A ranking answers a question you may not have asked yet. Before you open any list, write the job in plain words. This guide follows the records clerk's method: anything taken from a page or a file is marked as such, and anything else is editorial judgment.

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.

Write the gap as a short list

Sit down with the people who cover care now and list every task they handle in an ordinary week. Include the trips, the groceries, the laundry, the mail, the bills, the car, the yard, and the calls to the doctor's office. Then mark which tasks are being dropped, which are being done late, and which are being done by someone who is already stretched. Editorial: the gap is the distance between what the household needs done and what the people already doing it can actually cover.

Tell whether the gap is real

A gap is real when two people who share the work can name it separately, without checking with each other. Look for plain signs: a missed day of work, a bill paid late, the same person cancelling plans again, an errand that never gets done, or an argument about whose turn it is. Write each sign down with the day it happened, so the list is a record and not a feeling. Editorial: a sign in the household is a fact to note, not a finding about anyone.

Separate the chores from the health questions

If a change in how the person receiving care is doing is part of the reason for the gap, that question goes to the family's doctor first. An agency's intake staff cannot answer it, and a ranking cannot either. Keep the health question on its own line so it does not get mixed into the chores.

Read the list with the gap in hand

Open a list only after the gap is written. Check whether each candidate says it covers the tasks you named, and note what it leaves out. Some ranking pages mark one slot as a sponsor, so look for that disclosure before you read the order. From the page: if the page does not say whether a slot is paid, treat its order as unknown. Editorial: a ranking is a set of candidates to test, not a verdict on any agency.

For a St. Louis search, the St. Louis ranking page is one place to start. If the household sits in St. Charles County, the St. Charles County list is the one to test against. Either way, a list is only as useful as the gap you wrote down first.

The one-page sheet to finish before you call anyone

  • The gap, written in one sentence
  • The tasks the agency must cover, in order of how often they are missed
  • The days and times the household is short, and who is home at those times
  • The health questions, marked for the family's doctor
  • The one question the ranking did not answer