Annals of Elder Care: The Joy of Power

For five years I served as my mother's financial power of attorney. She had some complicated finances, and some very complicated health issues. Anyone who has done elder care for five minutes knows that "complicated health issues" = mounds of paperwork and hours of time per week dealing with it.

When mired in the thick of elder care paperwork muck, few people have time or energy to seek out others dealing with similar issues. It's not like everyone gets together at the elder care park, letting their loved ones frolic on the swingsets and seesaws so that serious information sharing and necessary venting can take place. There's really no place where people charged with caring for ill or elderly loved ones can regularly gather, except the internet.

That's why I thought it would be worth sharing some of my experiences.

Today's topic is the The Joy of Power.

If you are FPOA for a loved one, you may find yourself in what I call a unicorn family - everyone gets along, each person does what they can, and everyone's highest concern, ever and always, is the good of the loved one.

Or you may find yourself in a, shall we say, more realistic situation. In non-unicorn cases, the FPOA is understood by some or all family members to be controlling, conniving, and deceitful, and robbing the loved one blind. In short, their absolute power has corrupted them absolutely. Sadly, in far too many cases, something like this does happen. I have seen a son rob his mother of nearly everything, leaving her destitute and malnourished (while calling in bomb threats to the local school in his spare time).  I have seen cases where siblings are denied medical information about a parent by sibling(s) in control, who then feed the parent stories about how and why the denied siblings are evil. I have seen a child trash a parent's house, be evicted, and return to do it again. Money makes people crazy. The very wealthy are not exempt - Donald Trump, for example, once cut off health care for a sick child - his grandnephew - because the child's family contested Donald's daddy's will.

But in most cases, the FPOA is just a blindfolded donkey turning the millstone, taking the wheat of conflicting paperwork and grinding out the flour of financial stability, often as not with one or more family members pulling the cord tied to the mouth, the better to keep the FPOA turning in his or her tracks.* Jesus said of little children "But whoso shall offend one of these little ones which believe in me, it were better for him that a millstone were hanged about his neck, and that he were drowned in the depth of the sea." Taking to the waters with a millstone necklace often seems preferable to continuing in the traces. But escape leaves the loved one behind.

Here's a fun memory from my time in the traces that illustrates just how delightful it is to wield all that "power" of the FPOA.

In October of 2011, a collections agency sent a threatening letter demanding immediate payment for an overdue bill for my mom's visit to a doctor at a local clinic in June of 2011. Although the visit was for mom, the collections agency threatened me (and thus my credit rating).  I spent half an hour combing through old explanation of benefit forms, and two hours on the phone with Medicare and Blue Cross to determine that the bill had actually been paid and when it had been paid. The next day I spent half an hour on the phone with the collection agency who demanded physical proof in the form of faxed copies of documents from Medicare and Blue Cross stating that they had actually paid the bill. They demanded this proof by the next day.

A special sweet irony of the whole mess is that the person at the collections agency initially refused to talk to me because even though I was mom's POA, and even though the collections letter was addressed to me and even though it was my credit rating that was at stake, and even though they were trying to get the money out of me, the medical appointment was for mom and so they didn't want to discuss the issue with me because of "privacy issues".

I spent fifteen minutes trying to figure out how to get to speak to a person, not voice mail, at the clinic’s billing department to find out why they turned a paid bill over to collections and how to get this undone.  I finally got a helpful person who promised to undo the mistake and who caught another one that was about to be sent off to collections.  Someone submits a bill with incorrect coding, it comes back from insurance unpaid because of the error, and then someone in billing sees the bill is unpaid and sends it off to collections rather than fixing the error.  So it is probably more rather than less likely that you will be dealing with this scenario in the future, if you are so lucky as the be the donkey FPOA.  The person at the clinic offered to call collections and send them documentation and I planned to check in again later to see that things had been resolved, after I received copies of everything from the helpful clinic billing person. This all took another half hour to 45 minutes. At that point, I just assumed, till I knew for sure, that I was not yet done with the issue.

If you are keeping track, that is nearly four hours of time (not counting time out for cursing and despair) on ONE issue, that may or may not have been resolved. (Luckily for me, that was the end of the story.) When I worked in pharma, at one company we tracked our time in 15 minute billable units. Alas, there was no billing code for my four hours of labor, and so my end of the week timesheet in that system would have shown ten percent unbillable hours, which is the same as not working in the business world, and I would have been on the edge of reprimand.

I do not know how people with full time jobs outside of being a FPOA manage to get all this sort of thing done. When feminists and economists talk about the unpaid labor of women, it is precisely this sort of thing they have in mind. Mind you, the 45 minutes the clinic billing person spent on the phone with me resolving this issue, plus whatever time she spent after we got off the phone, was paid but unproductive labor. No one’s unpaid bills got paid, no one’s health care status was advanced, nothing was achieved but once more subverting the malicious effects of an avaricious, antagonistic, and ill-designed health care system.

If you are FPOA donkey, turning in your traces, grinding the most illogical paperwork nightmares ever conceived into dust, day after day, I salute you.

*I thank Country Life (The Journal for All Interested in Country Life and Country Pursuits), Vol 24, Oct. 17, 1908 p. 515, for the anecdote that inspired my FPOA-donkey metaphor.

5 responses so far

  • becca says:

    Not that you necessarily should handle this kind of problem this way, but you could have told the collections person to take a long hike of a short pier. From what I've read, it can't hurt your credit if you aren't a co-signer on debt (and that doesn't seem possible for a medical bill), even if you have FPOA. The person trying to collect this debt is effectively held to no ethical code, and can try to waste your time to the point where you just give in and pay them (which you should *never* do, without documenting the debt and how the payment will be applied).

    I mean, that's still a slim consolation for all the hours lost to resolving insurance payment and bills for stuff you *do* actually owe and would like to actually pay on (after appropriate credit for insurance payments made). I know how much of a time suck that can be just from my own medical stuff.

  • Zuska says:

    Yes, this is appropriate advice. At the time, I did not realize that I could probably have done that. This is the problem with being mired in the paperwork muck. You don't even have the spare energy to figure out things like this - you are constantly in reaction mode. It's unrelenting repetitive urgent minor bullshit punctuated by intermittent and unpredictable major crises.

    Which is why I hope discussions of topics like this might be helpful to anyone who is in the middle of it. Or anyone who might someday find they are suddenly in the middle of elder care without a how-to manual...which could be basically any of us.

  • Jaws says:

    What this really points out is Rule One of the Fair Debt Collection Practices Act:

    The debt collector cannot take any action for thirty days if you demand verification of the purported debt in writing upon the first contact. That "tomorrow"? It's a complete crock unless they've already been hounding you.

    Which leads to the obvious corollary:

    Don't ever communicate with a debt collector by phone. EVER. Their best weapon is the ability to threaten people over the phone with things that can't happen (and woe betide anyone trying to record the conversation). And especially don't do anything by phone when you're representing someone else's interests unless you're a professional at doing so.

    • Zuska says:

      I consider myself reasonably educated but this is not something I knew anything about. Nor, when I started elder care/POA duties, did it occur to me I should read up on debt collection practices and my rights in that regard. There are SO many things you just are expected to know about and deal with on the fly, in the middle of extreme and chronic stress. It's horrifying and disheartening and overwhelming.

  • thebewilderness says:

    Hoping the new year brings you what you need.