You may be asking for a simple number: What does help at home cost?
The answer can change before the first shift begins. A company may quote one caregiver for a block of time, then learn that one of the expected jobs requires two workers under its policy. The second worker may be billed for the full shift, for a shorter visit, or under a separate minimum. Some companies may not offer the job at all.
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.
You do not have to decide whether a job is safe for one person. Ask the hospice and the private care company to state, in writing, how many people their plan requires. Then compare prices for that actual plan.
Start with the jobs, not the hourly rate
Write down what you expect the paid caregiver to do. Use plain descriptions: help with turning, provide personal care in bed, help with toileting, change clothing, prepare food, remain in the room while you sleep, or assist with equipment already in the house.
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).
Do not write only “hospice care” or “help with Dad.” Those phrases are too broad for a dependable quote.
Beside each job, ask the hospice nurse to identify what the hospice care plan and teaching say about the number of helpers, equipment, and family participation. The federal hospice rule requires the plan of care to identify the services needed for the patient and family. Medicare describes routine home hospice as care delivered through planned services and visits, not continuous bedside staffing whenever the family wants it. That distinction is why a private caregiver quote must be built separately from the hospice visit plan. (Medicare hospice guidance and the federal hospice conditions of participation are collected on the Sources page.)
Ask what makes the second worker appear on the bill
Give each company the same written job list. Ask these questions before discussing a weekly total:
Does your policy allow one worker to perform every listed job? Which jobs would require a second worker? Is that decision based on your written policy, the hospice care plan, an assessment by your company, or all three? Must the second worker remain for the whole shift? Can the second worker come only for a scheduled task? Does each worker have a separate minimum? What happens to the charge if the second worker is unavailable?
Ask the company to show both possible totals in writing. One should cover a shift with one worker. The other should cover the arrangement the company would use when two workers are required. Include every minimum, scheduling fee, weekend difference, and charge for a shortened or cancelled shift.
A lower hourly rate may produce the higher bill if it carries a long minimum for each worker. A higher hourly rate may cost less if a second worker can be scheduled for a shorter, defined period. You cannot compare the offers until each company prices the same jobs and the same hours.
Keep hospice work and private work in separate columns
Hospice may provide nursing, hospice aide services, social work, spiritual care, equipment, supplies, and other services connected to the hospice plan. The frequency and scope belong in that plan. Private duty help is a different arrangement, even when a private worker is present during a hospice visit.
Ask the hospice which listed jobs it plans to provide, how often it plans to provide them, and what teaching or assistance it expects the household to supply between visits. Ask the private company which remaining jobs it will accept. Do not let either column say only “as needed.” Put a person, task, and expected time beside each item.
Missouri DHSS distinguishes hospice and other regulated home care from some private duty or private pay arrangements. Its consumer materials explain that private duty care may be sold in shifts and that some such companies do not receive a Missouri home care license. Ask the company what kind of provider it is, what oversight applies, and who supervises the worker. Do not assume that two companies using the word “caregiver” operate under the same rules. (Missouri DHSS materials are listed on the Sources page.)
Do not fill a second-worker gap with an unnamed relative
A quote may quietly assume that you will be the second person. Ask directly: “Does this price depend on a family member being awake, present, and able to help?”
If the answer is yes, put your name and the exact hours into the plan. If you cannot promise those hours, ask for a price that does not depend on you. The purpose is not to prove that you can do more. It is to keep an unpaid assumption from becoming the only way a paid shift works.
The National Institute on Aging advises families comparing care providers to ask for written fees, included and excluded services, hours, and minimums. National caregiver organizations also encourage families to define the work and backup arrangements before hiring. Those questions matter here because a second-person requirement can change all four at once. (The NIA worksheet and caregiver nonprofit resources are collected on the Sources page.)
Check whether another benefit changes what you must buy
If the person receiving hospice is a veteran, ask the VA or an accredited veterans service representative whether any authorized home support or respite benefit applies. Do not subtract expected VA help from your private schedule until the service is approved, a provider is assigned, and the actual hours are known. VA eligibility and authorization are separate from the Medicare hospice benefit. (VA caregiver and respite resources are listed on the Sources page.)
If you are exploring Missouri home and community based services, ask DHSS what assessment, eligibility, authorization, and provider rules apply. Treat a referral or application as pending help, not staffed hours, until you know who will come and when.
Ask for one page you can compare
For each company, request a written page showing the jobs accepted, number of workers, shift length, minimum billed time, rate for each worker, schedule differences, cancellation terms, backup plan, and the family help assumed.
Then test one ordinary night on paper. Mark when each job is expected, who is present, and whether the quoted staffing covers it. If the plan requires two people at a particular time, make sure both people are named. If one is you, make sure that is a choice you can keep making.
The useful price is not the smallest hourly number. It is the total for a staffing plan that can perform the named jobs without borrowing an unnamed second person from the family.