You are the one who does it. Every day, or most days. And now there is a week you cannot be there. A wedding in Ohio. A work trip that cannot move. Your own surgery. Or the plainest reason of all, which is that you have not had a week off in three years and something in you has quietly run out.

The question is never whether your mother needs help that week. You already know she does. The question is what it costs, how fast you can arrange it, and whether you have to move her somewhere to get it.

Here are the answers, with the numbers.

What is respite care, exactly?

Respite care is care that covers for the family caregiver. That is the whole definition. It is the same hands-on help a home health aide gives any other client, arranged for a fixed stretch of time because the person who normally does it needs to be somewhere else.

It is not a different service. It is a different reason. The aide who comes for a respite week does exactly what an aide does: bathing and dressing, help to and from the bathroom, meals, medication reminders, laundry, keeping the person company, and being awake and present through the night if that is what the week requires.

Does she have to go somewhere?

No. This is the part most families do not realize.

When people hear the word respite they picture a short stay in an assisted living building. That is one version of it, and for some families it is the right one. But a facility respite stay means packing a bag, moving an older person out of the room she knows, into a hallway she does not, for seven nights, and then moving her back. If she has any memory trouble at all, that move is the hardest part of the week, and the disorientation often outlasts your trip.

In-home respite skips the move entirely. Her bed, her bathroom, her kitchen, her television at the volume she likes it. The only thing that changes is who is in the house.

What does a week actually cost?

Our home health aide rate is $45 an hour . There is no minimum contract and no assessment fee. So the cost of a respite week is a straightforward multiplication, and you can do it yourself before you call anybody.

• Mornings and evenings only, 4 hours a day. 28 hours across the week. $1,260. This works when your parent is steady on her feet and the risk is really about meals, medications and bathing.
• Full days, 8 hours a day. 56 hours across the week. $2,520. Someone there through every waking hour, home alone only overnight.
• Overnights only, 12 hours a night. $540 a night, $3,780 for seven nights. The right shape when days are fine and nights are the problem, which is more common than families expect.
• Around the clock. $1,080 a day, $7,560 for the week. Continuous coverage, no gaps.

Most respite weeks we staff are not around the clock. They are eight to ten hours a day with the family checking in by phone. Before you price the biggest version, work out what the actual unsafe hours are.

Which hours are the unsafe ones?

Three questions get you to the right number of hours faster than any assessment form.

What do you do for her that nobody else does? Write down the actual tasks, at the actual times. Most family caregivers discover their real load is concentrated in two windows, morning and bedtime, with a long quiet middle.

What happens at three in the morning? If she gets up to use the bathroom and you currently hear her and go in, then nights are staffed hours, not quiet ones. If she sleeps through, they are not.

Would she call you if something went wrong? Be honest. Plenty of people would not, because they do not want to be a bother, or because they would not recognize that something had gone wrong. If the answer is no, the gaps in your schedule matter more than you think.

Does insurance pay for respite?

Usually not, and it is better to know that now than to lose two weeks finding out.

Medicare does not pay for this. Medicare covers skilled care, meaning a nurse or a therapist, ordered by a doctor, for a medical reason. A home health aide who is there so you can go to a wedding is not skilled care and never has been. The one narrow exception is hospice: if your parent is enrolled in the Medicare hospice benefit, that benefit includes short inpatient respite stays, generally up to five consecutive days at a time, in a facility rather than at home.

A long term care insurance policy may well cover it. If your parent has one, pull out the policy and look for two things: the daily benefit amount, and the elimination period, which is the number of days you have to pay out of pocket before the policy starts. A seven day respite week often falls entirely inside the elimination period, which means the policy technically covers respite and practically pays nothing for this particular week.

If your parent is a veteran or the surviving spouse of one, ask the VA about caregiver support and respite. The VA does fund respite, the rules are their own, and the timeline is not a week.

For most families booking a week off, this is a private pay expense. We tell people that on the first call rather than the third.

How fast can it start?

Give us as much notice as you can, and more than a few days if the week includes overnights. A respite week is not one shift, it is a schedule, and the schedule has to be built around real people who are already working.

That said, we do not require an assessment visit before we can quote you or schedule you. There is no assessment fee and no multi week intake process. If you call and tell us the town, the dates and the hours, you will get a price on that call.

If it is a real emergency, call anyway. Sometimes we can cover it and sometimes we cannot, and you will know which within the hour instead of the week.

What should you leave behind?

The families whose respite weeks go smoothly all do roughly the same thing before they leave. Write it down, one page, on the kitchen counter.

• The medication list, what time each one is taken, and where they are kept
• The doctor's name and number, and which hospital she goes to
• Your number, and a second number for someone local who can get there in twenty minutes
• What she eats. Not a diet plan. The three or four things she will actually eat
• The routine that matters to her. The chair she sits in, the show at four o'clock, the fact that she does not answer the phone before nine
• Anything that has recently changed. A new medication, a fall last month, a bad night two weeks ago

That last one is the one families skip, and it is the one that matters most. An aide who knows she went down in the bathroom in July watches the bathroom differently.

Does a respite week have to be a one time thing?

No, and this is worth saying plainly. A surprising number of the families who first call us for a single week end up keeping a few hours. Not because anybody sold them anything, but because the week showed them something.

They come home and hear that their mother had a shower every day that week, which she had not been doing. Or that she ate three meals instead of toast. Or they notice that for seven days they slept the whole night, and how different that felt.

Because we have no minimum contract, keeping four hours on a Tuesday afterward is a perfectly ordinary thing to do. So is stopping. The week does not obligate you to anything.

Arranging a respite week in Massachusetts

Care Remedy provides home health aide care across eastern and central Massachusetts, with offices in Woburn, Springfield and Brockton. Home health aide care is $45 an hour, one to eight hours a day, with no minimum contract and no assessment fee. Overnight coverage is $540 for a 12 hour night.

Call 781-957-8076 with your town, your dates and roughly the hours you think you need, and we will tell you on that call what the week costs and whether we can staff it. If we cannot cover your town for those dates, we will say so rather than keep you waiting.

Go to the wedding.