The hospice visit schedule is written down. The other help in your house usually is not, and that is where the trouble starts. If you have hired a non-medical caregiver for the hours the nurse is not there, the paper you sign decides more than the hourly rate does. Before the first shift, read it for one question: whose name is on each line?
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.
Who is the employer
Some agencies send you a worker and remain the employer. They hire, pay, withhold taxes, and carry the workers' compensation and liability coverage for that person. Others place a person with you and leave you as the employer, which means your household may take on the payroll duties that come with that role. Neither arrangement is wrong, but they are not the same bill and they do not carry the same risk. Ask the agency, in writing, which one you have. If you are the employer, ask what the agency will still handle for you and what you will have to do yourself.
What the certificate says
Ask for a certificate of insurance before the first shift. Read the name of the insured, the policy period, and the coverage lines. You are looking for workers' compensation and general liability. A certificate that names the agency is a different document from a policy that covers the person working in your kitchen, and you should be able to tell them apart. If the page says coverage is still being arranged, or leaves a line blank, do not accept a verbal promise to send it later. Ask for the finished page before the caregiver walks in.
Who answers if someone is hurt
Hurt can mean the caregiver falls on your stairs, your parent is bumped during a transfer, or a car is damaged while the caregiver runs an errand. The contract should say who is responsible for each of these and how a claim is started. Look for the clause on incidents and the number you call. Find out whether the agency expects a written incident report and how long you have to give it. These are questions to put to the agency and, if you hire directly, to the insurer that covers your home. A licensed attorney in Missouri can explain how those duties apply to your household. This page cannot.
What the caregiver may and may not do
The job description is part of the paper. A non-medical caregiver can give reminders that a dose is due and can pick up a prescription as an errand. The contract should state that the medicine routine stays with the family, the doctor and the pharmacist. If the agreement is vague on this line, ask for the wording to be made specific before you sign. The contract is not the place to decide how the medicine routine will run. That decision stays with the people who already hold it.
Read the cancellation and the replacement
Look for three terms: how much notice either side must give to end the arrangement, what happens if the regular caregiver is sick or does not come, and whether a replacement is guaranteed or only attempted. A contract that promises a name but not a substitute leaves the night in your hands. Write the answers in the margin next to each clause so you can find them at 2am.
Keep the paper where you can find it
Put the signed agreement, the certificate of insurance and the agency's contact person in the same place as the hospice binder. If something goes wrong on a weekend, you should not have to search three drawers. The Sources page lists the federal and state references this site uses for employment and benefit questions. The Local Help page is a starting point for questions closer to home in west St. Louis County.