medical helper can take: a grocery run, a ride, a visit to check the house. Some are household work: laundry, a light tidy, the trash. Some are decisions that belong to the family, to the person, or to the doctor, and a helper should not be asked to take them. Keep those on the family's side of the sheet. Health questions go to the family's doctor.
Once the sheet is written, the desk's front page is one place to start a search, read with the method note in mind.