Mad As a Hatter

Two Sister’s Journey Through Mental Illness

Ka’s Birthday

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Tomorrow is Ka’s birthday.  I sent card.  Unlike other sister situations, I can’t call and wish her a happy birthday since she doesn’t answer her phone.  I was going to send flowers but I don’t know if she’ll be home to take the delivery and her living situation doesn’t lend itself to having one of her neighbors take the flowers if she’s not home.

We’re in the process of trying to solve the credit card problems.  The JPMorgan Chase people weren’t much help.  First the call center person didn’t understand what a guardian was and didn’t have a supervisor I could talk to.  Then when we go another person on the phone, their response was, send us a letter which we did.

We got the response to the letter.  It is basically asking us to work out a payment plan.  They also don’t understand that I’m her guardian not the person responsible for the bill.  So they sent a letter asking us to work out a plan.  Given that the bills are up around $15,000 there is no way I am paying for any of this especially since if the bank had done even the most cursory of searches they would have seen that Ka’s credit and her $12,000 income didn’t justify a credit card with a limit that was above her annual income.

My guess is that now that Ka isn’t getting a bill she will simply forget about all of this.

So we press on.

Happy Birthday Ka,

Love, Cupcake

Written by Cupcake McQueen

June 16, 2009 at 11:14 pm

Responsible Behavior?

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Today’s call with “The Voice” went something like this.

“Ka was very upset when I discussed her credit card situation with her.  She didn’t want you to close the account, she wanted to keep paying it because she was worried about her credit rating.”

(WTF… credit rating? )

I responded, “Ka makes about $12,000 a year netting a little over $900 a month.  She has a $15,000 credit card bill.  How will she ever pay it back.  The credit card company never should have given her a credit card with that size credit limit.  She’s giving them between $300 and $500 a month.  She has to pay you $109 for her apartment, she also has to pay for her doctor visits, even though they are only $24 each time, that’s still cash she has to lay out.  She needs to buy food.”  

“Ka wants to continue to pay the bill.  I don’t want this situation to interfere with my clinical relationship with her.  I don’t think we should involve ourselves in this.”

(WTF.. clinical relationship?  These are the people who knew she was off her meds for 18 months before they called.  Now they are worried about a clinical relationship?)

Visualize my head spinning around.  I thought my head would explode.

“Ok, but you know that she worries about the cost of her medication.  She isn’t responsible with her money.  She doesn’t have any insight into the problems she is causing.  How can you let her continue to be irresponsible like this?  I’m the one who these guys will start calling when she gets herself into financial trouble.”

The Voice….  “I can hear in your voice that this is very troubling.  I understand how you feel.  But we need to be able to talk to her, to make sure she stays on track.”

“Ok, I’ll be the big bad sister, but this bill has to go away.”  

Have a nice day.

These were the very people who kept sending me bills for her rent that I paid to keep Ka from getting thrown out onto the street.  These are the people who wanted me to pay the $567 bills for the antipsychotic medicine because no one made sure Ka did her Medicare Part D application because Ka “didn’t want to do it”.  These are the people who have voice mailboxes that are always full and then say things like, “you didn’t get back to me in time.”

Ka is the one running up credit card bills with no way to pay them back.  She has no savings, she has no cushion. I can’t spend anymore money.  I’m tapped out from the eviction and the hospital and the fight to get her back on her meds.

So now what?  Do I keep moving with the plan to get the credit card company to cancel the card and forgive the debt?  Do I just leave well enough alone until things get out of hand again?  There’s no money left to take care of these kinds of eruptions.

Is it time to just walk away?

Cupcake McQueen

Written by Cupcake McQueen

May 22, 2009 at 12:30 am

IRS and Guardians

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Ka has some amazing credit card bills. I think we have narrowed them down to about $15,000 but every day’s mail can bring a surprise.

I took care of her taxes this year. I was very careful to make sure that the check would come to me so I could put it away for her and make sure there was at least a small amount of cash in case of an emergency. The refund was only about $1,000.

The IRS, despite all the paperwork with the tax return; guardianship certificate, instructions to issue a check rather than direct deposit, went ahead and made the direct deposit. Ka went and spent the money. My guess is it was because her social security number shows she is getting an automatic deposit for her social security check. This is what I was afraid of.  Another Bozo Explosion.

I still have $6,000 in outstanding bills I still need to pay, Ka has $15,000 in outstanding bills. This is very bad.
I don’t know if she can file for bankruptcy but this seems like the only way to get her out of this mess.  Who gave her this credit card with such a big credit limit? This certainly feels like entrapment.  Isn’t there any recourse?

This makes me very sad.  Angry just doesn’t seem to work anymore.  

Cupcake McQueen

Written by Cupcake McQueen

May 18, 2009 at 2:55 am

The Financial Guardianship

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I arranged to have Karen’s taxes done.  She was due some small refunds from her final paycheck at her grocery store job.  She worked there for 10 years before they closed the store.  They paid her for 10 years of vacation time.  She never took a day off.

