A walk-through is the in-home visit where an agency looks at the house and the household's needs before any schedule exists. The steps after it decide whether the first week runs smoothly. This guide follows those steps in the order they usually happen, so the family knows what to bring, what to watch, and what to put in writing.

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.

Before the walk-through

Write the need in plain terms on one page: which rooms the help will use, which doors and steps the aide will pass, where the parking is, and which tasks the household expects. Pick one family member to speak for the household and one to take notes. Decide which tasks the family keeps for itself before the visit, so the question does not come up on the spot.

During the walk-through

Walk the route the aide will take, from the car to the door to the room where most of the help happens. Note the steps, the lift if there is one, the clear paths between rooms, and the outlets and light switches the aide will use. Ask the agency to say in writing which tasks it will do and which tasks fall outside its listed services. A task left off both lists is an open question, not a yes.

After the walk-through

Ask for a written draft of the care plan within the agency's stated time. Compare the draft against your notes line by line. Anything the agency wrote that you did not discuss, and anything you discussed that is missing, goes back to the agency as a requested change. Ask for the revised draft and keep both versions. The plan belongs to the household as much as to the agency, so it should come to you as a copy you can keep.

Build the schedule from the plan

Turn each task on the plan into a line on a weekly grid with a day, a start time, and an end time. Mark the tasks that must happen on the same day and the tasks that can move. Check the grid against the agency's schedule proposal and mark any gap. Ask for the first visit time in writing, because a start that is only spoken can slide without anyone deciding it should.

Sign once the papers match

The plan, the schedule grid, and the agency's written terms should agree on what is done, when, and by whom. When they do, sign. On the first shift, have a family member present for at least part of the visit if you can, and write down what went right and what did not. Send that list to the agency's scheduler in writing, so the first week has a record and not just a memory.

For a plain look at which record applies to the agency you are considering, see home health versus non-medical home care before the walk-through.