Most of the attention in a home hospice goes to the bed, and it should. But the house your parent lives in keeps making its own demands. The dog needs to go out in the morning. The mail fills the box on the days it is delivered. A bill comes due every month whether anyone is sleeping or not. The gutter lets go in the first hard rain. None of these is a medical problem, and none of them will wait for a free afternoon that is not coming.
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.
This article is for the person deciding which of those jobs stay in the family's hands and which can go to someone else. It does not tell you what to spend. It asks you to sort the work first, because a hired person can only take on the jobs you have named clearly.
Write down every recurring job in the house
Before you call anyone, take one sheet of paper and walk through the house the way your parent would on an ordinary Tuesday. Include the things that run on their own schedule: trash and recycling pickup, the thermostat, the porch light, the pet's food and walks, the mail, the bills that arrive on paper and the ones that come by email, the yard in summer, the snow in winter, the furnace filter, the smoke alarm batteries, and the water heater.
Be honest about the list. Many families find it is twice as long as they expected, because the parent did all of it without anyone noticing. Next to each item, write who did it before the illness, and whether that person is now at the bedside.
Sort each job by where you have to stand
For each item, ask one question: does this job need someone physically in the house, or can it be done from a phone or a computer? Mail, most bills, and many subscriptions can be handled from anywhere. The Postal Service will hold mail for a set period, and most utilities and banks let you change how bills arrive or how they are paid. Check the rules for your parent's bank and utilities, because some changes must be made by the account holder in person or on a call the account holder has to take.
Jobs that need a body at the house are the ones that usually cost money to hire out and need the most careful checking. Dog walking, a neighbor watching the furnace, someone to let in a repair person, and the snow all belong here. Put them in their own column.
What hiring out changes
A person who walks a dog or shovels a walk works on the house, not on the person in it, and that difference should shape your questions. Ask whether the person is insured for the work they will do, and whether they will be on the property alone. Ask who they call if something goes wrong. Ask how they will get in and who keeps the key. Write the key rule in one sentence and give it to everyone who has a key.
Tell any hired person what they need to know to do the job safely: which door the family uses, that a hospice team may arrive at unexpected hours, and that the parent may be resting and should not be disturbed by someone who does not belong in the room. Do not ask a hired worker to take on anything involving your parent's personal care or medicines. Those stay with the family, the doctor, and the pharmacist. A hired person can help with the house, and that is all this list is for.
Keep one owner for the list
Once you have decided what to keep and what to hire out, put one name next to each job. The job with no name is the one that gets missed. Choose one person to hold the list and review it once a week. If more than one family member shares the work, the list is what keeps two people from both calling the same plumber or both paying the same bill.
For the wider picture of what the hospice visits cover and what the family covers between them, the main page of this site lays out the hours. If you want to know where the references behind these points come from, the sources page lists them, and local help lists groups in west St. Louis County that can talk through the practical side with you.