Before You Hire Overnight Help, Make the Agreement Cover the Moment Mom Opens the Door

You are not hiring someone merely to be inside the house. You are deciding who will notice when Mom gets out of bed, walks toward the door, or says she needs to go home.

Those moments can happen even in a familiar place. Dementia can make familiar rooms harder to recognize, and restlessness or an old sense of obligation can pull Mom toward an exit. The Alzheimer's Association recommends identifying when she is most likely to wander and planning supervision and activity around that window.^[1]

Before you commit to overnight help, make the provider describe the shift in actions, not comforting labels.

Ask whether the helper is awake

“Overnight” does not tell you whether the helper remains awake. Ask plainly: “Is this an awake shift, or may the helper sleep?” Then ask where the helper will be, what can wake them, and how quickly they are expected to respond.

If sleeping is allowed, walk from that sleeping place to Mom's bed, bathroom, stairs, garage entry, and every outside door. Close the bedroom door. Turn on the fan or television Mom normally uses. Test the actual door alert. You need to know whether it can be heard from the place where the helper will sleep.

Do not settle for “the helper will keep an ear out.” Put the expected checks and responses in writing. If you need someone awake because Mom has already tried to leave at night, say that directly and ask the provider to confirm it in the service plan.

Describe the night Mom actually has

Give the provider a short account of what happens after bedtime. Include when Mom usually gets up, which door she approaches, what she says, whether she looks for shoes or keys, and what has helped her turn back without an argument.

Also show the helper the route to the bathroom, the places where Mom pauses, and anything she may mistake for an exit. Night lights and clear routes can help with movement through the house, but no house change guarantees that Mom will not leave.^[2]

Ask the provider to repeat the plan back to you: “If Mom says she has to get to work and walks toward the front door, what will you do?” Listen for a calm, specific answer. You want to hear who approaches her, what they will say, where they will guide her, and when they will call you.

Make every outside door part of the agreement

Walk the helper to the front door, back door, patio door, basement exit, and door into the garage. Show how each lock and alert works. Include any door Mom has not used yet. A new exit can become important when the familiar one no longer opens.

Ask these questions before you sign:

Who checks that the doors are secured at the start of the shift? Who carries the keys? Does the helper receive an alert directly, or does it go to someone somewhere else? What happens if the alert fails? May the helper step outside with Mom? What happens if Mom enters the garage or gets into a car? Who calls for help if she cannot be found?

Safety changes should not leave Mom locked inside without a way for another person to get everyone out. The Alzheimer's Association specifically warns against locking a person with dementia in the home.^[1] Ask the provider to show you how the helper would open every exit in an emergency.

Give the helper permission to interrupt you

A vague instruction such as “call if anything happens” leaves too much room for guessing. Write down the points at which you want a call.

You might ask for a call if Mom tries an outside door, cannot be guided away from it, falls, becomes suddenly unlike herself, or is missing from the helper's sight. Name a second person to call if you do not answer. Put both numbers where the helper can find them without searching through a phone.

If Mom gets outside and cannot be found, the plan should move immediately. The Alzheimer's Association advises beginning the search at once and calling emergency services if she is not found within the first fifteen minutes.^[1] Your written instructions should say who searches nearby, who calls, and who stays at the house in case Mom returns.

Ask what happens when the assigned helper cannot come

A good plan must cover the ordinary failure of one person being unavailable. Ask whether the provider sends a replacement, who chooses that person, and how the replacement receives Mom's night instructions.

Also ask how you will be told that a replacement is coming. Decide whether someone unfamiliar with Mom may enter alone, or whether you want a family member there for the handoff. The Alzheimer's Association recommends asking in-home providers whether they are available when needed and whether backup is available when the usual helper is sick.^[3]

If there is no replacement, decide now who covers the house. Do not let that decision arrive with a cancellation message at bedtime.

Run one ordinary rehearsal

Before relying on the arrangement, have the helper complete a real handoff while you are still nearby. Show them Mom's usual evening rather than a cleaned-up version of it.

Let the helper receive a door alert, find the correct exit, locate the keys, call your phone, and open the written instructions. Ask them to show you where they would look first if Mom were no longer in the room. A trial during a non-emergency can reveal whether a respite arrangement fits before you must depend on it.^[4]

Then ask one final question: “What part of this night are you not agreeing to handle?” That answer matters as much as the list of services. It lets you fill the uncovered hour, door, or task before you leave Mom in someone else's care.

Keep the handoff short enough to use

Leave one page with Mom's usual waking times, the words that tend to settle her, every exit, both call numbers, and the missing-person steps. Add a recent photo and the places she may try to reach. Planning ahead with a recent photo and likely destinations can help if she becomes lost.^[1]

Review the page whenever Mom's route or night changes. If you need help building the wider evening plan, use Start Here: Dusk to Morning, in Order. For local support that can help you find and compare services, see Lifelines: Dementia Help in St. Louis.

Source notes

[1] Alzheimer's Association, “Wandering and Dementia.” [2] National Institute on Aging, “Caring for a Person With Alzheimer's Disease.” [3] Alzheimer's Association, “In-Home Care.” [4] Alzheimer's Association, “Respite Care.” These nonprofit and federal references are collected on the Mom Wanders Sources page.