If you are looking for overnight help for a parent on hospice at home in St. Louis, here is the honest answer. Routine hospice care is a schedule of visits from the nurse, the aide, the social worker and others, plus a phone line you can call at any hour. It does not usually put someone in your house through the night. For most families, overnight help means hiring a non-medical caregiver from a home care agency or hiring a person directly, and paying for it privately or through another source you have checked, such as a long-term care policy.
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.
There is one exception worth asking about. Hospice has a level of care for short periods of crisis, when more hands are needed in the home, and a hospice may also offer a short inpatient respite stay so the family can rest. Ask your hospice team whether either fits your nights. If they do not, the hours are yours to fill, and the rest of this page is about choosing who fills them.
What an overnight caregiver does beside hospice
A non-medical overnight caregiver sits with your parent so you can sleep. They can help with turning and changing in the way the hospice team has shown the family, keep the room quiet, offer sips of water if that is part of the plan, change linens, give a medication reminder the family has written down, and wake you or call the hospice line when something changes. They can pick up a prescription as an errand.
What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).
They do not give or manage medicine, including comfort medicines. That stays with you, the hospice nurse and the pharmacist. They do not decide what a change in breathing or color means. Their job is to notice, write it down, and call.
How to compare providers for the nights
Call at least two providers, and ask each one the same questions in the same order. Write the answers in the same notebook so you can lay them side by side. The provider that answers these clearly is usually the one that has done this before.
1. Have your caregivers worked nights beside a hospice team? Listen for a plain yes and an example of how they handled it: who they called, what they wrote down. A caregiver who has never sat with someone near the end of life may be kind and still be unready for the hours.
2. Will the caregiver stay awake the whole night? Some overnight shifts assume the caregiver can sleep. Beside hospice, nights are rarely quiet. Ask whether the shift is awake, and get it in writing.
3. Who does the caregiver call first? The right answer is the hospice line for anything about your parent's comfort or condition, and you, in the order you choose. Ask the provider to put the hospice number and your instructions in the caregiver's notes before the first shift.
4. How will the caregiver learn what the hospice team has taught you? Ask whether the caregiver can be present for a hospice visit, or whether you will walk them through the care plan yourself. Either can work. Not knowing is the problem.
5. What happens if the caregiver cannot come? Ask how much notice you will get and whether a replacement will be someone who has been told about your parent. A night with no one is the night you were trying to avoid.
6. How fast can you start, and can the schedule change quickly? Needs at the end of life can shift from one night to every night. Ask how quickly they can add nights and whether there is a minimum.
7. What will you write down for us each morning? A short note covering times your parent woke, what helped, and anything that seemed different gives you and the hospice nurse a picture of the night without anyone guessing.
What to listen for
A provider worth trusting will ask you questions back: what the hospice team has said, what the nights are like now, who in the family should be woken. A provider that quotes a time and a rate before asking anything about your parent has not thought about the night yet.
Be careful with any provider that tells you its caregiver can give medicine, or that suggests calling them instead of the hospice line. That is not their role, and it can get in the way of the care your parent is already receiving.
A direct hire, if you go that way
If a neighbor, a church member or a former aide offers to sit nights, the same questions apply. Write the answers down together. You will also become the person who arranges backup and pays them, so think through what happens on the night they are sick.
Getting the first night in place
Tell your hospice team you are bringing in night help, and ask the social worker whether they know of options in west county. Pick the provider whose answers were clearest. Before the first shift, leave a single page on the kitchen counter: the hospice number, your number, the order to call, the comfort routine the nurse has shown you, and where the linens are. Then go to bed. The first morning, read the note and tell the nurse what it says.
For the steps in order, start with Start Here. For public offices and organizations that help hospice families find help in the area, see Local Help for Hospice Families.