Medicare's hospice coverage does not pay the household bills, so the increase in heat, water and power when someone is home all day lands in the family's budget. The rise is usually spread across a few habits and settings, and you can find them by comparing two sets of bills rather than guessing.
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.
Compare the right two bills
Get the statement from the month before hospice started and the first full month at home. Put the usage figures side by side rather than the dollar amounts, because rates and billing periods change over time. Check whether the two statements cover the same number of days. A short billing period can make a month look lower than it was.
Heat, water and light
The thermostat is usually the largest single setting. A parent who feels cold and an adult who feels warm may both be in the room all day, so agree on one daytime setting and one for nights, rather than moving it each time someone walks past. If a space heater is in use, agree on a plain rule for where it goes and who switches it off. Hot water rises when bathing and laundry happen daily. Lights left on for night checks add up as well, so choose one lamp for the route and leave the rest off.
Equipment and devices
If the home has equipment that runs on electricity, ask the supplier which pieces draw power and whether any of it is billed separately to the household. Charging phones, tablets and a monitor for the night watch also count. Put the power strip at the bedside on a single switch so the whole set can be turned off in one motion.
What to ask the utility
Call the utility and ask about payment arrangements, budget billing and any assistance programs for households where someone is home for long stretches. Ask whether a higher reading can be reviewed against the same months of the prior year, and whether the meter reading dates on the statements are recorded correctly. The Local Help for Hospice Families page lists the St. Louis County resources we have checked.
Do not lower the heat in cold weather to save money until you have talked with the hospice team about the parent's comfort. The house is part of the care, and the bill is only one part of the picture.