There is a point in the week when the person in the bed can no longer help you move them. Nobody announces it. You are pulling the sheet toward yourself and realizing the weight is no longer shared. This piece is about deciding, before the next transfer, which moves in the house belong to you, which belong to a hired caregiver, and which belong to neither of you until someone else has been called.

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.

Name the moves

Most families argue about lifting as if it were one thing. Split it into the actual moves: turning in bed, sitting up at the edge, moving from bed to chair or commode, getting in and out of a car, and getting up from the floor after a fall. Each one has a different load, a different number of people, and a different answer. Write the list on paper before you decide anything. A plan that says we will help with lifting fails the first time a sheet is pulled.

Check your own back first

Be honest about what you can do alone on a bad day, not a good one. Can you hold a lift for the length of the move without stopping? Is there a second adult in the house who could take the other side? Is the bed at a height you can work from without bending? If the answer to any of these is no, that move is not yours alone, and planning around your own strength is not a failure. A strained back can end a home plan in a single night, so plan around it.

Ask the agency what they will lift

When you talk to a hired caregiver or an agency, ask specific questions and write down the answers:

  • Do they move a person alone, or do they bring a second person or equipment for certain transfers?
  • Who supplies the transfer belt and the slide sheet, the agency or your house?
  • Who trained them, and does that training cover the transfers your parent actually needs?
  • What is their rule for a fall? Do they call emergency services, the hospice after-hours line, or you first?
  • Which tasks will they refuse to do alone, and will they tell you that on the first call or on the first bad night?
  • Will they stay through the transfer, or leave once the task is done?

Ask the hospice team what the visit covers

The scheduled hospice visits are not a lifting service. At the next visit, ask the hospice nurse and aide which transfers they would teach you and whether they recommend any equipment for your house. Ask who orders that equipment and whether it needs a written order. Ask them to show the move once with the person in the bed, then have you do it while they stand beside you. Write down what they tell you rather than trusting what you remember in the middle of the night. For how the hospice benefit is set up, see Sources.

Compare the two sources by the hard day

Do not compare a hired caregiver and the hospice visit by price or by how pleasant they seem. Compare them by the hard day: the morning the person cannot help at all, the night a fall happens, the afternoon the second person you were counting on is at work. For each source, ask what happens on that day, who arrives, how long it takes, and whether anyone will be in the house to help with the next move. The answers will tell you more than any rate sheet.

Write the lift card

Once you have answers, make a single card and post it near the bed. Use three columns: moves you do alone, moves that need two people or equipment, and moves you do not attempt until a called person arrives. Put the after-hours number on the card. Show every adult who will be in the house the card, and have each of them read it aloud once. The card is not a schedule. It is the rule that keeps the next person from lifting alone when they are tired and sure they can manage it.

The rule for the night

At night the rule is simple, and it should be agreed on in daylight: nobody lifts alone a move the card places in the second column. If someone has fallen, the person who finds them does not try to lift them alone. They make the space safe, keep the person comfortable, and call for the help the card names. Agreeing to that ahead of time is the difference between a family that calls for help and a family that tries it alone and gets hurt.

Where to look for the help

If the card has more lines in the second and third columns than the people in the house can cover, you have found the real decision. Hired hours, equipment, and training are worth comparing on your own schedule, not in the middle of a crisis. The listings on Local Help for Hospice Families are a starting point for that comparison, not a recommendation.