The agency says its aide provides personal care. That phrase may sound as if it covers the whole evening. It may not tell you whether the aide will help your wife stand, steady her on the way to the toilet, change a brief in bed, prepare supper, wash the dishes, or stay beside her while you shower.

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.

Do not settle this through a reassuring phone conversation. Put the evening on paper, then make the service plan or contract answer for every job. You need to know what happens at 6 p.m., not what personal care usually means.

Start with the hours when you need another pair of hands

Write a short day sheet from the aide's arrival through the end of the shift. Use the right side of the page for the person responsible.

For example:

6 p.m. - Help her move from the chair to the toilet. Aide, husband, or both?

6:30 p.m. - Set up supper and remain close enough to help. Does the aide prepare food, reheat it, or only serve it?

7:15 p.m. - Clean the eating area while someone stays with her. Who stays?

8 p.m. - Change clothes and provide evening personal care. Which parts will the aide perform?

9 p.m. - Help her into bed and place the items she uses within reach. Is this transfer included?

Do not make the list longer just to make it complete. Write down the jobs that fail when you are the only person available.

Match every job to a sentence in the paperwork

Read the contract, service agreement, and care plan together. The contract may describe broad service categories while the care plan contains the actual tasks. If the salesperson's promise appears in neither document, ask where it will be recorded.

Beside each task, mark one of four answers: included, excluded, conditional, or not stated.

A conditional task needs another line of explanation. The agency might allow an aide to help with a transfer only after its own assessment, only with specified equipment, or only when two workers are present. Write down the condition and who decides whether it has been met.

Ask the agency to identify the exact wording that covers each important job. If the answer is, “Our aides usually do that,” ask for the task to be added to the written service plan.

Find the words that can stop the shift from working

Look for terms such as mobility assistance, transfer assistance, toileting, continence care, meal preparation, light housekeeping, supervision, standby assistance, and two-person assistance. Ask what each term means inside this agency.

Then check the exclusions. A task may be listed as a service in one section and limited elsewhere by a safety rule, staffing rule, equipment requirement, or worker restriction.

Ask direct questions:

Will the assigned aide perform this task alone?

What would make the aide decline it after arriving?

Can any trained aide on the schedule do it, or only certain workers?

If two workers are required, who schedules the second worker?

If the task changes during the shift, whom does the aide call?

What is the aide expected to do while waiting for instructions?

Write the answers beside the task. The point is not to argue about a label. The point is to know whether the job will happen.

Check what the contract promises about the worker

A task can be approved while the person sent to the house is not prepared to perform it. Find out how the agency passes the care plan to a substitute. Ask whether you must explain the entire routine again when the regular aide is absent.

Check whether the paperwork says anything about training, task approval, supervision, and changes to the plan. Ask who confirms that a replacement has read the current instructions before the shift begins.

Your own one-page handoff sheet can describe where supplies are kept, which words your wife understands, and the order that works best. It does not replace the agency's service plan. The agency still needs its own written authorization for the work its employee will perform.

Make the end of the shift visible

An evening shift may end at 9 p.m., but the job may run past that time if your wife is not ready for bed or a transfer takes longer than expected. Find the contract language for late departure, overtime, minimum shift length, and extensions requested during a visit.

Ask what the aide does when the scheduled end arrives before the final task is complete. Does the aide call a supervisor, remain until another person takes over, or leave at the scheduled time? Who may approve extra time, and how is that approval recorded?

Put the handoff itself on the day sheet:

8:45 p.m. - Aide tells husband what was completed, what was not completed, and what changed.

9 p.m. - Husband accepts the handoff, or aide calls the agency because there is no safe, workable handoff.

Do not let “shift ends” stand in for a handoff plan.

Read the cancellation and no-show sections before the first missed shift

Find the notice required when you cancel. Then find what the agency promises when its worker cancels. Those two rules may not be the same.

Ask whether the agency will try to send a substitute, how it will contact you, and when it will tell you that no replacement is available. Ask whether you can decline a substitute who has not been prepared for the listed tasks.

On your day sheet, write the fallback beside the first job that cannot be done alone. It might be a named relative, another paid provider, or a call to the agency supervisor. “Husband manages somehow” is not a handoff.

Do not sign with blank spaces still carrying the evening

Before signing, compare the final paperwork with your task list. Check the start and end times, days of service, approved duties, excluded duties, staffing conditions, cancellation terms, and the number to call during the shift.

Keep the signed contract, current care plan, and agency contact instructions together. Put the day sheet where you and the aide can use it. When the agency changes the plan, replace the old copy instead of keeping several versions in circulation.

If the paperwork still leaves an essential task unanswered, the shift is not fully arranged. Ask for a written answer, change the hours, add the required hands, or keep that task with yourself until there is a workable handoff.

The contract does not need to describe every minute in your house. It does need to tell you whether the work you cannot do alone will actually be covered when evening comes.

The Home Care Contract Says “Personal Care.” Make It Name the Evening Jobs You Are Buying.