Frequently Asked Questions About Home Care

Since 2011, more than 6,000 families in St. Louis, St. Charles and Chicago’s western suburbs have trusted Assistance Home Care with a parent or spouse. These are the questions they asked first, answered the way we answer them on the phone: plainly, with the numbers, and with nothing held back for a sales visit. If your question isn’t here, call any hour. A person answers.

Getting started

What’s the difference between home care and home health?

Home health is medical and short-term. Home care is everyday help, for as long as you need it. Home health means a nurse, a physical therapist, or an aide visiting a few times a week under a doctor’s orders, usually after a hospital stay, usually for a few weeks. Medicare pays for it. Home care, which is what Assistance Home Care provides, is a Care Professional in the home for hours at a time: bathing, dressing, meals, medication reminders, rides, companionship, someone there overnight. Families pay for it privately, through long-term care insurance, or through the VA.

The confusion costs families. Many assume that because Medicare sent a nurse, “care” is covered, and then discover the nurse comes for 45 minutes on Tuesday and Thursday and nobody is there the other 166 hours of the week. The two work best together, often at the same time: home health handles the wound, the therapy, and the vitals; we handle the day. We work alongside home health teams all the time, and we’re glad to be on the phone with the discharge planner or the agency nurse.

A simple test: if the question is “who will change the dressing,” that’s home health. If the question is “who will be with Mom,” that’s us.

How quickly can home care start?

Often the same day, when the situation calls for it. We offer same-day assessments: call any hour, and a member of our Care Team can usually sit down with you at the kitchen table that day. Most families begin care within a day or two of that visit. When a parent is coming home from the hospital tomorrow, or a family caregiver has hit the wall tonight, we have started care the same day.

Responding on short notice is something we built the company around: hundreds of Care Professionals across St. Louis, St. Charles, West County and DuPage County, a Care Team on call around the clock, and no contracts or deposits to slow anything down. Tell us what’s happening, and we’ll tell you plainly what we can do and when.

Do you have minimum hours?

Almost none. We ask for one visit a week of at least four hours. That’s the whole requirement: no minimum number of days, no weekly hour total, no contract. Most agencies in St. Louis won’t send a caregiver for fewer than 15 to 20 hours a week, and many want more, which is why so many families wait for a crisis before they get help.

We built our CarePlus program around a truth every family knows: the hardest part isn’t finding help, it’s getting Mom or Dad comfortable with someone new in their home. CarePlus lets you start small, two or three visits a week with the same Care Professional, so trust has time to grow. There’s no contract and no commitment. But we do ask families considering CarePlus to plan on 90 days or longer, because that’s how long it usually takes to see the real difference, in your parent and in you.

One honest note: CarePlus isn’t built for a week or two of temporary help. If you need heavier coverage for a short stretch, after a surgery, say, or while the family caregiver travels, that’s our standard hourly care, and the rate is lower once care passes 20 hours a week (the numbers are under “How much does home care cost?”). Tell us what’s happening and we’ll match the program to the need.

Do I have to sign a contract?

No. There’s no contract, no deposit, and no long-term agreement. You can change the schedule, add hours, pause, or stop with a phone call. We’ve worked this way since 2011 because the opposite, locking a family in during the most uncertain stretch of their lives, never sat right with us.

If the day comes to end care, we’d love a little notice so the transition is smooth for everyone, your parent and the Care Professional who has come to know them included. But nothing is required.

What you will see from us is a care plan, written after the Discovery Visit and updated by your Care Team as your parent’s needs change, and two promises in writing. Our Professionalism Pledge tells you exactly what to expect from every Care Professional while they’re in your home. Our Customer Service Pledge backs it up: if a day ever falls short, call us within 24 hours and we’ll make it right, waiving up to 100% of that visit.

What happens at a Discovery Visit?

A member of our Care Team comes to the home, usually within a day of your call, and sits down with you and your parent for 60 to 90 minutes. There’s nothing to sign and nothing to buy. We’re there to listen: what a normal day looks like, what’s gotten harder, what worries you most at night, and what your parent wants to keep doing on their own.

