Every agency will speak well of itself. That is expected, and it tells you little about what a bad week looks like. A reference, meaning a family who has used the agency and agreed to talk with you, can fill in what the brochure leaves out.

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.

Ask the office for references, and accept its limits

Ask the agency for two or three families willing to speak with you. Some offices will not share names because of privacy, and that is reasonable. In that case, ask whether they will pass your phone number along so a family can call you. Do not push for the names of families who have not agreed to talk. A reluctant office is useful information too.

What to ask the family

Keep the questions concrete. How often did the regular helper change? When a shift was missed or came late, how did the office respond, and how quickly was a replacement in the house? When you raised a concern, what happened next, and did you hear back? Did the helper learn the household routine, and did they follow the written notes? Did the office's answers at the start match what actually happened?

Listen for specifics. A family that describes a particular morning, a particular call, or a particular fix is giving you more to work with than one that says everything has been wonderful.

Ask what the references cannot tell you

A family can describe how the office communicated and how it handled problems. A family cannot tell you what the agency's current staff will do in your house with your loved one. Treat references as evidence about the office's habits, not a promise about your situation.

Check the basics yourself

Ask each agency for its licensing and required paperwork, then look for those listings through the state's public records in general terms. Ask where the agency's complaint process is written down, who receives complaints, and how long the office says a response takes. Ask to see that process on paper before you sign anything.

Keep health questions where they belong

References may mention how a family's loved one was doing, but health questions go to the family's doctor. No agency on this site makes a medical call or offers care for a condition, and a reference's account of a bad day is not a substitute for a clinician's judgment.

This site explains how it sets up its own comparisons in how this site lays out its comparison criteria, which can help you decide which questions matter most for your household.