Podcast #133 Eldercare Is Episodic – Rick Northrup

This week I have a conversation with none other than an old family friend. And while I love talking to the experts out there, there’s something just kinda basic about about chatting with a friend who’s “been through it” with his parents and in-laws. What are the lessons he gleaned? What went well in their family situation? What are the pitfalls he has seen, personally and through his work? We talk about both the personal and the big picture of eldercare — how do we approach this stage, why is it so complicated, what do families need to know, and how can they prepare themselves for the later stages of people’s lives?

Transcript:

Diane Hullet: Hi, I am Diane Hullet and welcome to the Best Life Best Death podcast. Today my guest is a lot of fun for me because this is literally one of my oldest friends. Rick Northrup is somebody who, gosh, our parents were friends Rick, right? In the sixties. That’s right. And so when they had children, you know, Rick and his sister, Karen and I, we all knew each other.

So welcome Rick. Thank 

Rick Northrup: you. Thanks for having me. I’m really excited to be here. Yeah. I think we’re 

Diane Hullet: gonna have a good conversation because you know, Rick is a banker and comes from a financial background, but we’re not, we’re not here to talk about the nitty gritty of that today. We’re kind of wanting to get more into this big picture of how do we do elder care?

Why is it so complicated? What do families need to know and how can they prepare themselves going into different stages of people’s lives? 

Rick Northrup: Yes, that’s right. And, and I’ve had firsthand experience with a number of these situations, unfortunately. And Diane, as you and I were talking I, I, I, I, I dropped some ideas or concepts on you, and next thing you know, I’m on your podcast.

So thank you for having me. 

Diane Hullet: Exactly. We reconnected recently ’cause I’ve got a daughter down in Ann. Arbor and Rick’s in Ann. Arbor. So it was like, oh, hey, I’m gonna reach out to Rick. And in like, yeah, within like three minutes I’m like, you gotta be on my podcast. So I think Rick is just really a strategic thinker and that’s one of the things that I think is challenging when we’re in the middle of these kind of processes with parents or loved ones or aunts or uncles or spouses.

So, you know, how do you, where do you wanna start, Rick? 

Rick Northrup: I, I, and I think that’s right. It’s, it’s difficult what, when you’re going through it or when you’re in it, to sometimes recognize the bigger picture and what’s happening. And if you can do that. You can help yourself and others around you, including your parents, or maybe it’s your brother or sister or something that is beginning to have some age-related issues.

 You, you can make that path maybe a little bit easier. It’s hard no matter what. But the way I think about it is, is trying to help. People ahead of time and even while it’s happening to them. Cause these are typically slow, slow motion sort of We’re trainwreck, but they can be sometimes. And, and how to avoid that day.

Diane Hullet: Yeah, I think, I think that’s huge. And what you said I think is perfect. It’s hard. It’s hard no matter what. And sometimes choices we make or choices we don’t make, make it harder. Right. So what do you think people need 

Rick Northrup: to do? Well, and, and let me give you a little, a little bit of background. My my wife and I, we lost all of our, all four of our parents within a five-year timeframe.

 And my parents actually passed within 10 months of each other. And so we went through that. My sister also, which you, you, you made mention of, she lost not only our parents, but her in-laws. In that same timeframe as well. So we’ve seen a lot of this. And, and one thing the overriding thing that comes to me from all of those experiences are that elder care is episodic.

It, it’s not continuous, it’s not smooth, it’s episodic. And, and I think that’s Diane what, something that resonated with you when we were talking. 

Diane Hullet: Yeah, because I think we, we sort of think of it as a smooth ride, or we think of it as one crisis, but really it tends to be episodic crises with different hospitalizations, different health choices to be made.

A doctor retires. All of these are junctures, all of these are moments along this journey where decisions have to be made. 

Rick Northrup: That’s, yeah, that’s exactly right. And, and so the, the, the, the more professional way to, to reference all this is that, you know, elder care was event-based, you know, oh, I sound like I’m, you know, you know, some professor may, may, maybe I’ll write a book about this someday.

