St. Louis, September 2026
A letter, in chapters
To the husband who has not left the house in a while
Friend,
It is late, the house is quiet, and she is finally asleep. Maybe she came home from the stroke unit a few weeks ago. Maybe the memory trouble has been creeping forward for a year. Either way, you are the one on duty, and you have been on duty every hour of every day.
Instead you type short sentences into a search box: can I hire someone to sit with my wife, does Medicare pay for someone to stay. This letter answers them in the order most men need them, one job at a time.
Nobody writing here is a doctor, and none of this is medical advice. Her health and her medicines belong to her doctor and her pharmacist. This desk hands you plain facts from public pages, the local numbers, and a way to get four hours back.
IChapter one
Tonight, before you go to bed
You do not need a plan for the year tonight. You need five things on one sheet of paper, taped to the refrigerator.
- Write her day on the clock. When she wakes, eats, sleeps and is up in the night. Circle the stretch that goes worst.
- Mark four hours you want back. Your own doctor visit, a haircut, the hardware store, a nap. That block is the first thing to hand off, not the whole week.
- Write who has a key. A neighbor, a son, a daughter across town. If nobody does, that is tomorrow's first errand.
- Put her papers in one folder. Medicine list, doctors' numbers, insurance cards, hospital sheets. If you land in an emergency room, nobody should have to guess.
- Make one call in the morning. In St. Louis County or St. Charles County, Aging Ahead's Community Options line is (636) 207-0847. In the city, the St. Louis Area Agency on Aging is (314) 612-5918. Ask what exists for a husband caring for his wife at home, and write down who you talked to.
If she is in danger tonight, call 911. If it is 2 a.m. and the question is about dementia, the Alzheimer's Association Helpline answers around the clock at 800.272.3900.
The first job is not the whole week. It is four hours, written on paper, with a name next to them.
IIChapter two
What help in the house looks like
Most husbands picture two choices: do all of it yourself, or move her somewhere. There is a middle that many men never hear about. Paid, non-medical help comes to her own house for set hours. Missouri's health department calls it private duty or private pay care, and companion care of that kind needs no physician order.
- Someone to sit with her
- A companion stays while you go: conversation, lunch, a walk to the mailbox. The first visit can be short while she gets used to a new face.
- The late-day stretch
- If evenings unsettle her, an evening shift covers supper, the dishes and the wind-down, so the hardest hours are not yours alone.
- A night you sleep
- Overnight presence means another adult in the house, so you can sleep in the next room without listening for every sound.
- Bathing and dressing
- Help with the shower and dressing is personal care, not nursing. Many men hand it off early.
- The house itself
- Meals, laundry, errands and light cleaning.
What it is not: a nurse, a change to her medicines, or the home health visit a doctor may order. Medicare.gov says Medicare does not pay for 24-hour-a-day care at home, or for personal care when that is the only care someone needs.
Start small: a few hours a week, the same days, the same person when possible.
IIIChapter three
Every piece, sorted by the job
Everything this desk has written, sorted by the job. Each piece ends by telling you who to call.
The day sheet 5 pieces
- How do I know if I am burning out as her husband?No diagnosis. The jobs instead: your own appointment, the four hours, who has a key.
- She won't let me out of her sight: what shadowing is, and how husbands get four hours backWrite the 15-minute handoff. First sitting shift: 90 minutes, not four hours.
- Sundowning at our house: evening routines husbands can run from 4 p.m. to 9 p.m.The hard window is a clock problem: lamps, noise, and the 4 p.m. to 9 p.m. hire.
- My wife wanders at night. What do I do before 2 a.m.?Lights. Coats and keys out of sight. The 15-minute rule. Do not lock her in.
- If I go down, who takes over: what happens if I get sick and I'm the caregiverA one-page shutdown sheet: the key, the printout, who sits tonight.
The handoff 9 pieces
- Can I hire someone just to sit with my wife?Yes. Sitting is a real job, and the four-hour shift is written as a punch list.
- Can someone come to the house for dementia care in St. Louis?Yes. Sitting, meals, bathing and dressing in her own house. Not a nurse.
- How do I get a break from caring for my wife?Write the four hours. Pick the shape. Call one door.
