She is in the car outside her own house. There are nine steps up to the door. She was walking in June and she cannot stand now, and the two of you in the driveway are about to try something you have never done before.

Or the reverse. Her bedroom is on the second floor, she has not been down since February, and there is a wedding on Saturday.

This is the most searched question in our line of work and the answers online are almost all wrong for the person asking. Here is the honest version.

How do you get someone up stairs who cannot walk?

There are only four real answers, and most families are only ever told about two of them.

• A gait belt and a helper. This works when the person can still bear weight and take the step themselves. If she cannot stand, this is not an option, whatever you read.
• An installed stairlift. The right answer for daily movement between floors, forever. Weeks to assess and fit, and thousands of dollars.
• Move the bedroom downstairs. The most common advice given, and sometimes correct. It is also the one that quietly gives up half the house.
• Bring in a motorized stair chair and trained staff for the trip you need. Same day or next day, no construction, no change to the house. This is the option nobody mentions, which is why we wrote this.

Which one is right depends almost entirely on one question that the advice pages skip.

Is this a permanent problem or a specific trip?

Everything follows from that.

If she needs to move between floors several times a day for the rest of her life, buy the stairlift or move the bedroom. A visiting service cannot solve a permanent architectural problem and we will tell you so on the phone.

If what you actually need is a defined number of journeys, a dialysis run three times a week, a discharge on Thursday, a grandson's wedding, the first sunshine she has seen since Christmas, then a stairlift is an enormous amount of money and delay for something that can be solved this week.

Families come to us mostly in the second category and get quoted for the first.

Can two family members just carry her down?

Please do not, and we say that as the people who get called after it goes wrong.

A person who cannot bear weight is not a weight you can share evenly. She will grip, she will panic partway, and the two of you are on a staircase with no free hand. The person at the bottom is walking backwards down steps carrying most of the load. Injuries in this category are rarely the older person falling. They are a fifty year old daughter with a spinal injury who is now the second person in the family who needs care.

This is not squeamishness. It is the settled view in healthcare that manual lifting of people should be replaced by equipment wherever it can be, and OSHA's guidance for providers is to rely on technology to make patient handling and movement safe rather than on staff strength. That is on level floors with trained staff. A domestic staircase is considerably worse.

If you are going to do it yourself anyway, at minimum do it in daylight, with shoes on, with nothing in the hallway at the bottom, with a third person at the foot of the stairs, and never while she is holding anything.

What is a motorized stair chair?

A portable powered chair that climbs the staircase itself. She sits, she is secured, and powered tracks take the chair down or up one step at a time under motor control.

The part families are most relieved to hear is that nobody is carrying her. The motor takes the weight. Our two staff position the chair, operate it and stay with her, which is a different job from lifting a person and needs a different kind of person to do it.

It comes in the van, it comes out again afterwards, and nothing is fixed to your house. No landlord conversation, no drilling into a hundred year old staircase, no permanent reminder in the hallway that something has changed.

What does it cost to get someone up the stairs?

$200 per visit. A motorized stair chair and two trained staff, up or down, however many flights the home has. Quoted on the phone before you book and it does not change when we see the staircase.

Out and back on the same day is two visits. Full working on the price, including how it compares to a stairlift over a year, is on our page on what stair assistance costs.

We publish this because almost nobody in the industry does. If you have rung round and been told somebody will call you back with a number, that is the reason.

Should we just move her bed downstairs?

Often yes, and we will say so even though it is not a sale for us.

If the second floor is only a bedroom and she is unlikely to use the stairs again, a bed in the dining room is quicker, cheaper and safer than anything else on this page. Get a hospital bed if you can, put a commode nearby, and do not feel that you have failed at something.

The honest counterweight is this. Downstairs living works until the bathroom is upstairs, and then it stops working immediately. Before you commit, walk the ground floor and ask where she washes.

And it does not solve getting out of the house, which is the part families underestimate. A bed in the living room still has nine steps between her and the car.

What about getting her out, not just moving her around inside?

This is the request we get most often and the one that almost never appears in the advice online, because the advice is written about safety rather than about a life.

People stop leaving their houses because of steps, not because of illness. The illness is often stable. It is the front stoop that ended the trips out, and nobody treats that as a solvable problem.

• Appointments. Stairs at the door, wheelchair transport to the clinic, an aide through the appointment if it is a long one.
• A discharge. The steps and the ride, arranged together, ideally booked before the discharge date rather than on the morning. There is more on that in what to do when the hospital says the bed is needed.
• A family event. A christening, a funeral, a birthday, Thanksgiving at her daughter's house. This is the booking we are proudest of and it is a normal thing to ask us for.
• No occasion at all. Down the steps, an hour in the garden, back up. Some families book this monthly.

Are there staircases you will not work?

Yes, and we would rather say it now than on your doorstep.

Very narrow winding flights, high stairs with no rail at all, and outdoor steps in ice are the usual ones. Where we decline, we say what would make it workable instead, whether that is a temporary rail, a side entrance, a different door or a ramp.

What we need in order to answer: how many steps, inside or outside, whether the flight turns, whether there is a rail and on which side, and roughly what she weighs. One photograph taken from the bottom of the stairs usually answers all of it.

How quickly can somebody come?

Often the next day, sometimes the same day, and the limit is almost always the van rather than the staff.

Two practical notes. Friday afternoons are the busiest slot of our week because that is when hospitals send people home, so a Friday discharge wants a Tuesday phone call. And if the journey is a regular one, tell us when you book, because a standing appointment is easier for us to hold open than a series of separate calls.

Where to go from here

Two different problems, two different places to start.

• If the difficulty is getting in or out of the building. Book stairs and a ride here. Stair assistance is $200 a visit with a motorized chair and two trained staff. Wheelchair transport is $115 each way or $230 round trip within five miles.
• If the difficulty is the rest of the week. Tell us what the week actually looks like and we will say what it would take and what it would cost, on the call. Home health aide care is $45 an hour.

If you are not sure which it is, call and describe the house. We have had this conversation a great many times and it usually takes about five minutes to work out what you actually need, including when that is nothing from us.

Care Remedy Inc, 100 TradeCenter Suite G-700, Woburn, MA 01801. Call 781-957-8076 and ask for the office nearest you: Woburn, Brockton or Springfield. Home health aide care, wheelchair transportation and stair assistance across Greater Boston, the South Shore and the Pioneer Valley.

Sources: OSHA, Safe Patient Handling for healthcare providers. This article is general information and is not medical advice. Whether a particular person can be moved safely, and whether a particular staircase can be worked, is assessed case by case. Our rates are current as of publication and cover the first five miles.