The agency's brochure describes the care. The service agreement decides who pays when the care does not show up, how many hours you are billed for, and who has to make the call when plans change. Most of the trouble families describe later was written into that document before anyone signed it. Read it slowly, and read it with the sibling who will share the bills in the room.
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.
This is a guide for comparing the paperwork, not legal advice. If a clause is unclear or the stakes are high, a Missouri attorney can read the contract with you, and the Missouri Bar offers a lawyer referral service for finding one.
Check who is actually bound
Find the name of the party on the contract and confirm it matches the agency you met. Ask who signs, and whether the family member signing does so for Mom, as her representative, or as a payer. Those are different roles, and they can carry different responsibilities. Ask whether the agency is licensed with the state and, if it is, where to look up that license. The Missouri health department publishes lists of licensed providers, and the agency should be able to tell you which category it falls under.
Read the hours and the minimums
Look for a minimum number of hours per visit or per week, and for how the agency rounds up partial hours. Check whether you are billed for the full scheduled block if the caregiver arrives late or the visit is shortened. Write down the schedule change process: how much notice you must give, whether it is by phone or in writing, and who on the agency side confirms it. A clause that charges for the hours you asked to move is a line item you will see every month.
Read the cancellation and exit terms
Find the notice window for cancelling, any fee that applies if you cancel late, and whether prepaid hours are refunded if the service ends. Ask what happens if the agency cannot send a caregiver, and whether it has a written backup plan. Ask how the agreement ends if Mom moves, is admitted somewhere else, or dies, because the cancellation clause may still apply in those cases.
Confirm the task list matches the need
The contract should list the tasks in plain words. For a non-medical in-home caregiver, the list may include meal help, light housekeeping, errands, and companionship. A caregiver may give medication reminders and pick up prescriptions as an errand. A caregiver should not be listed as handing out, administering, sorting, or managing medicine. That work stays with the family, the doctor, and the pharmacist. If the contract is vague on this point, ask the agency to write it down before you sign.
Check the rate and the review date
Look for the clause that allows the agency to change its rates, how much notice it must give, and whether you have the right to end the agreement if the new rate does not work for your family. Note the date the contract is reviewed or renewed, and put that date on the calendar of the person who handles the bills. A contract nobody rereads is how a reasonable arrangement turns into an expensive one.
Before you sign, bring the list of questions to the family meeting, assign one person to read the document line by line, and make sure the sibling who pays a share has a copy. The Sources page lists the public references behind this guide.