Before any home support starts, ask the agency to put its promises on paper. A friendly first phone call does not tell you who will walk through the door, what they have been checked for, or who is responsible if something goes wrong in your home. This guide covers the documents to ask for and the questions that make those documents mean something.

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.

Start with the basics

Ask whether the agency is licensed or registered with the state, and what that license or registration actually covers. Ask who is the employer of each helper who would visit your home. If the answers are vague on a first call, ask again before you commit.

Screening

Ask whether every helper has a criminal background check, and when it was last done. Ask whether driving records are checked for anyone who will drive the person you care for. Ask whether references are called, and how the agency confirms identity before a first visit. Write the answers down word for word so you can compare them with what you see on the day someone arrives.

Insurance

Ask for a certificate of liability insurance and proof of workers' compensation coverage for helpers. A certificate should show the agency's name and whether the policy is current. Ask who is responsible if a helper is hurt in your home, and whether the coverage applies to helpers sent on short notice. If you hire a helper directly rather than through an agency, the family takes on more of these duties. A lawyer or the state's consumer protection office can explain your responsibilities as an employer. This guide cannot.

Training

Ask what training each helper has finished, what it covered, and how the agency keeps that training current. Ask specifically about working with memory changes, how a helper reports a change they notice, and what a helper does when the person they care for refuses help. Good answers name real topics and real routines. Vague answers such as caring and experienced are a reason to ask one more question.

What to ask for in writing

Ask for a written summary of the services, the hours, and the tasks the helper will and will not do. Ask how the agency handles a visit when the helper cannot come, and who at the agency you should contact when something feels wrong. Ask for a copy of the complaint process as well. Keep these pages with your other care papers.

If an agency will not put these answers in writing, that is an answer too. Use any ranking, including ours, as a list of agencies to call, not as a decision. Our method is explained on the how this desk scores memory support page, so you can see what the scores do and do not measure.