A hired hour is not one price. The rate on a quote depends mostly on what the helper is asked to do inside that hour. A helper who sits with your wife costs less to book than one who must lift her from the bed to the chair. Before you sign anything, take the day sheet for the hours you want covered and mark each job by its level.

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.

Sort the jobs before you ask for a number

Split the tasks into three piles. The first is company: sitting with her, talking, reading aloud, a short walk with a steady arm, simple meals, light tidying, and errands. The second is personal care: help with dressing, toileting, washing, and grooming. The third is handling: transfers from bed to chair, car, or toilet, turning her in bed, and any lift that needs a belt or a second person. Agencies and independent helpers often price these piles differently, and some list the handling pile as a separate line.

What pushes the rate up

Handling costs more for three reasons. It takes training and practice to do safely, it carries more risk of injury to the helper, and it often needs a second person or equipment. Ask whether the agency requires a two-person assist for any transfer, and whether the rate changes when it does. Ask whether the quote assumes the helper will use the lift, sling, and wheelchair already in your house, or whether the agency brings its own. Personal care tends to sit between the two piles, so ask for its rate on its own line too. Before a helper starts, ask who is responsible if they are hurt on the job.

What pulls the rate down

Keep the handling pile small by setting up the house for it. A stable bed height, a clear path from bed to chair, and a sling that fits her all reduce how much hands-on work a helper must do. Not every hour needs to be hands-on. A helper who sits with her while you sleep or step out is doing company work, which is usually the lowest rate on the sheet. Planning the day so that transfers happen in one short window, rather than spread across the day, also keeps the number of charged handling moments down.

Medication is a line, not a job you hand over

A non-medical helper can remind her when a dose is due and can pick up a prescription as an errand. Sorting, handing out, and managing her medicine stay with you, her doctor, and the pharmacist. Do not price that work as part of the helper's day, and do not leave it on the sheet as theirs.

The questions to put in writing

Ask each provider for the rate on company, personal care, and handling separately, and whether any of them has a minimum per visit. Ask whether the lift equipment is included, whether the helper is insured and bonded, whether they run a background check, and what happens when a helper cannot do a transfer on a given day. Ask what changes the bill if she needs more help next month than she does now. Write each answer on the day sheet beside the job it covers, so the quote and the list of jobs match.

Compare the same sheet

Two quotes can only be compared when they cover the same piles. Put the same day sheet in front of each provider, have each one price it line by line, and compare totals only after the lines match. For help finding providers near you, start with the local help page on this site.

The Task Level Sets the Rate: What a Lift or Personal Care Adds to a Hired Hour