A utility bill is one of the costs that changes quietly when someone starts spending the day at home. The bill shows a total. It does not show you which part of the day is responsible. Before you cut anything, find the drivers.
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Pull the last twelve bills and compare the same months
Gather the last twelve bills and, if you can find them, the same months from the year before. Look at the usage figure, not only the amount due. Usage tells you whether the household is using more energy or whether the rate changed. Those two causes call for different responses, and a rate change is not something you fix by turning down a thermostat.
Sort the likely drivers
The common drivers are the heating and cooling setpoint and the hours it runs, hot water used for showers, laundry, and dishwashing, space heaters or window units used in individual rooms, lights and televisions left on through the day, and any powered equipment the household now relies on. Walk through the home once and mark which of these changed when the routine changed.
Ask the utility what it offers
Call the utility and ask three questions: whether it offers a budget billing plan that spreads the cost evenly across the year, whether it offers a payment arrangement if the bill is already behind, and whether it has a way to note that the home relies on powered equipment. Many utilities do, and the rules differ from provider to provider, so get the answer in their own words and write down the name of the person you spoke with.
Check for assistance programs and their eligibility rules
Some utilities and local agencies offer bill assistance or home energy upgrade programs. Eligibility rules, income limits, and application steps vary, and they change over time, so confirm the current rules directly with the program rather than relying on anyone's summary, including this one. The Local Help for Caregivers in St. Louis page is the place to begin looking for local options, and the Sources page lists where the information in this series comes from.
Do not cut warmth that the person in the home needs
Lowering the heat or cooling is a common first move, and it can be the wrong one. Before you change any setting, ask whether the person living in the home needs a particular temperature to stay comfortable and safe. If the answer is yes, the adjustment belongs in a different place: the house envelope, the draft, the hot water temperature, or the hours the equipment runs. Make those changes one at a time so you can see which one moved the number.
Compare the next two bills against the first
After one or two changes, compare the next bills with the baseline you built. If the usage dropped, keep the change. If it did not, the driver is somewhere else on your list. Write the result in the same notebook as the rest of the household plan.