Mom may sleep through most nights and still need someone ready for the one night she wakes, dresses, and heads toward the door. Dementia can change sleep, bring repeated waking, and lead to wandering after dark. Those changes can disturb both Mom's rest and yours. (National Institute on Aging and Alzheimer's Association. See Sources.)

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.

Before you commit to overnight help, ask one plain question: "Is this an awake shift, or may the person sleep?" Do not accept "someone will be there" as the answer. You need to know what that person will be doing when Mom first gets out of bed.

Write down the night you need covered

Start with Mom's actual night, not a general description of dementia. Note when she usually settles, where she sleeps, how she reaches the bathroom, which exterior door she approaches, and what you have seen just before she tries to leave. Include ordinary needs such as the toilet, a drink, a warmer room, a familiar voice, or help finding the bedroom again.

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).

People living with dementia may wake often or become restless and confused as daylight fades. A regular routine, a quieter evening, and a clear night route can help, but those measures do not tell you whether Mom can safely be left without someone ready to respond. (National Institute on Aging. See Sources.)

Give each provider the same short account: "Mom sometimes gets up after everyone is asleep. She may walk past the bathroom and continue toward the front door. She does not reliably call for help." Then ask the provider to describe the response from the first sound or movement through Mom's return to a settled place.

Separate presence from active watching

Ask whether the overnight worker may sleep, where the worker will be, and what is supposed to wake them. If the answer depends on Mom calling out, ask what happens when she says nothing. If it depends on an alert, ask who carries the receiver, how loud it is, and what happens when the worker is helping Mom in another room.

Then make the provider name the checks included in the shift. Will someone look in at set times? Will the worker remain awake between checks? May the worker leave the house? May the worker use headphones, shower, or close a bedroom door? These are not small housekeeping details. They tell you whether the service matches the moment you are trying to cover.

The Alzheimer's Association recommends defining the help needed before choosing an in-home provider and asking about availability, dementia experience, specific care needs, references, and backup when a worker is sick. (Alzheimer's Association. See Sources.)

Ask for the doorway response in ordinary words

Do not stop at "wandering support." Ask, "If Mom says she has to go home and reaches for the lock, what will you do first?" Listen for a calm, usable answer. The worker should know whom to call, what usually settles Mom, which exits must remain secure, and what information must go with a call for help if she gets outside.

Ask how the worker will respond without arguing with Mom or crowding the doorway. Share the name she prefers, familiar subjects that hold her attention, the chair where she settles most easily, and the simple phrases your family already uses. Information about a person's preferences, history, and familiar memories can help an in-home worker build connection. (Alzheimer's Association. See Sources.)

Now ask about the less dramatic moments. Who helps when Mom cannot find the toilet? Who notices that she is cold, uncomfortable, or searching for someone? Who stays beside her if she begins pacing? A worker who knows only how to stop an exit may miss the need that started the walk.

Make the handoff visible

Ask who gives the worker the first-night briefing and where the written instructions stay. The handoff should name Mom's usual bedtime, walking route, bathroom, doors, calming routine, emergency contacts, and the point at which you want a call. Keep the instructions short enough to use while standing beside her.

Find out whether the same workers return regularly. If several people may cover the shift, ask how each one receives updates and how you will learn who is coming. Ask what happens when the scheduled worker calls out, arrives late, or leaves early. A provider's backup procedure is one of the basic questions the Alzheimer's Association recommends asking before selection. (Alzheimer's Association. See Sources.)

Also decide who receives the morning report. Ask for concrete notes: when Mom woke, where she went, what she said, what seemed to help, whether she tried a door, and whether the house setup failed anywhere. "Good night" is not enough if you need to prepare the next one.

Run one observed night before you rely on the arrangement

If possible, begin while you or another person who knows Mom can stay available. Show the worker the route in the real house. Let them find the bathroom light, the contact sheet, the door alerts, Mom's coat and shoes, and the place where she usually pauses. Ask them to repeat the call order back to you.

During that first shift, check the ordinary weak points. Can the worker hear Mom from the assigned place? Can they reach her before she reaches the exterior door? Do they know which sounds are routine and which require them to get up? Can they guide her without turning on every light or starting a long explanation?

If Mom's sleep or nighttime behavior changes suddenly, write down what changed and contact the health care office that knows her. Sleep trouble can have causes beyond dementia, including discomfort, illness, or a medicine. (National Institute on Aging. See Sources.)

Do not commit until you can finish this sentence

You should be able to say: "When Mom gets up and moves toward the door, this named person will already be awake, will notice her this way, will meet her here, will try these familiar steps, and will call this person if she does not settle." If the provider cannot help you complete that sentence, you do not yet have overnight coverage. You have only arranged for another person to be in the house.

For St. Louis organizations that can help you look for caregiver support, respite, and dementia resources, use Lifelines: Dementia Help in St. Louis. If tonight's doorway is the immediate problem, return to Start Here: Dusk to Morning, in Order.

Before You Hire Overnight Help, Find Out Whether Someone Is Actually Awake