By the end, you’ll know what we’d suggest, what it would cost, and when it could start. We leave you a written care plan built around the two or three things that matter most to your family, and we explain how matching works, so the Care Professional who walks in on day one already knows your parent’s name, their coffee order, and the things they’d rather do themselves.

Many families tell us the visit was the first time anyone asked how they were doing. That’s on purpose.

What areas do you serve?

Greater St. Louis and Chicago’s western suburbs.

In Missouri: St. Louis City; St. Louis County, including Webster Groves, Kirkwood, Clayton, Ladue, Creve Coeur, Chesterfield, Ballwin, Manchester, Wildwood, Eureka, Sunset Hills, Florissant and Oakville; St. Charles County, including St. Charles, St. Peters, O’Fallon, Cottleville, Lake St. Louis and Wentzville; and the northern parts of Jefferson and Franklin Counties, including Arnold, Imperial, Fenton, High Ridge, Pacific and Washington.

In Illinois: DuPage County, including Downers Grove, Naperville, Wheaton, Glen Ellyn, Elmhurst, Lombard, Hinsdale, Oak Brook, Lisle, Westmont, Woodridge and Darien; and the nearby parts of Will, Cook and Kane Counties, including Bolingbrook, Plainfield, La Grange, Western Springs, Burr Ridge, Geneva, Batavia and St. Charles, Illinois.

We have offices in Rock Hill, St. Charles, Ellisville and Downers Grove, and one Care Team answers the phone for all of them, any hour. There’s no distance fee anywhere we serve. The rate in Wentzville is the rate in Webster Groves. If you’re near the edge of our map, call anyway; the answer is usually yes, and if it isn’t, we’ll tell you who to call instead.

Cost and paying for home care

How much does home care cost in St. Louis?

With Assistance Home Care, $43 an hour for families who need 20 or more hours a week, or $48 an hour on our CarePlus program for families starting smaller. Both rates are flat: the same price days, nights and weekends, with no “level of care” surcharge, no distance fee, no deposit and no contract. Care can start with as little as one four-hour visit a week, which comes to $192. Holidays are billed at 1.5 times the rate, as they are across home care, and we’ll tell you which days before they arrive.

Most agencies quote a rate that “starts at” a lower number. Then come the add-ons: a distance fee based on how far the caregiver drives, and a higher rate based on how difficult they judge your parent’s care to be. Both vary widely from one agency to the next, and together they let a company arrive at almost any number it wants, after you’ve already said yes. Our clients don’t like surprises, and they don’t like being nickel-and-dimed. Neither do we. The full picture, including how the industry prices care and the ways families pay for it, is on our pricing page.

Couples who both need care are one Care Professional at 1.25 times the rate, not two caregivers at two rates. Veterans may qualify for our Veterans Program at no cost to them, through the VA.

Does Medicare pay for home care?

No, and that’s true of every non-medical home care agency, not just ours. Medicare covers short-term, doctor-ordered home health: a nurse or therapist visiting after a hospital stay. It does not pay for the help most families actually need day to day: bathing, meals, companionship, someone there overnight. Assistance Home Care is private pay, and we don’t accept Medicaid or Consumer Directed Services either.

What families do use: long-term care insurance (we handle the claims paperwork), the VA (through our Veterans Program), and personal funds. The next two questions cover insurance and the VA.

Does long-term care insurance pay for home care?

In almost all cases, yes. Most long-term care policies cover non-medical care at home once the policyholder needs help with two of six daily activities (bathing, dressing, eating, toileting, moving from bed to chair, continence) or has a cognitive impairment such as dementia. Nearly all have an elimination period, a set number of days you pay for before benefits begin, and a daily or monthly maximum.

