The hourly rate on a care quote is the number everyone compares, and it is the number that hides the most. Before you set the monthly gap, list every cost that exists because Dad is living at home, not only the hours someone spends with him.
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.
Start with what the rate covers
Ask each agency or independent caregiver to put in writing what the hourly rate includes. Check whether it covers gloves, disposable underpads, wipes, hand soap, laundry supplies, and the basic kitchen items used for his meals. Some quotes include them. Many do not, and a family often finds out on the first invoice. Ask who buys these items, who keeps the receipt, and how and when the family is reimbursed. If the answer is 'the family,' write that line into the budget now.
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).
Equipment the house does not have yet
A shower chair, a transfer belt, a walker, a commode, or bed rails may be needed before the first shift. For each item, find out whether it is rented, bought, or loaned, who pays for repairs, and whether the supplier charges a delivery or pickup fee. Coverage depends on the payer and on the medical order behind the item, so ask the prescribing office and the supplier what they cover and in what form. Do not assume an item is covered because someone else's relative had one.
Errands and time that carry a cost
A non-medical caregiver may give medication reminders and may pick up prescriptions as an errand. Medication itself stays with the family, the doctor, and the pharmacist. The pickup trip is still a billable line in many agreements. Ask whether travel time, mileage, parking, and pharmacy waiting time are billed separately, and whether there is a minimum charge for a short errand. Write down the mileage rule and the rate that applies to it.
Groceries and meals
If the caregiver shops or cooks, ask whether the food cost is billed at the register or built into the rate. Ask whether itemized receipts will be provided every time. A simple test: pick one week, list the food the household would have bought anyway, and compare that list with what will now run through the account. The difference is the cost you need to plan for.
Build the supply line into the monthly gap
Add three columns to the budget: what the agreement covers, what the family buys, and what is still unknown. The unknown items are the ones that show up later as surprises, so resolve them before the first invoice. Review the list with whoever will pay the bills, and keep copies of every receipt. Clean records also make it easier to review what the household spent on care over time, which matters when the numbers have to be explained to someone else.
Where to check next
The St. Louis offices on the Local Help page can point you to the right contacts for your county. The Sources page lists the VA.gov pages behind this briefing, and the Start Here page sets the order to read the rest of the series.