Working with the elderly. A life for me?
January 17, 2017 10:17 AM   Subscribe

I am interested in becoming a Certified Fiduciary. Can I make a decent living doing this?

I live in one of a handful of US states that licenses folks to do this job:

Note: This is not a bank fiduciary.

I've been working in Medicare for a few years and have a law degree (After many, many years, I'll be licensed next month.) I know how frustrating healthcare can be and am overall a very patient person. I've been looking for a way to enter a "helping profession" without being a direct caregiver.

I am all but done with Corporate America and wondered if the fiduciary role might provide me a way out but I can find almost no information about how much I might be able to earn. I'm not looking for untold riches but I live fairly well on my current salary. I am child-free with an SO who makes a good living himself.

Any ideas on salary (and perhaps what I can expect for day-to-day work life?)

posted by nubianinthedesert to Work & Money (4 answers total) 5 users marked this as a favorite
I have a few older friends who do this work and I've considered it as a second career. The article talks about hourly rates of $100-150 which is not chump change but also has to cover all the parts of this job particularly transportation etc. A big part of it is determining if there is a need for it in your community and if there is a decent enough sized population in need of this sort of services and/or if you can get official court-appointed work which is more regular. In some places there are support services already built into community services that do some of this. In communities, particularly affluent communities, with fewer of these services, this can be a great career.

Your law degree will be a HUGE help in this regard since you can provide legal services as part of this and not have to contract out for it. Depending on how you decide to do this sort of thing, a lot of it can be like a general contractor for someone's life, helping them get not just medical and legal assistance but also organization, house repairs, travel assistance, who knows. The hardest part of this type of work can be, form what I have heard, working with family members who may be concerned about their own interests or who may have differing views than what your clients want. And, of course, dealing with elderly populations where people may not be at their highest cognitive functioning and trying to do what is best for them which may not always be exactly what they want.
posted by jessamyn at 10:32 AM on January 17, 2017

I work in a related field and have seen ads for what looked like an entry level conservator job I think is similar to what you're describing, quite recently in fact. It's a county thing here so it pays better than comparable social work jobs. I think this one started at mid-high 60s (possibly a shock after law jobs) but also county jobs tend to have steps and this one ranged well up from there.

The day-to-day of that kind of job I'm not sure of and am curious as well. My guess is endless bureaucracy and a modicum of human interaction. If it's a county job where you are, it does at least have the advantage of a certain security and not much need to account for your time as you may have done in law jobs.

I imagine your background in Medicare will be quite helpful both in getting the job and in doing it.
posted by Smearcase at 10:38 AM on January 17, 2017

Could you possibly also take on work through an agency or organization as a representative payee?
posted by praemunire at 10:47 AM on January 17, 2017

My family hired a fiduciary to deal with an insurance billing nightmare that involved two different insurers fighting with each other. I believe that the fiduciary's rate was $80/hour, but this was about 5 years ago and in a flyover state. She seemed to have a lot of business; at least, she had built up a staff of several people working for her.

I was curious about the work and asked about what she did. She said that dealing with medical billing and insurance was a big part of the job. She mentioned that both elderly people with no family available dealing with complex medical issues and people who are incapacitated by unexpected medical problems (like an accident) can have hundreds of thousands of dollars of doctor and hospital bills. There are often mistakes in the bills, and mistakes in the insurance processing, and she can sort it out. She basically said (not a direct quote) that she and her people are more effective at dealing with this than typical untrained consumers because they know the typical bullshit moves insurers pull and they know how to call them on them. For example their files always have detailed written notes on the phone calls with the insurance companies that include the date, time, and name of the representative they spoke with, and they know how/when to escalate complaints, and that sort of thing. Plus they're basically infinitely patient and persistent.

She also told me a bit about other parts of their business. They can manage financial decisions for elderly or incapacitated people, maybe through powers of attorney? (I don't remember the details about this bit.) I think she also mentioned dealing with estate issues, which is discussed in the article.

In terms of day-to-day work life, it seemed like they spend a lot of time just organizing and understanding clients' mess of paperwork (that was certainly true for my family's issue), spending time on the phone with providers/insurers for insurance-related things, meeting with clients, documenting, organizing files, and other paperwork. Some time in court maybe for estate-related things?
posted by medusa at 10:52 AM on January 18, 2017

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