We’ve helped hundreds of families use these benefits, and the paperwork is where most policies go unused. Our team reviews the policy with you, helps file the claim, and sends the insurer the care logs it needs each month so benefits start and keep coming. We can also schedule a joint call with your long-term care insurance provider, so the right questions get asked, you understand exactly what the policy covers, and you leave with your questions answered and your benefits put to full use.

Does the VA help pay for home care?

For many veterans, yes. Veterans enrolled in VA health care can be referred by their VA care team for home care, and the VA pays the agency directly. Assistance Home Care is an accredited VA provider, and our Veterans Program works exactly this way: the same Care Professionals, the same standards, at no cost to the veteran.

The hard part is usually knowing which door to knock on first. You’re welcome to call us before you call the VA, with no obligation, just to better understand the landscape: how the referral works, who to contact, and what to have in hand. And if you’d rather start with the VA and come to us after, that works just as well.

Our Home Care Professionals

How do you choose and train your Care Professionals?

Slowly, and with purpose. We hire about 2 to 3% of the people who apply. Every applicant goes through a 16-step process: experience checks (most of our Care Professionals bring three to five years or more of professional caregiving), background and reference checks, a formal pre-employment assessment of aptitude and temperament, interviews that test for patience as much as ability, and a hard look at whether they live our core values. The people who make it through are the ones you’d want in your own mother’s kitchen.

There’s a reason the bar sits that high: we put two promises in writing. Our Professionalism Pledge spells out what we ask of every Care Professional, and it tells you exactly what to expect while our team is in your home. Our Customer Service Pledge backs it up. If you ever feel we didn’t do a wonderful job on a given day, call us within 24 hours and we’ll make it right, waiving up to 100% of that visit. All we ask is that you tell us what happened and how we can do better tomorrow. No other home care company we know of makes that promise, and you can only make it if you hire people you’re willing to stand behind.

So we hire the best of the best, and then we keep investing in them. Every Care Professional completes 12 hours of continuing education a year, including dementia-specific training. We pay among the highest wages in the field and offer benefits that are rare in home care, which is why our people stay. A caregiver who stays is the one who notices when something’s off with your dad before you do. That’s what we mean when we say we’re committed to making home care work: for your parent, for you, and for the people who do this work.

What if we’re not happy with a visit?

Call us within 24 hours and we’ll make it right. That’s our Customer Service Pledge, and it’s in writing: if you ever feel we didn’t do a wonderful job on a given day, we’ll waive up to 100% of that visit. There’s no form to fill out and no case to argue. We ask two things: what happened, and how can we make tomorrow better.

Why 24 hours? Because a problem we hear about on Tuesday is one we can fix by Wednesday. The Care Professional can be coached, the care plan adjusted, or a different person in the home, before a small thing becomes the reason your mother stops wanting help at all. Families who wait a few weeks to mention something usually waited because they didn’t want to be a bother. You’re never a bother. Hearing about it fast is what lets us keep the promise.

After 6,000 families, we know most days go well. The pledge is for the days that don’t, and it’s how we get better. We’re not aware of another home care company that makes this promise, and we make it because we hire people we’re willing to stand behind.

How do you match a Care Professional to my parent, and what if it isn’t a fit?

On more than skills and schedule. By the end of the Discovery Visit, your Care Team knows what your parent needs help with, and also how they like their mornings to go, what they like to talk about, and the things they’d rather keep doing themselves. We use all of it to choose a Care Professional whose experience and temperament fit, and we brief them before day one so they arrive already knowing your parent, not just the task list.

Continuity matters, and we treat it that way. Families starting small are cared for by our CarePlus team, whose job is to keep the same Care Professional walking through the door each visit so trust has room to grow. Life happens, and no agency can promise one person forever, but that’s the goal, and we work hard at it. On heavier schedules, we keep the circle of people in your home as small and as steady as we can, so there’s always a familiar face.

