Managing a Loved One's Finances: 'Do You Have a Magic Book?'

Kathy D. Miller, MD


April 25, 2022

This transcript has been edited for clarity.

I have a personal message for you today. Some of you may have noticed I haven't submitted as many Medscape videos over the past 6 months, and I wanted to give you an idea of what's been going on in my family life that has kept me away from you.

Late last fall, my mother, who had been a vigorously healthy, 79-year-old lady, suddenly became ill. In the span of 4 short weeks, she went from driving 3.5 hours to my house on her own for a very active weekend and driving herself home again to being in hospital, struggling to sit up, and struggling to talk more than a word or two that frequently didn't make sense.

A couple of weeks later, she was diagnosed with a severe varicella encephalitis. Turns out my mother had never had chickenpox, and when you have chickenpox for the very first time as a 79-year-old woman, you often don't develop any of the skin rashes, not a single vesicle, and that makes diagnosis incredibly difficult.

She has recovered, but she has recovered with some residual cognitive deficits that, at this point, make it still unsafe for her to return living alone. She's doing well. We're hopeful that she'll continue to recover, and she's moved to an assisted living facility that really suits her needs incredibly well. That means my sister, who lives in California, and I, who live in Indiana, have needed to take over managing all of the financial affairs for my mother, who lived independently in Ohio.

The good news here is that my parents kept meticulous records and they had shown me where in the office, in their house, all of the financial paperwork — including bank accounts and all of the insurance accounts — was kept. Everything was obsessively labeled and organized. My sister and I even found what we now called the "magic book": a spiral bound 4- by 6-inch notebook, with tabs indicating each page, that has the usernames, passwords, and all of the codes for every website where she had ever done business.

So you would think that managing her financial affairs might be an easy task. Despite that, 6 months later, there are still accounts that I can't access, arrangements that we're still struggling to sort out and take care of, and things that we still don't know and are only now finding out.

Some of the challenges include websites that use dual authentication. That's a great thing for safety, but those were not sites that she needed to visit very frequently. In one case, the dual authentication went to my father's cellphone. My father died suddenly last January. That dual authentication doesn't work and without that authentication, I can't access the website.

I tried contacting that company, but they think I'm a scammer. No amount of pleading, giving them information, or offering to send them the power of attorney has had any effect. One of the dual authentications goes to one of my mother's old email addresses — an email address that she let go and with a carrier that does not even exist any longer. Same problem. I can't do the dual authentication and can't access that account. Thankfully, that's one that right now we don't need to access to in order to take care of the urgent needs in her financial life.

Imagine how much more difficult this must be for the family members of our patients if the records were not so meticulous, if they couldn't find the magic book, or if the magic book didn't even exist. When all you want to do is love your mother, love your father, your family members, and take care of their physical and emotional needs, it is so easy and time-consuming to get bogged down trying to manage the financial details, finding access to things, spending hours on hold with insurance companies and bank examiners trying to make certain that the bills are paid and those details are taken care of.

Think about this the next time you talk to your patients. Ask them if they have given their family members a tour of their office areas. If they're suddenly not able to manage their financial details, where would the people that they love and trust find that information? Is that information up-to-date?

It sounds so simple, and yet, we often lose sight of it. I hope you never find yourself in this position. Best wishes to all of you.

Kathy D. Miller, MD, is associate director of clinical research and co-director of the breast cancer program at the Melvin and Bren Simon Cancer Center at Indiana University. Her career has combined both laboratory and clinical research in breast cancer.

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