Carolina Conversations: An Interview with Amy Natt, Aging Outreach Services President & CEO

by Amy Phariss | Photography by Mollie Tobias & Morgan Masson

Twenty years ago, newly-landed in Moore County from Oklahoma, Amy Natt quit her job at a long term care facility and announced to her family, “I’m starting my own business. There has to be a better way to care for older adults as they age. I’m going to find it.” Two decades later, Amy and her staff run an elder care firm advocating for older adults, connecting those who wish to age in place and in the comfort of their homes with caregivers, identifying community resources, and developing individualized care plans to make this possible. It is consumer directed care, at its best, driven by the individual’s desires and vision of aging. From the nitty-gritty details of running a business to lobbying in Washington D.C. on behalf of caregivers and seniors, to publishing this very magazine as a means of providing resources for the community, Amy Natt has followed her passion of helping older adults live life on their own terms. Whether it’s navigating a crisis, finding the perfect caregiving situation, linking clients with services or advocating on behalf of the community, Natt believes not only in her mission of helping adults age in place and secure quality care in individual situations, but also that her role as a business owner and mentor fill her personal need to give back to the community, mentor other professionals and leave a legacy of her own. 

Amy Natt sat down with OutreachNC’s editor Amy Phariss for a glass of wine and a chat about where her passion for aging on one’s own terms comes from, how she sees her role in this arena and what she hopes to achieve through her community involvement
and support.

This interview has been edited for length. 

Amy Phariss: How did you get into this field?

Amy Natt: Experiences growing up. Both of my grandmothers lived in Illinois, and during summers we went and stayed with them. My great-grandmother, Little Grandma, and I shared a June birthday. Every summer we spent our birthdays together. When I was 12 or 13, Little Grandma (Winifred) was placed in a nursing home. That had a really big impact on me. Then, during summers, we would go visit LG in the nursing home. We would do arts and crafts and eat together. I would write to her, and she would take my letters and flip them over and she would write them back. In retrospect, she probably had Alzheimer’s or dementia, but at the time I only knew she had hardening of the parties (arteries). Then in college, I was studying family relations and child development, but I felt drawn to older adults like my grandmother. I realized I could focus on gerontology, so I did that. I had no idea what I could possibly do with that degree, but it felt right to me. I wanted a graduate degree, and I got into Oklahoma State University, which had a graduate degree in gerontology. Nobody even really knew what it was. OSU was one of the few schools that even had the program. When I graduated, nobody knew what I’d actually majored in. I was 23 and engaged to my oldest son’s dad who got a job in North Carolina with Purdue Farms. We moved here, not knowing it was a retirement community. I tried to find a job, but nobody really wanted someone with a gerontology degree. They all wanted social workers, and I wasn’t a social worker and didn’t want to be one. I ended up teaching aerobics and slowly began working within the community. I was an activity director in a long term care facility and then I was working as a director for a start-up Alzheimer’s unit. One day, I quit my job and decided to start my own business. I was pregnant with my first child, and my husband looked at me like I was crazy. My dad lived in Florida at the time and was sending me brochures about care management, which was a big deal in Florida. I read about it and thought: I can do that. So, I did. 

AP: What was it about the nursing home experience with your grandmother that impacted you so much?

AN: It was how depressing it was to me as a child, to watch someone I loved go from a home environment to a facility setting. At the time facilities could still restrain people. I don’t know why they restrained her, but at times they did. Perhaps it was for her own safety, but it was still hard to see. Nursing facilities today are greatly improved but it is still difficult to see loved ones make that transition. When I worked in a similar setting, I realized a lot of care delivered was driven by meeting minimum state requirements or insurance reimbursement criteria. The budget and the staffing and what insurance would cover was often a significant factor in the care provided. Some days I would go home in tears, frustrated. It was like experiencing what I saw in my childhood with my grandmother but from
another side. 

I felt helpless at times. I felt helpless with my grandmother and then again in the facilities as an employee. I realized there had to be a way to improve the quality of  the aging experience. 

AP: What has surprised you most about this field and about working with older adults and their families?

AN: I think it’s how unique everyone’s story is. When you get to know people on the individual level, you see how rich and unique their lives have been. The stories and the things I’ve learned from the people along the way was surprising. It’s easy to forget the human part of it when you work in a nursing home, but even now, in people’s homes, you get to know people and their families. Maybe it’s not such a surprise but more of an underlying benefit of what I do; I get to know people on a more human, personal level.

AP: What is the biggest misconception about older adults?

AN: I think we look at them and don’t see them. We forget the life they’ve lived and the experiences they’ve had that have led them to where they are. You just see the person in front of you. You think they’re not engaged or with the same drives and desires, but if you sit and talk to them, the 90 year-old has the same desires as younger people; we just don’t acknowledge them anymore. 