Sometimes, even with care, it isn’t a fit. Maybe the personalities don’t click, or Dad would just rather have someone who talks baseball. Tell your Care Team. Often the first step is a conversation with the Care Professional, because our people are committed to their clients and most want the chance to get it right. If it still isn’t working, we’ll make a change, usually within a day or two. Either way, there’s no awkward conversation for you to have and no hard feelings on our end. Getting the match right is our job, not yours. It’s also why we’d rather hear about a small concern on day two than a big one on day thirty.

What happens if my caregiver calls off?

We fill the shift. Our Care Team is on call around the clock, including for the 5 a.m. phone call. When a Care Professional calls in sick, we start on a replacement right away, pull from the people who already know your parent whenever we can, and call you to tell you who’s coming and when. You don’t make the calls, and you don’t have to miss work.

Call-offs are a fact of life in home care. The question to ask any agency isn’t whether they happen, but what happens next. With hundreds of Care Professionals across St. Louis, St. Charles, West County and DuPage County, we have backups for our backups, which is depth a small agency or an independent caregiver can’t match. In practice, when a shift goes uncovered it’s almost always because the family chose it: they’d rather wait for their regular Care Professional, or move the visit to another day, than have someone new. That’s their call, and we respect it.

One exception, and we say it up front: our CarePlus clients don’t get a substitute when their Care Professional is out. Fifteen years have taught us that a parent who is just getting used to one trusted person would far rather skip a visit than open the door to a stranger. So we reschedule instead. If your situation needs coverage no matter what, that’s a sign you need our standard hourly care rather than CarePlus, and we’ll tell you so at the Discovery Visit.

When things change at home

What if Mom refuses help?

She probably will, at first. Almost every family we’ve worked with heard some version of “I’m fine” or “I don’t want a stranger in my house” before care began. It isn’t stubbornness. It’s a person who has run her own home for sixty years feeling that slip, and holding on. We’ve learned not to argue with it. We’ve learned to make the first step small enough that it doesn’t feel like giving anything up.

That’s what CarePlus is for: starting small. Two or three four-hour visits a week, with the same Care Professional every time. Help with the heavy things, a ride to the hairdresser, someone to make lunch and stay to eat it. We build the care plan around what your mother wants to keep doing herself, not around what she can’t do, and we don’t walk in with a clipboard asking about the bathroom. We ask what a good day looks like. Then we give it time. In our experience, the parent who said no on the phone is usually asking when “her” person is coming by the second or third month.

Two things families tell us helped. First, make it about you: “Mom, I need this. I can’t keep doing everything and work and sleep.” Parents who won’t accept help for themselves will often accept it for their daughter. Second, call it a trial. There’s no contract and no commitment, so “let’s try it for a month, and if you hate it, we stop” is a promise you can keep. And the Discovery Visit is with her, not about her. She’s in the room, she’s asked what she wants, and she has a say in every step.

When does someone with dementia need home care?

Earlier than most families think. The diagnosis isn’t the trigger. The trigger is the first time you catch yourself saying “I can’t leave him alone,” and by then the help is overdue, not early. Families who wait for a crisis usually tell us afterward that they wish they’d started a year sooner.

The signs we hear most often from the families who call us:

• The stove left on, or a pot burned dry
• A fall, or bruises nobody can explain
• Getting lost on a route driven for thirty years
• Pills missed, doubled, or found in the couch cushions
• Spoiled food in the refrigerator, or the same meal every day
• The same clothes for several days, or a reluctance to bathe
• Unpaid bills, or a stranger on the phone asking for gift cards
• Sleeping all day and up all night
• A spouse who is exhausted, snapping, or getting sick themselves

Any one of these is a reason to call. Two or three mean it’s time.

Dementia is the strongest case we know for starting small and starting early. A Care Professional who comes two or three times a week while your mother can still learn a new face becomes “my friend Denise” by the time she can’t. Try to introduce that same person a year later and she’s a stranger in the house, every single visit. Routine is medicine with this disease, and routine takes time to build. That’s why we built CarePlus the way we did.