I think the lose of her job and the lost of the structure of the work environment may have added to her deteriorating situation last year but there’s no way to know for sure.

I wanted to put the tax refunds into her trust account.  I am afraid that she is running through her cash too fast and with the thousands of dollars of credit card bills, I wanted to make sure that she had a little money set aside to pay the bills; to make sure she didn’t just spend the money.  Doing the tax returns were not a big deal, depositing a $180 check was a whole other matter.

First you have to provide the bank with proof you are the guardian.  Here I am attempting to put the money into the account that has Ka’s name on it, where there is a certificate that I am a qualified trustee.  The account has been in place for over 10 years.  I never have had a problem taking money out. So, I had to provide a copy of the Certificate of Guardianship along with the deposit.  These sealed guardianship certificates have to be paid for.  The first check for the state refund required a certificate and it appears that they will need another one with the federal return.  This is exactly the same document.  No one knows how to handle these transactions.  You also get the vibe that the clerks seem to think you are stealing someone’s money.  It’s a subtle attitude but it’s there none the less.  Maybe it’s reasonable for someone to assume that if someone has a pay check and is getting a tax return that they are able to manage their own finances.  They are outsiders looking in and really don’t understand the bad spending when it starts.

This is one of the other problems dealing with a financial guardianship.  Nothing is easy.  

Yours truly,

Cupcake McQueen

Written by Cupcake McQueen

May 6, 2009 at 9:07 am

Lou

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Ka’s Ex-husband called today.  Lou and Ka were married for about two years.  I don’t think it was a marriage made in heaven but I think that he was and is a really good guy and would have worked hard to make the whole thing work.

After the divorce we lost touch.  I never got the straight story about what happened but what I know is that this was probably the beginning of when thing started to come unhinged.

Lou calls every month or so.  I love to talk to him.  He makes me laugh and he remembers Ka when she wasn’t ill, when she was funny and fun and mostly happy.  Lou doesn’t understand what happened.  It comes up every time we talk on the phone.  He asks how Ka is.  He still wants to talk to her, maybe just to hear her voice.

Today I told him about the phone.  I bought it, gave it to her, taught her how to use it and then she either turned it off or threw it away but she doesn’t answer and according to the phone guys, that she hasn’t used it, only two or three minutes were used; the time we used to show her how it worked.  

He asked me how it’s going.  I said fine, she’s taking her drugs and living in a nice place.  I didn’t say, I really don’t know.  She doesn’t stay in touch, and I really don’t know.  I’m stopping by this weekend but I’m not even sure she’ll answer the door.  I didn’t say that right now I just need a break from all these mental health people.  I’m not giving up but I’m getting close.  I’m hoping a break will work.

I’m glad we talked today.  I got a good laugh and made a good connection.  I just don’t know how to tell him that he really doesn’t want to see this, that he should leave his memories intact but I don’t know if I have the right to do this.  He really wants to talk to her.  I don’t think this is going to end well.  I don’t want him to be hurt.

Truly,

Cupcake McQueen

Written by Cupcake McQueen

May 1, 2009 at 9:24 pm

More Bad Behavior

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Here’s the latest article on the Courts mistreating someone with obvious mental illness. Would he have done this is the person appearing before him had cancer?

http://www.foxnews.com/story/0,2933,517382,00.html

Sadly,

Cupcake McQueen

Written by Cupcake McQueen

April 22, 2009 at 1:53 am

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Adult Guardianship

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One of the most difficult aspects of attempting to care for someone with mental illness is the need to have an effective way to find out what’s going on; to be allowed to get information and to advocate for your loved one even when they are too out of it to want you to.  You are frequently stymied  by the laws in place to protect a patients privacy as well as access to detailed medical information.  Add to the mix laws to specifically protect the mentally ill and to prevent them from being dumped into institutions or forced to take antipsychotic drugs without a hearing.  For a lot of what goes on you are forced to watch without a way to help or know what’s happening.   You can be sure you’re the last person to be called when things start deteriorating; when maybe you could intervene and come up with a plan to help fix things.  As soon as things go totally off the cliff, you’ll be the first one to be called.; then things are urgent and you need to move fast.  That’s when your bat phone rings and you are supposed to switch into super hero mode.

The answer to this conundrum is supposed to be the adult guardianship, a hard to get piece of paper that gives you legal authority over someone’s personal, financial, and medical affairs.  Brace yourself, it’s expensive and difficult to get, harder to use to get things done and frequently reinforces your role as a meddlesome relative getting in the way of the mental health burearcracy resulting in a barrage of forms and bad attitude but not much in the way of cooperation unless you have a lawyer in tow.  I am Ka’s legal guardian.  Here’s how it happened. 

Back in the 90s there was a period of time when Ka hadn’t left the house in almost two years, she was getting messages from the TV and was becoming more and more explosive in her behavior.  Add to the mix, she was living with my mother in a two bedroom apartment.  My mom had COPD and congestive heart failure and Ka thought she was faking.  (There’s a lot of illness denial in the family.)  When I reached the point where I was unable to navigate the whole mental health system another minute and desperately needed help to try to get Ka some help, I called a lawyer friend who referred me to a family practice lawyer, Doreen.

