Outdoor work is the part of home care that the hospice team never sees and the family rarely schedules. The walk is not cleared by the time the aide arrives. The leaves cover the step to the side door. The gutter overflows onto the path the wheelchair uses. None of it is a medical question, and all of it changes how safely people can get in and out. The decision is which of these tasks the household does, which it pays someone to do, and when each one has to be finished.
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.
Sort the tasks by deadline, not by difficulty
Make a list of every outdoor job the house needs in an ordinary season. Mark the ones that must be done before a visit or a delivery, such as the walk, the drive, and the path to the side or back door. Mark the ones that can wait a week, such as mowing, raking, and the back patio. Mark the ones that can wait a season, such as gutters and tree limbs. The list is for planning. The first group is the one that decides whether the house can be reached.
Decide who clears the walk when it snows
Snow is the task that cannot wait, and it tends to start at an inconvenient hour. Name the person who is up and able to clear the walk and the drive before the morning visit, and name a backup for the nights that person cannot. If the walk is not clear and the arriving person cannot use the path with their equipment, tell the hospice office, so the team can plan around it rather than find out at the door.
What to ask a service before you hire it
If you hire a snow or yard company, ask whether they carry liability insurance and workers' compensation. Ask whether they will come on short notice after a storm, and whether they clear the path to the door and to any ramp or lift route before the driveway. Ask how they handle a storm when many customers call at once, and whether you can pay for a priority visit in bad weather. Ask for the quote in writing, with the scope named: which surfaces, how many times per storm, and whether salt or de-icer is included. For the gutter, ask whether the work includes hauling the debris away and whether the crew has a plan for working on a ladder.
What to do yourself, and what to leave alone
Doing the work yourself makes sense for small, scheduled tasks you can finish quickly without a ladder. Hiring makes sense for tasks that need a ladder, a truck, or a fixed hour. Some tasks are not worth doing at all when hours are short, such as the back lawn while the front walk is still not clear. Be honest with yourself about what you can keep up with, and let the rest go on the list for later.
Check the outdoor route each week
Once a week, walk the route from the car to the door you use most, and from that door to the road. Look for the places where leaves or puddles collect, where a board is loose, and where the light fails at dusk. Note what you find and what you did about it. If the route is hard for the aide or the team to use, tell the hospice team. The Local Help for Hospice Families page on this site lists local help for families in the area, which can be useful when the outdoor work is more than the household can manage.