Every Care Professional on our team completes dementia-specific training every year, and your Care Team adjusts the care plan as the disease moves, so you aren’t renegotiating care at every stage. When nights become the hard part, our overnight Care Professionals stay awake and on duty all night, every night.

We understand this one from the inside. Assistance Home Care was started in honor of our founder’s mother-in-law, whom the family lost to Alzheimer’s disease, and for his wife, who was her family caregiver for more than five years while raising three small children. Our founder serves on the board of the Alzheimer’s Association Greater Missouri Chapter today. When you call, you’re talking to people who have sat where you’re sitting.

Do you care for people with Parkinson’s, stroke recovery, or other conditions?

Yes. Alongside Alzheimer’s and other dementias, our Care Professionals regularly care for people living with Parkinson’s and other movement disorders, recovering from a stroke or surgery, managing heart failure, COPD or diabetes, going through cancer treatment, or receiving hospice care at home. We’re non-medical, so we don’t replace the nurse or the therapist. We work alongside them: following the care plan, encouraging the exercises, keeping medications on schedule, and being the steady presence in the house between their visits. Tell us the diagnosis and we’ll tell you plainly what we can and can’t do.

What happens when Dad comes home from the hospital tomorrow?

Call us right away. Hospital discharges come fast, often with a day’s notice or less, and this is exactly the situation we built our same-day response around. A member of our Care Team can meet you at the hospital or the rehab center before discharge and get everything in place, so that in most cases a Care Professional is there when Dad walks in the door.

The first few days home are when things go wrong: the trip to the bathroom at 2 a.m., the new prescriptions that don’t match the old ones, the “I’m fine” that turns into a fall and a second ambulance ride. That’s what we’re there to prevent. A Care Professional helps with the walk from the car to the bed, meals, the bathroom, and getting up safely. They keep the new medication schedule on track. They stay awake overnight so nobody lies on the floor until morning. They watch for the signs that mean a call to the doctor rather than a wait, and they drive to the follow-up appointments that are the whole reason he was sent home. If Medicare home health is ordered, a nurse or therapist a few times a week, we work alongside their plan: encouraging the exercises, keeping to the instructions, and covering the hours between visits, which is most of them.

Most families need heavier coverage for the first few weeks, then taper. That’s our standard hourly care: no contract, change the schedule with a phone call, and the rate is $43 an hour once care passes 20 hours a week. When Dad is steady, you scale down or stop. Many families keep a few visits a week afterward, because the hospital stay turned out to be the wake-up call.

For the family caregiver

Does needing help mean I’m letting my mother down?

No. It usually means the opposite. The daughter who calls us has typically been doing the work of three people for a year or more: the errands, the medications, the 2 a.m. phone calls, the worry that never switches off. Asking for help isn’t giving up on her. It’s making sure the person who loves her most doesn’t burn out before the job is done.

Here’s what we see happen after care starts. The arguments about pills and showers stop, because that’s someone else’s job now. Visits become visits again: a cup of coffee, an old photo album, a drive. Most families tell us they got their mother back, and she got her daughter back. That’s the whole point. Let us be the caregiver, so you can be the family.

I’m exhausted. Can you give me a break?

Yes, and you should take one. Family caregivers tend to put off their own doctor’s appointments, their own sleep, and their own lives, and the people who care for someone full-time get sick at higher rates than the people they care for. A break isn’t a luxury. It’s how you keep going.

We call it respite care, and it can be any size: a Care Professional for one afternoon a week so you can have a standing lunch with a friend, a weekend so you can see your grandchildren, or two weeks of full coverage so you can take the trip you’ve put off for three years. Short-term coverage like this is our standard hourly care: no contract, no minimum weeks, start and stop by phone. And if the break turns into a realization that you need regular help, we’ll be there for that too. Call us. We’ll start by asking how you’re doing, and we’ll mean it.

Call us 24/7: St. Louis (314) 631-1989 · St. Charles (636) 724-4357 · Ellisville (636) 200-2909 · Downers Grove (331) 260-0444