- Respite care for a spouse in St. Louis County: who offers it, who pays, how to askIn-home hours, adult day programs and short stays.
- Where do I take her for adult day in St. Louis County?She goes for the day. You get the hours at home.
- Your back is not a Hoyer lift: how to lift a wife from bed safelyAsk the occupational therapist, and stop doing a two-person job with one back.
- My wife has Parkinson's and I cannot do this aloneThe help that can walk into her own house, and the hour you stop being the lift.
- What number do I call at the Alzheimer's Association in St. Louis?800.272.3900, day or night, and what to ask for on the first call.
- Is there a husband caregiver group in St. Louis I can call?Call the helpline and ask for a group near your ZIP.
After the hospital 2 pieces
- Bringing your wife home from the stroke unit: caring for a wife after stroke at homeThe first two weeks are logistics: papers and the therapy calendar.
- What help can I get at home after her stroke in St. Louis?Home health is a visit. The hours between visits need a name in the box.
Who pays 2 pieces
- Does Medicare pay for someone to stay with my wife?Mostly no. Then the other doors: MO HealthNet, private duty, the VA.
- I am 75. Can I get help caring for my wife?Yes. Age is not a bar. Call the aging office that matches her address.
Want an order instead of a list? Start here. Two sister desks cover nearby moments: Dad Refuses Help, when he says no to everyone, and Since Mom Died, for the father left alone.
Paying someone to sit with her for an afternoon is not giving up on her. It is how you are still here next year.
IVChapter four
Questions men ask
Am I allowed to hire someone just to sit with her?
Yes. Sitting with her is a real job. Missouri's health department describes private duty companion care as paid for privately or by insurance, with no physician order needed.
Will Medicare pay for someone to stay with my wife?
Mostly no. Medicare.gov says Medicare does not pay for 24-hour-a-day care at home, or for personal care when that is the only care she needs. MO HealthNet, long-term care insurance and VA benefits are the other doors to ask about.
I do not know where to start. Who do I call first?
If she lives in St. Louis County or St. Charles County, call Aging Ahead's Community Options line at (636) 207-0847. In the City of St. Louis, call the St. Louis Area Agency on Aging at (314) 612-5918.
She gets upset when I leave. How does a stranger ever take over?
Slowly. Keep the first visit short, stay in the house for part of it, and step out while she is busy with the other person instead of making a long goodbye. If her distress seems new or much worse, tell her doctor.
What happens to her if I end up in the hospital?
Write a one-page backup sheet tonight: who has a key, where her medicine list is, who her doctors are, and who can sit with her on short notice. Give a copy to one person you trust.
Take the four hours. Write them down first.The Caring for My Wife desk
Recommended local provider, sponsor
Someone to sit with her while you go
Tell New Plan Care Solutions which hours weigh the most: the late afternoon, the morning shower, the night. A person will talk it through with you and reach you only the way you ask.
New Plan Care Solutions is independently owned and operated in St. Louis by Stacie Postol and serves St. Louis and St. Charles counties and the communities around them. The help is non-medical: personal care and daily routines, companionship, meals, laundry and household help, and respite for the family caregiver. Caregivers are background-checked, the plan is built with you and changed when life changes, and it can start with a few hours.
It is the only provider featured here, and the guides on this site are educational, not medical advice.
AAppendix
Numbers for the refrigerator
Each number was read on the organization's own page on 12 September 2026. Call the one that matches her address first.
| Who | Number | What to ask for |
|---|---|---|
| Aging Ahead, Community Options | (636) 207-0847 | Caregiver support in St. Louis, St. Charles, Franklin and Jefferson counties, including in-home respite and adult day, as funding permits. |
| St. Louis Area Agency on Aging | (314) 612-5918 | Services for older adults who live in the City of St. Louis. |
| Missouri Senior Resource Line | 1-800-235-5503 | Enter her ZIP code and the call goes to her local Area Agency on Aging. |
| Alzheimer's Association Helpline | 800.272.3900 | Dementia questions and support groups, any hour of any day. |
| DSDS Call Center, Missouri DHSS | 866-835-3505 | To request Medicaid home and community based services. |
| VA Caregiver Support Line | 1-855-260-3274 | If either of you served. Monday to Friday, 8am to 8pm Eastern. |