A family looking at daytime help for a parent usually sees two products: an adult day program the parent attends, or an in-home aide who comes to the house. Both can keep a parent supervised and fed through a workday, and either may be partly covered by VA benefits, but they are sold, staffed, and billed differently. Compare them on the terms each one puts in writing.1

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.

What each option actually sells

An adult day program sells a block of supervised hours at a site, usually with set open days, set hours, and a shared activity schedule. An in-home aide sells time in the parent's own house, with the schedule built around his routine. The program gives you a fixed place and a group. The aide gives you one-to-one attention and a home setting, but you carry more of the coordination.

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).

Questions for an adult day program

Ask for the hours of operation and whether a half day is allowed. Ask how transportation works, who rides along, and what happens if your father needs to be picked up early. Ask what meals and snacks are included. Ask who supervises the room and what their training is. Ask how the program handles medicine, and get the answer in writing, because it defines what staff will and will not do with the pill organizer. Ask what the program charges, whether by the day, the hour, or the month, and what it charges for an absence.

Questions for an in-home provider

Ask for the hours and the minimum shift length. Ask whether travel time or errands are billed separately. Ask what the aide does about medicine: a non-medical caregiver can give medication reminders and pick up prescriptions as an errand, while the family, the doctor, and the pharmacist keep the medicine itself. Ask whether a written plan of care exists and who updates it. Ask what the cancellation terms are and what happens if the aide cannot come.

Where the VA fits

VA health care includes an adult day health care program at some VA medical centers for enrolled veterans, and any cost depends on enrollment and income rules.2 The Aid and Attendance increase to the wartime pension is a cash benefit that can help pay for care, whether the care is an in-home aide or a program fee.3 These are separate routes with separate applications. Confirm with the VA medical center whether the program is offered near you and what it would cost your father, if anything, before you assume the pension pays for it.

The comparison that decides it

Put the two offers side by side on the same five lines: hours covered, who supervises, what happens with medicine, what the month costs with one absence included, and what happens when your father has a bad day. The option that answers all five in writing is the one to price. Anything answered with 'we usually' is not yet a term.

This desk is not affiliated with the U.S. Department of Veterans Affairs. The Sources page lists every page cited here.

Footnotes

1. VA.gov, veterans health care and long-term care benefit pages.

2. VA.gov, Adult Day Health Care program page.

3. VA.gov, Aid and Attendance and Housebound benefit page.