Somewhere in the first week the refrigerator starts to tell the story. Milk turns that nobody remembers buying. Two pans sit on the stove because the one who cooked was called to the bed. Meals were never the hard part on paper. They are hard because they come three times a day, and nobody was assigned them.
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.
Hospice pays for the visits of the nurse, the aide, the social worker and the chaplain. It does not pay for groceries, and a family should not assume a visit includes a hot dinner. The rules behind these statements are listed on our sources page, and they are worth reading before you hire anyone.
Name the three jobs
Meals are three jobs that look like one: planning what to eat, buying it, and cooking and cleaning up after it. Write them on separate lines of the same page. Under planning, write who decides the menu and who knows which foods your parent will still take. Under buying, write who makes the list, who drives to the store or places the order, and who keeps the receipts. Under cooking, write who heats the food, who cuts it, who washes the pots and who wipes the counter.
What a hired caregiver can take on
A non-medical caregiver can usually shop from a list, prepare simple meals, keep the kitchen clean and put away what is left. Ask the agency to put each of these duties in writing, the same way you would ask for any other term. Ask whether the caregiver will use your kitchen, your pots and your food, and whether they will cook for the family as well. Ask who pays for the groceries and how the receipts come back to you.
Medicine stays with the family, the doctor and the pharmacist. A caregiver may remind someone that a dose is due, and may pick up a prescription as an errand. A caregiver does not hand out, sort or manage the pills. That line matters most at mealtime, because the pill and the plate often arrive together. Decide before the first shift who sets out the medicine and who puts it away.
Decide what the family keeps
Most families keep the menu planning, because it depends on what the parent likes and on what the family has been told about the doctor's instructions. Ask the hospice nurse whether the doctor has written any limit on food or fluids, and ask to see it in writing. If there is no written limit, write down the foods that have been refused, so the next person does not offer them again.
Hire out the work that repeats and needs no judgment: the grocery run from a list, the weekly cleaning of the kitchen, the dinner that is cooked when the family cannot get home. Compare the hours a helper will be in the house with the hours the family is there. A dinner cooked at four and reheated at seven needs a plan for reheating and a plan for who serves it.
Check before you sign
Read the list of duties in the agency's paper and find the word kitchen. Ask whether shopping counts as a task or as an errand, because the answer changes what the helper may buy and what they may charge for it. Ask what happens when the list changes in the middle of the week. Ask who stocks the freezer and who throws out food that has spoiled. Write the answers on the same page as the menu.
If you want a place to start with local questions about in-home help and food, the local help page lists resources for West County families.