At two in the morning the hospice team is often not the first voice you reach for. You want someone who will pick up, hear the whole sentence, and tell you what to do next. The hospice has an on-call line, and you should know that number by heart. But there are other lines and groups around it, and they are not all the same. Before you need one, find out which of them answers, what it can do, and what it sends you back to.

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.

Know the sources you can reach

Most families end up with three kinds of help outside the sickroom. The first is the hospice itself, which owes the family counseling and support as part of the benefit, including bereavement support after a death. The second is a national caregiver organization, several of which run toll-free helplines and online groups for family caregivers. The third is local: your area agency on aging, a senior center, a parish or congregation, or a support group that meets in person or by video. The federal Eldercare Locator can point you to the agency for your own address. If the patient served in the military, the VA runs a caregiver support program worth asking about, even when the care is at home. The sources page on this site lists the federal and state places these guides rely on.

Ask the same five questions of each one

Call each source on a weekday afternoon, and again after ten at night if it takes calls then. Write down the answers. Ask these five things.

Who picks up after hours: a person, a recording, or a callback the next business day? Ask for the exact answer, not the general hours printed on the website.

What can the person do on the call? Some will listen, give information, and make a referral. Some will schedule a respite visit or check an eligibility question. Ask what they cannot do, so you know where the call ends.

Does it cost anything, and does the intake ask for income or insurance details? Ask what those details are used for before you give them.

Which area does it serve, and does it cover your address in west St. Louis County? A program that serves the county in general may still send you to a different office for in-person help.

Does it know the hospice, and what does it send you back to? Ask the person to tell you, in their own words, what they would say to a family member who called at night because something had changed with the patient. The right answer sends you to the hospice's 24-hour number. If the answer tries to settle the medical question for you, stop relying on that line for that kind of call.

Test the callback

Leave a message on the line you least expect to be answered, and time how long a person takes to call back. Ask for the name of the person you spoke with and a direct number. At two in the morning, a line that gives you a name and a direct number is worth more than one with a long menu.

Check the groups and the respite

A support group only helps if it meets at a time you can attend. Check whether it meets in the evening, whether you can join by phone or video, and whether a sibling who lives far away can take part. Ask whether the group is for caregivers of people on hospice or for caregivers in general. That fit matters more than the group's name.

Respite is a separate question. Under the hospice benefit, respite is a short covered stay with a set limit, and the rules are laid out on the sources page. When a locator or a community program offers respite, ask what it covers, what it does not cover, and how the hours outside that coverage would be paid for. Do not accept a yes until you have the answer in writing.

Put the answers side by side

Make one sheet with a column for each source. Write the phone number, the hours, who answers, what they can do, what they cost, the area they serve, and where they send you for medical questions. Keep the sheet with the hospice binder, and tape the best number near the phone. When the hour comes, you will not be searching. You will be dialing a line you already tested.

The local help page on this site explains how to find these sources by county and zip code.