Source note: this guide is editorial. It draws on no public file. It is a clerk's checklist for a household, and it tells you what to write down, not who to hire.

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.

The problem in plain terms

Most families who look for help at home did not start with a plan. One person began picking up a task, then another, until a single adult child, spouse, neighbor or friend was the only one who knew the schedule, the route to the appointment, and where the spare key is kept. The problem is not only that someone is tired. The problem is that the arrangement has no second person in it.

Check one: who is free at each hour

Take a sheet of paper and draw seven columns, one for each day of the week, with the hours down the side. Mark every hour when a household task needs someone present: getting up, meals, help with bathing if that is needed, outings, bedtime, and any hours when the person receiving care should not be left alone. Then write the name of the person who covers each block. If one name fills most of the blocks, you have found the first sign.

Check two: what happens when the main helper is away

Ask the household to name the backup for each block. Then ask what the backup would need to know: where the schedule is kept, the phone numbers, the door codes, and the route to the usual outing. If the answer is that nobody else knows, the arrangement is held together by one person. A home in that position has nothing to fall back on when that person has a work trip, a sick day, or a hard week of their own.

Check three: the task that never gets done

List the household jobs that have slipped: the grocery run, the laundry, the mail, the ride to the outing that was cancelled twice. A job that slips again and again has an owner on paper and no owner in practice. That is a gap, and it is usually the first gap a family can name without argument.

Health questions go to the family's doctor

This sheet does not measure anyone's health. If a change in memory, mobility, or daily routine has raised the question of help, health questions go to the family's doctor. This checklist only counts hours, people, and tasks.

Plan one week of support before you call anyone

Fill the blank hours on the sheet first. Then sort the open blocks into three piles: tasks a friend or relative could take, tasks that need a paid non-medical helper, and tasks a family member should keep because they are personal to the household. A plan for one week of support is easier to test than a plan for a whole season. Run the sheet for one full week, mark what actually happened, and bring the marked sheet to any interview.

What this sheet cannot tell you

Editorial: the sheet shows the shape of the need. It does not say which kind of help fits, and it does not compare any provider. Once the gaps are named, the next step is to decide whether the help should come from an agency or a private aide, and to check whichever route you choose. The desk's guide on telling home health from non-medical home care helps with the first part.

Home health versus non-medical home care: which record to check