Right. But if, if, what I mean by event-based is, is just what you’re talking about. But it’s even more than. We’re in a care situation and now it, it’s become more critical or there needs to be more resources put at it. It even goes back to things like estate planning, right? And living long-term, living arrangements and, and things like that.

 So if, if you accept then that, that elder care is, is episodic and our, our minds. When we’re younger, we make plans and, and we can see into the future at, at some, to some degree. But as you get older, as our parents get older, they actually, you actually start losing some of that ability and you’re al also facing your own mortality and so forth.

So decision-making becomes hard. So if, if you accept that it is event-based and the changes that are needed aren’t really smoothly planned and executed against, they come at this time where, oh, somebody fell. Maybe they broke a, a hip or a bone or something. Now they’re in the hospital. Now they’ve gotta go to rehab.

They may or may not be able to be discharged back to their home. And, and it, it, you get these many crises and, and that’s really the only way elder care advances. Unfortunately. And so what my, my message is if you accept that it’s event-based. Then I, like I tell people at my bank, you know, now that you know that, what are you gonna do about it?

Right down. Yeah. Yeah. The, it’s, it’s well, okay, rather than complaining about it, if you recognize it now you can start to make some plans. And really, it’s, it’s pre-planning that happens. And, and so you, you that if you’re gonna do that now, you’ve gotta put your sort of your care team together, right?

Diane you know, who is providing care for people. Along with yourself and others, do you have siblings or friends, or is there extended family and you’ve gotta kind of marshal all these things so. And that’s a big bunch of concepts and things that I’ve unloaded on you. I dunno how, how that strikes you, 

Diane Hullet: your audience.

It’s great. Yeah, I think it’s great. This idea of looking at in the face and saying, this is going to be an events-based situation. Multiple things are going to continue to happen. And I can just react to those as they happen. Or I can do a little bit of thinking ahead and create a team to support me. But say more what you mean?

Like who’s on this team? What kind of team? What kind of pre-planning? 

Rick Northrup: Yeah, I’ll, I’ll, I’ll give you an an example. My sister and I, to have a real-life example, had the opportunity to take a trip with my parents the four of us. And we went up to Mackinac Island in Michigan in northern Michigan.

It’s a lovely place and it’s a touchstone for my family. So we went up there with my parents and we didn’t know what was about to unfold over the next 18 months. But my sister and I, who entered this with a good relationship already had the chance to sit down and talked through some things.

About my parents. My, my mom was beginning well at that point was already having some cognitive declines and she was on the dementia continuum. And my dad had been fighting cancer off and on for the prior, you know, five years. It would go on her mission and come back, those kinds of things.

So for us it was Karen and I. My sister Karen and I were the primary people on the care team, but also our spouses. My wife, Dawn and her husband Mark were kind of formed this care team, but we had the opportunity to sit down. On that vacation and talk about mom and dad and talk about the things that they had done and, and where we were going.

And we actually started to think about what if something happened to one or the other, what would we do? And I think that was the genesis for this. So for us, it was my sister and I and our spouses were the care team and not everybody’s family looks like that. And so it, it could be. You know, a, a son or a daughter and they may or may not get along with their siblings, if they have any.

They may or may not get along with their extended family, but I think it starts with recognizing who makes decisions and who helps make, who helps you make decisions in this process. 

Diane Hullet: Those are key. Who makes decisions and who helps make decisions. And I love, you’re like, you know, to say in my tagline here, it’s like conversations matter so much and in that case, for you and Karen, it mattered that it was face to face.

And it was on this vacation where you were seeing your parents and going, oh, we really, we see some things here. And if mom dies first, it’s one scenario and if dad dies first, it’s another scenario. And how do we kind of. Talk that through and begin to think about 

Rick Northrup: it ex. Exactly. And, and just because I say elder care is episodic doesn’t mean that they were ignoring the situation.

My parents had done a really great job in their estate planning years earlier. And so all of the financial resources and so forth were already put together and there was a, a smooth transition as they began to pass. They had purchased years, many years ago, a, a lovely ranch home in East Lansing with the express idea of being able to stay there as they got older.