AP: What do you think we can do as a society to make better environments for older people?

AN: I think it’s treating them as individuals and allowing for plans and treatments created for the individual, sometimes outside of the box. If you look at other cultures, there seems to be more respect for the elderly than there sometimes is in ours. 

I’m a huge fan of inter-generational interaction. The young learn from the older adults and vice versa. I’d like to see more of that. 

Also, we’re living so long in our society, it’s difficult to balance quality with quantity. People are living well beyond 90, so how do we continue quality care for so long? And as families are spread out, it makes it more of a challenge. 

AP: What can family members do to help older adults?

AN: Talk about it. Prepare for it. Don’t wait until there is a crisis. People often go crisis to crisis instead of planning ahead for a loved-one’s care. 

AP: What would you say older adults are most
excited about?

AN: I think it depends on the person. That’s the problem. You can’t stereotype people into a category. Some people are excited to slow down if they worked a lot and had a busy life. Some are excited to spend time with family and loved ones. Some are excited to give back to society. That’s the issue: it depends on the individual person’s values. 

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AP: What are they most afraid of?

AN: I think some of them are afraid that they haven’t left their mark. They haven’t contributed what they’d hoped for. They fear what happens next, what they can’t control. Grief can often be involved, and a lot of that grief is unsettled. 

AP: What are some of the struggles family members have with older family members? How have you seen children and grandchildren deal with it better than others?

AN: I think siblings and spouses process differently, so some siblings may think about the financial aspects, or emotional issues, etc. Siblings end up fighting and there is family conflict. You see conflicts about money and financial exploitation and abuse. I think money can bring out the worst in people, so if you come to the end of a person’s life and there is a cost attached to that, it can be divisive. In today’s society, when family structures are less traditional (divorce, distance, re-marriage, etc.), it can be a challenge to decide what’s best for a parent. It’s different from the days when mom and dad were on the family farm and would stay at home and be cared for by the family as a whole. It’s different now, and with that change comes some challenges. 

My favorite outcome is when we see families and adult children put what the older adult wants first, above what the kids want, what money dictates, etc. You see some really neat situations where families are willing to come together to provide care and let the older person age the way they want even if the kids don’t necessarily agree with it. When other people forgo their opinions to allow for the loved-one to age in their own way. 

I have loved to see adults who live their way, on their own terms. Those are the people who stick with me. 

Safety is always a concern. Safety and wellbeing always have to be considered, but family members have to also consider the person and his or her choice. 

AP: If you could sum up your work in three adjectives, what would they be?

AN: Challenging, rewarding and human. I problem solve. It’s like a big puzzle. It’s someone’s life, and I get to have an impact on how it ends. I play a role in someone’s story, and the weight of that isn’t lost on me. I want to get it right and honor the person. It takes a lot of creativity to help someone end the story on their own terms, but to me that’s success. I deal with challenging problems, which is rewarding and, at the end of the day, it’s all about the human, the person, the individual. 

The stories that stick with me are two kinds: the ones who get to live on their own terms until the end or the ones where a family member won’t let that happen. Both stick with me. It’s really hard to watch situations to see people not have control, not live out the end of their lives on their own terms.

If you ask 10 different people how they want to live out the end of their lives, you’re going to get 10 different answers. 

One of the experiences that stuck with me the most or had the biggest impact was being with someone at the end of life as they took their last breath. It’s a compelling and profound experience. Seeing someone pass on has been, curiously, one of the best experiences, knowing you can be there, can be with someone in that pivotal moment. It’s powerful. 

Touch is a very powerful thing at the end of life. A lot of people forget how important touch is. Older people still have the same needs and desires. Something as simple as putting lotion on someone’s hand can matter. Just sitting with someone, holding their hand, becomes really important. It gives each person a sense of consecutiveness and belonging. 

I can remember a few people who I’ve been with at the end of life, giving them permission to let go, reminding them that they have been loved, that they have lived well and that they can go.  

Each of us has a certain calling in life. I’m very type-A and business-minded, but at the end of the day, my passion is for this population, and this is the path I am called to take. I am a huge believer in the fact that if you know you can make a living by working with your passion or your calling, that’s the best way to live, to make a difference doing what you’re called to do.  

AP: What have you learned from following this calling?

AN: To follow your dream and your passion and love what you do. If you are going to have a career that will span 20+ years, you have to love what you do. The hidden part of my career is mentoring other young people who want to work in a field they’re passionate about, to go to work every day feeling empowered and good about their work. It’s important to me to create and foster an environment where people feel empowered to follow their passions. I lucked out that I have enjoyed both being a business woman and working in gerontology. It’s hard work. I sacrificed. But I feel really lucky.