Doreen, who to my deep disappointment recently retired, is an angel.  She went into family practice and focused on mental health issues after her son-in-law murdered her daughter because he was convinced Doreen’s daughter had been taken over by demons He was going to liberate her.  As her son-in-law got sicker and everyone around them watched his decline unable to do anything, she worried about her daughter.  It was too late, after all there was privacy, patient rights, and the entire disbelief system that someone as talented and bright as her son-in-law could fall into this abyss so fast.  She knew but watched from the outside, painfully.  It didn’t need to explain to her what I was going through.  She just knew.

First she made a plan.  She reinforced that the Eviction ploy for getting someone with mental illness help was one of the only things we could use because Ka was over 21 and wasn’t about to cooperate on her own.  I didn’t like it then.  I don’t like it now but it was all we had in our arsenal.  She put the wheels in motion so we were in control at least a little bit.  

Then she took on the credit card people.  Ka had thousands and thousands of dollars of credit card bills.  Back then the mental health professionals told me it was due to the manic part of being bipolar.  Today, they don’t know.  Doreen told the credit card people that tey never should have given credit cards with gigantic credit limits to someone who hadn’t worked in years, had no credit history, and about whom they knew absolutely nothing.  She also told them to knock off the calls and the threatening letters.  When they fought back she calmly explained she would be more than happy to call the Washington Post and give them the whole story.  She would explain how the credit card companies had given Ka cards she shouldn’t have had and then when Ka’s illness caused her to spend wildly the collectors went on a “dialing for dollars” spree with constant calls to the house and threatening letters.  Doreen told them she would explain that Ka lived in my mother’s apartment and that this was causing my mother great stress and would jeopardize her health.  Oh yes, and law suit to follow.  That put an end to the credit card guys.  I don’t know the actual details but the calls and correspondence stopped.

Then we worked on a plan to see how we could get the mental health bureaucrats to be forced to give us information, to give us some ability to try to make sure Ka was getting help, to make sure they were n’t doing anything stupid.  It would provide us with the ability to make sure she was getting benefits or to get her benefits if she refused to get them on her own.   I could stop the credit cards myself it all this continued.  I could sign Ka’s tax returns and other documents to make sure things got done.  Doreen crafted the documents to go to court to get a Legal Guardianship.  This was a Guardianship designed for adults.  

Then you get to meet the bottom-feeding Guardian Ad Litems (GAL) who are supposed to work for Ka to make sure that I am not the evil sister trying to throw my sister into a Willowbrook like hell hole and steal her money.  You have to pay for the GAL, they generally don’t do much except slow down the process, they like to pretend that they are doctors insisting that they need to review medical records so you get to pay for them to pull the records and to pay for the visit with the doctor to explain the records.  The fact that Ka wouldn’t talk to the GAL, that we confirmed that she had been in the house for two years, was no good.  Then add that they wanted a current doctor’s evaluation.  Well, here’s the problem, what we were trying to do was get her help, to get her to see a doctor.  It took months and cost a fortune to get the GAL to file the two page document that essentially said, “Yep, Ka needs help.”

The Court finally agreed and we had a lovely sealed document that said I was Ka’s legal guardian with control over her health and financial affairs.  Aside from the lovely sealed document, it was supposed to give me access to information and allow me to participate in her care.

The problem with adult guardianships is that they are designed for people who are totally incapacitated or who are in nursing homes and can’t manage their affairs while they are managing their health.  When you have a guardianship for someone who swings back and forth between periods of being functional and periods of being totally out of it the system falls apart.

Being someone’s guardian is a big responsibility but it doesn’t give you much in the way of authority unless the patient was going to cooperate.  So, when Ka decided she wasn’t going to take her medication, there was nothing we could do.  After all I couldn’t force the pills down her throat.  When she was wildly ordering things from mail order catalogs, if I couldn’t get to her money, or her newly crafted credit cards unless I know about them.  Frequently The Voice and her cohorts refused to intervene with the US mail.  When someone lives independently, you’re ability to keep things under control is limited.

The Guardianship worked for getting the people where The Voice worked to send me forms once a year authorizing them to communicate with her doctors, etc.  They were very big on paperwork.  It didn’t do much about getting them to actually communicate with me.  It was good for getting the hospital to ask me to track down ridiculous amounts of paperwork and to pay for pills, but wasn’t good for getting them to return phone calls.  It was good for me being able to close Ka’s account but it isn’t stopping her from getting more credit cards.  

The Guardianship worked well when you yelled and threatened, usually with a lawyer in tow, but when you asked for cooperation and to arrange for some kind of information exchange, it didn’t work.  I think it because you were messing in the mental health world and you were unwelcome.  As I frequently had to remind people during these meetings, “Hey, I’m the only one in this room not being paid to be here.”  This is not for the faint of heart.

Sincerely,

Cupcake McQueen

Written by Cupcake McQueen

April 21, 2009 at 3:18 am