Every appointment you drive Mom to is a trip someone else isn't making. That's labor, and it belongs on the list. The question at 2am is usually not whether Mom needs a ride. It's which option will get her there, back, and on time without someone in the family giving up a whole afternoon every time.
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.
Write down the trips first
Before you compare anything, write out the trips you actually need. For each one, note how often it happens, how far it is, what time it starts, and how long the appointment usually runs. Note whether Mom walks to the car, uses a walker or wheelchair, or needs a hand from the door to the seat. Note whether someone must ride along to answer questions at the visit. This list is your yardstick. Compare the three options against it, not against each other.
Option one: the public paratransit service
Most areas around St. Louis have a public paratransit service for riders who cannot use the regular bus or train. Because it is meant for trips a rider can't otherwise take, it usually requires an eligibility application first. Ask the transit office these questions before you count on it:
How long does eligibility take, and is there a waiting period before the first ride? How far ahead must a trip be booked? Does the service give a pickup window or a set time, and how wide is that window? What happens if the appointment runs long, and how is the return trip booked? What is the cancellation rule, and what counts as a missed ride? Does the driver help Mom from the door to the vehicle? Can a companion ride along, and is there a fare for that companion? Which payment method does the service accept, and do you need a card or pass?
Option two: a rideshare or taxi account
A rideshare or taxi account is faster to set up, but it depends on what the app and the company will do for a rider who needs help. Check whether someone other than Mom can book and track the ride from their own phone. Ask whether the company offers vehicles with a ramp or lift, whether those vehicles are available where you live, and how far ahead they must be requested. Find out whether the driver waits at the door, how long the wait is, and whether waiting time is charged. Confirm that a wheelchair or walker fits in the vehicle you'd get. Ask what happens when a driver cancels, and who receives the receipts. Then do one short trial ride with Mom before you rely on it for a real appointment.
Option three: a family driver
A family driver often looks free because no one sends a bill. Count it anyway. Write down the mileage, the hours away from work, the parking, the time spent sitting in the waiting room, and the trip home. Add the afternoon you lost. This is the most expensive line on the page and the least visible one, which is exactly why it causes resentment later. If you choose this option, set a rule now for who covers which trips and what happens when the driver is sick, on vacation, or simply can't make it.
Put the three side by side
Make a simple table with three columns, one for each option. For each row, write the answer for the trips on your list. Use these rows: how far ahead you must book, the pickup window or time, the expected wait, what happens when the appointment runs long, what happens when the plan falls through, who must be present, and who pays for what. If you don't know an answer, write 'ask' rather than guessing. The blank rows are your list of calls to make.
Service areas, eligibility rules, and fares change over time, so confirm each detail with the transit office or the company before you commit. The point of the table is not to find the cheapest option on paper. It is to find the option that gets Mom to the appointment without one person quietly absorbing the cost.
Decide the split before you need it
Once you know which option fits, decide how the cost is shared and write that down where everyone can see it. If a family driver covers some trips, put a value on those hours and show it as a line item, not a favor. If a paid service covers the rest, agree who pays the bill and how it gets reimbursed. For help finding transit contacts and other local resources, start with Local help. Settling the ride question once is far easier than settling it again at the next missed appointment.