Every arrangement for help at home creates a stack of small paper and phone work. There are forms to file, mail to open, calls to return, and a contact sheet that has to stay current. Some of this is simple enough to hand to a hired worker. Some of it belongs to the family, because it needs a signature, a choice, or a judgment that only the family can make. This guide helps you sort the work before the first shift, so the question of who does what is not decided at the kitchen counter during a busy week.

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.

Sort the paper into three piles

Start with everything in the house that touches the arrangement. Put each item into one of three piles. The first pile is what the family keeps: anything that needs a signature, a decision, a payment, or a reply that commits anyone. The second pile is what a hired worker can handle: copying a list the family has already approved, filing signed copies the family has already read, or bringing in mail to a basket the family checks. The third pile is undecided. Settle every item in the third pile before the first shift. Desk note: an item left in the undecided pile tends to sit until someone needs it urgently.

Decide who answers the agency phone

Name one person in the family as the main contact for the agency. Write that person's name and number on the contact sheet. Then decide who receives a call when a worker is late, when a visit needs to move, or when a change is proposed. Ask the agency whether a worker may take a call from the agency at all, and if so, what that worker may say. Keep the answer plain: a worker can pass along a message, but the family approves any change.

Keep the contact sheet current

The contact sheet is the single page everyone uses. List the agency's office number, the family's main contact, the household's backup contact, the building entry details, and the name of each worker who has been approved to come in. Put it where a worker and a relative can both find it. Update it on the day anything changes, and strike out the old line rather than writing over it. Desk note: a sheet with two numbers for the same person is worse than no sheet at all.

Mail, forms, and sealed envelopes

Decide the mail rule before the first visit. The family usually opens anything that asks for a signature, a payment, or a reply. A worker may bring the mail in and place it in the basket the family checks each day. Ask the agency whether any worker will ever open a sealed envelope. If the answer is yes, the family should write the limit down and sign it.

Forms that need a family signature

Any form that commits the household to a choice stays with the family. This includes consent papers, agreements, changes to the schedule that alter what is paid for, and any request for information about the person being helped. Read each form before anyone signs it. Ask what the form releases and to whom. Health questions go to the family's doctor, and the family should not hand that decision to an aide.

Questions to ask before you divide the work

  • Which papers in this house need a family signature, and where do they go?
  • Who is the one family contact the agency will call?
  • May a worker take a call from the agency, and what may they say?
  • Will any worker ever open a sealed envelope?
  • Where will the contact sheet hang, and who updates it?

When the family wants the work handed off completely

Some families want a clean break and ask an agency to take over all of the paper. Before agreeing, check the agency's written scope and the files behind it. For a basic overview of which public record to read for which kind of help, see Home health versus non-medical home care: which record to check. A complete handoff still leaves the decisions with the family, so write down which decisions stay home.

Settle the three piles on paper before the first shift. The family that decides early has far fewer missed calls and lost envelopes later.