At two in the morning the question is rarely about money. It is whether someone will be in the room when your parent wakes and calls out. But when you start looking for overnight help, the first quote you get will be a number with a word attached to it, and that word decides what you are actually buying. Before you compare one agency to another, find out how the night is being counted.
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.
Three ways a night gets priced
Overnight help usually arrives in one of three shapes. Some agencies bill an hourly rate for every hour of the overnight. Some bill a flat rate for the whole shift, often described as a night rate. Some offer a live-in arrangement, where a caregiver sleeps in the home on terms set by the contract. Each shape can be fair, but they are not interchangeable, and a low hourly figure can produce a larger monthly total than a higher-looking nightly figure once you multiply it out.
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).
Write down the length of the shift you need, from the time the caregiver arrives to the time they leave, and the number of nights per week. Then multiply it out under each pricing shape before you read any other line of the quote. You are doing the arithmetic on your own week, not on the agency's example.
Awake, asleep, or on call
The most important word in an overnight quote is often not the rate. It is whether the caregiver is awake for the whole shift, or whether they are permitted to sleep and be woken. Some agencies bill an awake overnight at the full hourly rate and a sleep period at a lower one. Others treat the whole night as one block. Ask which one applies, and ask what counts as being woken. If your parent calls out twice, is the second call a separate charge, or does it fall inside the shift you already paid for?
Ask the agency to write down what the caregiver is expected to do during each part of the night. Reminders about the schedule, help with getting to the bathroom, and staying in the room are very different jobs. Medicine stays with the family, the doctor and the pharmacist, so the caregiver's part is reminders and any errand the family asks for, and the quote should say exactly that. A quote that promises more than that is one to ask about in writing before you go further.
Live-in is a different contract
A live-in caregiver is not simply an overnight shift that runs longer. Ask how many hours are worked and how many are free, whether the caregiver has a private room and regular days off, and who covers when they are sick. If the arrangement is described as live-in, ask what happens on a night when your parent needs more than one person can give, and what the agency will do then. The answer tells you whether the price includes a backup or a single person with no relief.
What the hospice benefit does and does not carry
Hospice coverage at home is built around the visits a hospice team makes, and it generally does not pay for round-the-clock companion help at night. Some hospice agencies offer short inpatient respite stays, and some have aides who visit for limited periods. Ask the hospice agency directly which parts of the night, if any, its own staff will cover, and ask for that answer in writing. Do not assume that because the agency is working with you, the nights are included. Check the election paper and the admission packet for the line, and the Sources page on this site lists the public rules we cite.
Count the interruptions before you count the cost
Before you sign, estimate how often a night will be broken in a normal week. Keep a plain tally for three or four nights if you can, noting the times your parent wakes and what they need. Then ask each agency how its quote changes if the interruptions run higher than your tally. A quote that stays flat no matter how often the night is broken is either very clear or very incomplete, and you should be able to tell which.
When you have numbers from two or three agencies, put them on one page with the same shift length, the same number of nights and the same interruption count. Then look for the lines that are not on the page: minimums, cancellation terms, a charge for changing the start time, and whether the rate rises on certain nights. The point is not to find the lowest figure. It is to find out which figure will still hold in the third week of a hard month.
What to bring back to the table
Ask for the overnight rate in writing, with the shift structure spelled out, and ask how a night is counted when your parent is awake for part of it. Ask whether the caregiver can pick up a prescription as an errand, and whether that is included or billed separately. Ask who covers when the caregiver cannot come. If you cannot get a straight answer on any of these, that is information too.
For the local options for overnight and daytime companion work in west St. Louis County, the Local Help for Hospice Families page is the place to start. For how this site decides what it will say and how it cites its sources, see How We Write.