 And they did, and it worked out well. So they were already living some of these things. They had already done some planning and, and been able to execute it against that. Now we’ve all seen, and I I’m sure everybody watching this knows of people whose parents just won’t admit what’s happening.

They don’t make the changes and they’re in living arrangements that they don’t, that aren’t suitable. They maybe aren’t seeing the doctors that they’re supposed to see and, and that just, those are terrible situations. 

Diane Hullet: They’re really hard and, and I, I’m unclear how to support people who do that except I think keep reaching out to friends, keep reaching out to siblings or.

You know, whatever is your group that will help you in this time. Because I think caregiving is so isolating. Mm-hmm. And decision making can be very isolating. 

Rick Northrup: Yeah. You can feel really alone if you’re early in this journey or you’re just getting information about what, what the future might look like.

Yeah. Be prepared to feel really alone. Be prepared for it to be hard, but again, there are things you can do to help with that. My, my piece of advice, my view is start thinking about, hey, if mom is gonna need to go to an assisted living place that, and because there might be memory care issues down the road, go find them.

 And find the ones that might fit with the resources that might be available, and if there might not be resources available, figure out what that looks like. Then again, I, I’m not a lawyer and I’m not here to give advice on that, but you can recognize we might have this change in living condition and it’s gonna require some resources.

What do we have and what facilities would we go to? Right? So my, like in my case, my sister and I with my mom. We had said, Hey, there’s, you know a place in East Lansing that’s pretty good. There’s a couple of other places that are good, but maybe not as good as the one we had in mind. And my mom actually ended up being in a memory care place here in Ann Arbor which was wonderful for her.

But we had already decided and started investigating which ones we wanted them to be in. Right, right. So you take those pieces, those, those big functional pieces of the future. And, and start working on them or, or pre-deciding Now estate planning and stuff requires your parents to, or, or whoever you care about, to actually do something while there’s still a, you know, sound mind.

You can find, you know, different living arrangements, you know, or maybe it’s in-house care. You know, and, and so there, there are steps as, as people progress through the aging process. But you go pre-decide those things with your, your care team, with your support team. 

Diane Hullet: Yep. And as much as, as much as can be decided early, or it doesn’t even have to be a decision, it can be a conversation that begins to move the needle.

I, I always think it’s so interesting. A friend years ago said to me, you know, Diane, you always kind of wanna jump to the answer. And she said, sometimes it’s just not that clear what the answer is. She said, clarify the trajectory. So make the one phone call that begins to get the ball rolling, send the one email that begins to have a conversation with somebody.

Go to three websites that you’ve been meaning to look at and actually spend some meaningful time with them. That begins to clarify the trajectory of what the answer will be, even if the answer isn’t right there immediately. 

Rick Northrup: E, exactly. And, and you can engage obviously with your parents or whoever it may be that you’re caring for or supporting.

 They may or may not be receptive to it, but you can still make that progress, gather information, confirm information, and, and have contingency plans sort of pre-decided. Because one, one thing that I see in the business side of my life is when, when, when there’s an with a, when there’s an event or something not right has happened.

You typically don’t have time to go get all the information and make a. A calm, rational decision. You whatever, you know at the time it happens, that that’s your universe of what, of, of your options. And so the concept of making sure, you know, the universe and, and pre-identify different paths. Then when it happens, you sort of, you know, break the code open and say, oh, in this case we thought mom should go to ABC care facility.

And we already have a relationship with them, or maybe even we put a deposit on the place years ago. Right. 

Diane Hullet: I learned too that in bigger you know, in bigger cities, there are gosh, what’s it called? There are. Wait 

Rick Northrup: list. 

Diane Hullet: There are wait lists and there are also people whose job is to do placement right?

And so you can placement coordinators depending on your metropolitan area, which is a pretty interesting option as well, because I spoke with one placement coordinator who said, you know, it’s not that I have one particular place that I feel is the best and that’s where I wanna put everybody. She said, it’s.

It’s a mix. What does the person need? Where are spots available? How soon does the family need this kind of placement? And so there’s a lot of factors. So she said, I, I get away from thinking there’s one best place. Many places are really good. If what’s memory care, what’s needed what’s super challenging.

