Cleaning is the job nobody schedules until it has already piled up. The floor of the room where the person lives, the dust on the shelves nearest the bed, the bathroom sink and fixtures, the mirror and the door handles: none of these looks urgent on a single day, and all of them build up quickly once a household is running on the hospice schedule. Whether you clean them yourself, pay someone to, or split the work is a real choice, and the split works only when each task has a name beside it.
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.
Write down the cleaning you already do
Before you decide anything, list what gets cleaned in a normal week, room by room. Include the parts that do not show: the handles, the light switches, the floor under the chair, the cabinet fronts. Mark the tasks you do now and how often. Then mark the ones that have stopped happening. Do not estimate from memory. Track the tasks as they are done for one week and see what is left over.
Once the list is on paper, sort the tasks into three groups: the ones only you should do, the ones a paid cleaner could take, and the ones that could go either way. The first group usually holds the parts of the room you already touch as part of care, and anything involving the person's medicine, bottles or medical supplies. Those tasks stay with the family. Do not hand them to a cleaner.
What to ask a hired cleaner
Ask whether they will clean the patient's room and the bathroom, or only the common areas, and whether they are comfortable working in a room where someone is receiving care. Ask whether they bring their own supplies and products, and whether any product must be kept away from the bed or the oxygen equipment. Ask whether they will move furniture, and whether they will put it back where it was. Ask whether they will handle soiled linens or cleanup after a bodily-fluid spill, because many general cleaners will not, and you should not assume they will. Ask who holds a key, when they arrive, and what happens when a visit is skipped or runs late.
Tell any cleaner, before the first visit, that medicine, pill bottles, medical supplies and equipment controls stay where they are. They may wipe around them. They do not sort, move or tidy them. Put that instruction in writing and keep a copy with the house instructions.
Keep the split on one page
Put the final split on one page, in two columns, one for the family and one for the cleaner, with a line at the bottom for anything that is in neither column. Post the page where the cleaner will see it on arrival, and review it after the first two visits. A split that is working will look dull on paper. A split that is not will show up as a room cleaned unevenly, and that is the sign to change the page, not to add more work to the person who already carries the week.
For the local side of this decision, see Local Help for Hospice Families.