You finally have a number of hours in your head. Maybe you need help every weekday morning. Maybe you need enough coverage to work one full day without answering care calls from the parking lot.
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.
Then an agency gives you an hourly rate, and the arithmetic looks simple.
It is not simple yet.
The bill is shaped by where those hours sit, how short each visit is, what the worker must do, whether one worker can safely do it, and what happens when the regular person cannot come. You are allowed to make the agency price your real week instead of selling you a clean hourly number that belongs to an imaginary one.
Write the schedule before you ask for the total
Put each needed visit on one page. For every visit, write the start time, end time, tasks, and what must happen before the worker can leave.
Do not write “morning help.” Write what morning help means: arrive before your parent gets up, help with dressing, prepare food, clean the immediate work area, and stay until your parent is settled. If the worker must drive your parent, wait during an appointment, run an errand, or document what happened, put that down too.
Now ask the agency to quote that schedule as written. Ask it to identify every visit that does not fit its standard rate or minimum visit length.
Find the hours that cost differently
Ask whether the rate changes for evenings, weekends, holidays, last-minute requests, or visits outside the agency's usual service area. Ask how the agency defines each of those categories. “Weekend” may begin earlier than you expect. “Holiday” may include days your family does not treat as holidays.
What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).
If your schedule crosses from one rate period into another, ask whether the whole visit changes price or only part of it. Get the answer on the quote.
Then ask about visit minimums. If you need a brief morning visit and another brief evening visit, you may be buying two minimum visits rather than paying only for the minutes of hands-on care. Compare that with one longer block that carries additional tasks you currently do yourself.
This is not a reason to stretch a visit just to fill time. It is a reason to compare schedules that solve the same problem.
Ask what happens when the week becomes fragmented
A schedule can contain enough total hours and still be difficult to staff. Short visits, split visits, changing start times and isolated weekend hours can narrow the pool of available workers.
Ask the agency these questions:
Can the same worker take the whole recurring schedule? Which visits are hardest to fill? Does the rate change if different workers cover different pieces? Is travel between clients included in your charge? Are mileage, parking or appointment transportation billed separately? What happens to the charge if an appointment runs long?
The U.S. Department of Labor treats some travel during a worker's day as paid work time and requires covered employers to count compensable hours correctly. That does not tell you what an agency will charge you. It tells you why “driving is included” needs a more exact explanation. The public references behind this guide are collected on the Sources page.
Make the task list test the quote
Ask the agency to mark each task as included, excluded, or available at a different rate. Use the actual tasks, not broad labels.
Check bathing, toileting, transfers, meal preparation, laundry, housekeeping, medication reminders, transportation, errands, supervision, pet care and documentation. Ask whether any task requires a worker with different training or whether agency policy requires two workers for any part of the visit.
Do not accept “we can usually do that.” Ask what the agency needs to review before it can commit. If an assessment could change the rate, minimum visit length or number of workers, the quote is not final until that assessment is reflected in writing.
Price the call-off, not just the scheduled shift
You are not buying relief if every worker absence hands the shift back to you.
Ask whether replacement coverage is automatic or whether you must request it. Ask who calls you, how quickly you are told, whether a substitute may arrive at a different time, and whether the rate changes for replacement coverage.
Also ask what you owe when your parent cancels, refuses entry, goes to the hospital, or no longer needs the visit. Get the cancellation window, notice method and charge in writing. Put the agency's after-hours number beside those rules.
Separate agency hiring from direct hiring
If you are comparing an agency with a worker you hire directly, do not compare the agency rate with the worker's take-home pay. Ask who is the employer, who handles payroll records and taxes, who provides insurance, who finds a substitute, and who pays for required work time.
The Internal Revenue Service says a household worker may be your employee when you control both what work is done and how it is done. A label such as “independent contractor” does not settle that question. You do not have to become a payroll expert tonight. You do need to know which responsibilities are included in each option before calling one cheaper.
Ask for one page you can compare
For each agency or direct-hire option, make one row for the ordinary weekly charge and separate rows for visit minimums, schedule premiums, transportation, mileage, parking, assessments, extra workers, cancellations and replacement coverage.
Then add one sentence: “If the planned worker cannot come, this is what happens.”
That sentence belongs in the cost comparison. Your unpaid return to the care shift is not a zero.
If you are in the St. Louis area and the private-pay schedule does not fit what you can sustain, check the caregiver and respite routes on Local Help for Caregivers in St. Louis. Ask each program what it covers, who qualifies, whether there is a wait, and whether you may choose the worker or schedule.
Use the quote to choose a week, not merely a rate
The lowest hourly rate can produce the higher weekly bill when it comes with longer minimums, separate travel charges or a schedule the provider cannot reliably staff. A higher stated rate can cover more of the work you were going to carry yourself.
Choose the option that answers these four things in writing: the schedule it will staff, the tasks it will own, the full set of charges, and the plan when the assigned worker is absent.
You are not being difficult by asking the quote to match your life. The quote is not useful until it does.