And if you’ve not spoken of it prior to the event, it just is all that harder. 

Rick Northrup: Exactly, and, and that’s a good call out on the, on the coordinators because again, when something happens, when the episode is occurring, you can’t think clearly. You’ve got a lot of emotions, you get tunnel vision and you guys can look up what happens when you’re emotionally stressed.

You physically and mentally just look down a very narrow path. The, the coordinators can help you. And again, they don’t. Say, oh, everybody’s gotta go to 1, 2, 3 facility or ABC housing development. They look at holistically and they can help you make those decisions on the spot and augment your pre, your pre-planning, if you will.

Augment, 

Diane Hullet: your pre-planning. Yeah. In some ways I think it’s so powerful when I hear about your parents and my parents proactively move to places that were gonna be better for them. Right. That’s, that’s really, that takes a lot of chutzpah, you know? And I think our families both said, this is important.

We need to live in a one story house and we’re gonna do this now. And I don’t know how you felt. I mean, I think I felt like, oh gee, maybe it’s a little premature. Does it really have to be now? But. I think for my parents, they were really making that choice so that it was theirs. They were choosing it, they were figuring it out, and they didn’t want it to have to be in response or in reaction to an event.

So, you know, if you’re listening to this in your 40, 50, 60, I would say start looking ahead and thinking about what changes are gonna make sense for you. That don’t mean you have to make those changes at seventy-five or 80, which is 

Rick Northrup: right if you is your current. Physical space would it accommodate you if you begin to lose your mobility or your eyesight, for example?

 And if it’s not, what can you do? Is there a renovation or should you move? And, and these are difficult, difficult questions because resources are limited by nature. And, and trying to figure this out is hard, but. It doesn’t mean you shouldn’t think about it, right? Because when you know, so as again something happens you know, my dad had a fall and broke his ankle and while they were, while he was in the hospital, they discovered that his cancer was back to such an extent that they couldn’t treat, they could no longer treat him.

And so it is like, whoa, okay. But my sister and I had kind of already talked about that. We didn’t know that was gonna happen, but that situation, so yeah, planning around your, your, your space and, and your finances and, and so forth is really essential. I have two. You know, implications, I guess for what I’m talking about, if I may, Diane please.

 The first one is if you accept that elder care is episodic and changes needed, changes are only gonna happen once, they absolutely have to, you can’t go back to your home. It’s not a safe and appropriate discharge. Learn that language. Right. So if, if these if it is episodic and you wanna pre-plan, that care team is really important.

If you have a good relationship with your Sibs or other people that are helping you recognize that and try and make it better. If you have a bad or non-existent relationship, recognize that and try and work on it, because when these events happen, they’re gonna totally stress. Everybody out in the family and decide who the decision maker is, right?

You may be one of five kids who’s gonna make the call, and how will you do that around mom and dad, right? So this, you, the, the care group is really important and this will, the events will stress people out, work on that ahead of time. And then the, the other thing to recognize is that our parents or whoever it is, as they age.

Again, like you said, our parents did a good job of this and, and we live in a, a, a ranch house, right? Ourselves. Cause we’ve done some pre-planning, some of this stuff will happen. Pick up where maybe the next steps they haven’t thought about. And try and work on your relationship with, with the, the elder person as well.

So it’s conversations are important to use your language, Diane. And those are the implications if you accept that elder care only happens when events happen. 

Diane Hullet: Right. Well, give us some Rick Northrop has always had some excellent Northrop-isms. What are some of your other sort of sayings that you bring 

Rick Northrup: table?

Well, I’ve, I’ve laid two on you. Right. Elder care is episodic and now that you know that. What are you gonna do? What are you gonna do about it? Right? Yeah. What are you gonna do with that information? You know I have four rules at the bank where I work, and the first, and they’re, they app, they’re applicable here in some fashion, but the first one is don’t panic.

Don’t panic, and we’ve talked about that a little bit already because you get you, you get a mental and a physical narrow focus. Yeah. Don’t panic. And second rule in my work is it’s a team game. Utilize your team. Don’t put yourself on an island. Recognize if you’re inadvertently by yourself, and it is lonely.

We already established that elder care can be very lonely. So use your team again, your, your Sibs or your extended family. Get that organized as best you can, right? And then once you got your team together, make a plan. That, that, that’s the third rule at at, at work. Make a plan. So you’ve got your, your team has come together, you’ve made a plan.

And the fourth rule is work your plan. And like you said, Diana, if, if your plan is I just need more information, I’ve been meaning to go to that website, I’ve been meaning to call this place, you go ahead and do that. Work your plan. Right. Works plan. I love that. Yeah. So, so those are my. Those, those are my, my, my pithy, some of my pithyisms, and I’ve, I’ve got a, a ton that more relate to, to banking and so forth, but those, those can be applicable in, in, in any in any endeavor I believe.

I think you’re 

Diane Hullet: absolutely right. And I wanna go back to this team thing because I really, I’m so struck, like gosh, you know, so say you’re an only child, you’re the, you’re the only son and you live an hour from mom, and mom and dad are divorced and you know. You work full time. Mom is kind of in a home.

That kind of works. But at the same time, mom is starting to have memory stuff. How do you, what? Who do you want on your team? How do you even begin to formulate 

Rick Northrup: a team? Right? And well, and it starts also, you know, with talking with mom and dad as best as they can. Maybe still work the work, the problem with you.

How do you want this to go, mom? You’re gonna need more and more care and, and there’s a whole bunch of emotions and, and dealing with your own mortality and what the future may hold. But if you can begin having that and you don’t have, it’s not one conversation. It’s oh, here’s another pithy thing that I talk about, the conversation circle.

Just get into that conversation area and have discussions and talk. Over many different phone calls or visits about it. Just get in there and don’t, you know, ’cause you wanna say, mom, what do you want when you have to go to a place? What do you want me to do and how am I supposed to do this? You know, you can’t move in with you if you come in like that.

Nothing’s gonna happen, but just start talking about the future, right? With your mom or your dad, and what are their expectations? You’ll at least find out how unreasonable they might be. Well, I’m just, oh, you’re gonna quit. You’re gonna quit your job and you’re gonna live off my small pension and, and take care of me, you know the rest of the way.

Well, 

Diane Hullet: okay, I’m just gonna stay in this house and you’re gonna come help. 

Rick Northrup: Yeah, I, I actually know people whose parents have said that to. So yes, it’s the, the team and, and trying to organize your own support. You know, and yeah, if you’re, if you’re a, an only child and mom and dad are maybe divorced and in two different locations and they’re both having problems.

Get your own personal friends together, or maybe you’ve got some cousins, I don’t know. But again, recognize that you’re gonna need that help. You’re gonna need a team, 

Diane Hullet: right? In a way, it’s two teams, right? In a way, it’s team for the caregiver to support that person who’s the, who’s the frontline decision-maker.

Mm-Hmm. And then it’s team around. Mom, wherever mom is or dad is, right. We keep talking of parents, but that’s probably the most common scenario. So how do you create a team there? And I, I look at, I look again at my parents who live in a really small town, and I think they’ve done an amazing job because, you know, there’s new research out about the importance of not just close social networks, but even just the simple networks of going grocery shopping and saying hi to the same cashier.

Mm-Hmm. So I looked at my parents and I think, you know, they’ve done a pretty good job of creating these. Micro social moments with people in their small town and then they’ve created relationships with friends their age and friends who are younger and you know, they walk so they say hi to their neighbors.

Yeah. So just those kinds of simple things are a bigger safety net for them mentally and socially. Someone would notice if they weren’t okay. You know? Yeah. So they kind of created a team and then my brother and I look at, okay, how are we a team moving forward and what do we need to do to support them?

And I think it’s really important. You know, my brother said a great thing the other day. He said, you know, I’m not trying to tell them what to do. He said, you know, I just wanna support them in what they wanna do. And I think not everybody feels that way. A lot of times kids end up being the one who come from outta state and start boss and mom and dad around.

Rick Northrup: Right, right, right. Yeah. Well, and and without getting into too much of old home, wake, your brother’s a special person to me as you are. ’cause we’ve, our parents met at Michigan State University and, and, but we’re friends the whole time. But yeah, that’s true. And, and that’s another, pitfall that people get into is you get frustrated with mom and dad ’cause they’re not doing what you want them to do.

And there’s, they’re still here. They, they can still decide things for themselves and it’s very hard to accept that. And that’s a, that’s a, a big trap that people can fall into. You end up. Hurting your relationship with, let’s just stay with the parent model because you’re, you end up haranguing them off the whole time and they know that, that you’re nagging them and haranguing them, and they know that, that you are as disappointed in them, but yet they’re mad at you because you’re not letting them.

Live their life. And, and again, it goes back to that relationship and that, that conversation that you can have. But at the end of the day, you gotta do, you need to support them and you wanna be energy giving as, as much as possible because what, you know, everybody goes through and hopefully Diane you and I someday will be, you know, old enough to be aging out like that.

 You know, that’s, that’s hard on its own for mom and dad. And to, to come at them with, with both barrels and tell ’em they’re not doing it right and how hard they’re making it for you. You know, that kind of thing. You can, the relationship with your parents is really at risk 

Diane Hullet: in these things. Yeah. Yeah.

My parents had a wonderful friend who was a very active person and he had some rounds with cancer and every time something difficult would happen between the cancer or he’d have a birthday, he’d say, Hey, consider the alternative. You know, he just really lived, like every day was a gift and he didn’t know when it was gonna end, right.

So I think that’s really a powerful reminder to us, no matter what our role is. And we’re really talking here about roles. I think that’s interesting too. So our roles as children, our roles as parents, and how do we, you know, break some of those open so that it can be a bit, you know, less from that tight role of childhood and more into supportive adult relationships.

Rick Northrup: And, and if you want to crack open the, the support team, and let’s say it’s, it’s you know, you and maybe a sibling or two, and then the spouses, right? It’s amongst the siblings. That’s the decision-making group, right? The spouses are the supporting group, the sounding board, the generating ideas and so forth.

But I’ve seen these things go sideways where the spouses or the in-laws, the married, into the, that group, begin to try and assert themselves or make decisions. And now that, now they’re, that that group dynamic has gone bad and mom and dad still need help and, and, and need help making decisions. So, and that was.

I think my sister and I were the exception, not the rule. We were very clear with each other that, that we were making decisions for our mom and dad and when our spouse’s parents were passing, we were supporting our spouses giving ideas and so forth. But it was Dawn and it was Mark’s call to make. Yeah.

And, and, and that can be hard in a supporting role as well. Well, 

Diane Hullet: I just reach out to your little sister and find out if it really went as good as the big brother says. 

Rick Northrup: You should. You should. Hey, she’d love to hear about you, and I believe she’ll say yes. I’m sure she would actually. We, we have such a good relationship.

 We, we just built a home in a small town next door to downtown Ann Arbor and, and again walking grocery store around the corner, those kinds of things. My sister went and bought a house two blocks away that, that she rents so that she can live here when she retires. So isn’t that 

Diane Hullet: great? That’s, I think it says we were okay.

I think you were okay. I think you were pretty good. Well, Rick, I appreciate your time so much and just the way that you kind of think about these things and I, and I hope have given listeners just some food for thought on this big picture approach to elder care and how event-based or episodic needs a team and needs an understanding of that process.

And hopefully with that understanding and conversation, people can figure out what it is they wanna do. Thank 

Rick Northrup: you. Exactly. I, I am so glad that, that you had me on. And then I can sort of share my, my pithy statements and homespun wisdom around all this. But yeah, if it’s episodic, just try and pre-plan as best you can.

Get your team together and keep them together as you go forward. None of it’s easy. Gonna, none of it easy. None of it. 

Diane Hullet: It’s gonna, well, maybe we’ll make that the title of this podcast. None of it’s easy. No, 

Rick Northrup: none. None of this is easy. But thank, but thank you again. 

Diane Hullet: Thank you, Rick. As always, you can find out about the work I do at bestlifebestdeath.com, and I’ve been talking today to Rick Northrup from Ann, Arbor, Michigan.

Thanks, Rick. 

Rick Northrup: Thank you.