In this episode of Caregiver Conversations, hosts Kristie King and Antonia Harbin Lamb sit down with Natalie Joyner to discuss the unique challenges and triumphs of being an only-child caregiver. Natalie shares her deeply personal journey of caring for her mother, navigating the complexities of the healthcare system, and finding emotional and logistical support along the way. From advocating for her mother’s needs in a flawed system to managing the emotional toll of caregiving, Natalie’s story is both a reflection and a guide for others facing similar situations. She also emphasizes the importance of self-care, building a support network, and planning ahead for long-term care. This insightful conversation sheds light on the realities of caregiving and offers valuable advice to those on their own caregiving journey.
Guest: Natalie Joyner
Hosts: Kristie King and Antonia Harbin Lamb
Topics Covered:
Contact Information:
Natalie Joyner
Southeast Michigan Senior Regional Collaborative (SRC):
Elder Law and Advocacy Center (ELAC) : Phone: (313) 937-8291, nlsmichigan.org/elder-law/
Kristie: [00:00:00] Welcome back to Caregiver Conversations, where we dive into the stories, insights, and strategies that matter most to caregivers. I'm your host, Kristie King, Executive Director of the Southeast Michigan Senior Regional Collaborative.
Antonia: And I'm your co-host, Antonia Harbin Lamb, Staff Attorney at the Elder Law and Advocacy Center and Program Manager of the Great Lakes Legal Mediation Division.
Today, we are honored to welcome Natalie Joyner to the show.
Kristie: Natalie has over 30 years of experience in healthcare, specializing in community health, population health, and public health. She is a servant leader with a mission to address disparities and inequities in disadvantaged communities.
She is also a fellow in the American College of Healthcare Executives, meaning she is certified in healthcare management.
Her expertise, combined with her personal experience as an only-child caregiver, brings valuable insight to today's discussion.
Antonia: Welcome to the show, Natalie. It’s a pleasure to have you.
Natalie: Thank you. Thank you. My pleasure. [00:01:00] I appreciate the opportunity.
Antonia: Let's start by talking about your experience as an only-child caregiver. What unique challenges have you faced in taking on that role alone?
Natalie: First, I just want to say that I am no longer actively caregiving. My mom passed in 2022, so this will be a reflection on my experience. And you know, if I knew then what I know now, there are definitely things I would have done differently.
Being an only child was both a blessing and a challenge. On one hand, I didn’t have to ask anyone for permission—there were no family meetings to decide what to do about my mom’s care.
That was the blessing.
But it was also the curse—I didn’t have anyone to bounce ideas off of or someone to share the journey with.
I was fortunate to have a great village supporting me throughout the process, and that helped me tremendously. But yes, being an only child can be both empowering and isolating.
Antonia: I can definitely see that. But like you said, you didn’t have to deal with the family conflicts that can sometimes arise when multiple people are involved in caregiving decisions. You had the autonomy to make decisions for your mom, and that must have provided some peace of mind.
Natalie: Yes, absolutely. My mom and I had a very close relationship. As her only child, we had been through so much together, and I found comfort and peace in knowing I could make the best decisions for her.
Kristie: So, Natalie, I know you personally, and I always like to be transparent with our audience. Over the years, we’ve become very close friends, even though we haven’t known each other that long.
I remember when this journey first started for you. I’ve worked in senior care for years, and you were my counterpart in another department.
What were the first signs that something was changing for your mom? As an only child, how did you handle not having a sibling to check in with and share concerns?
Natalie: In the beginning, it was overwhelming. I kept thinking, Who can I turn to for help?
And you know, in our culture, we want to keep our loved ones at home as long as possible. We believe nobody treats your mom the way you do.
But I was struggling to balance everything—work, caregiving, and raising my young daughter. At that time, I had no idea what direction to go in.
Kristie: How did you manage the emotional aspect of it? Because beyond just knowing the steps you needed to take, there was also the emotional weight of it all. At the end of the day, that’s still your mom.
Natalie: A lot of prayer and meditation. I spent hours researching online, trying to understand what I needed to do next. I really leaned on my faith during this incredibly overwhelming time.
Antonia: At what point did you realize that you needed help?
Natalie: I knew I needed help when my mom started getting her days and nights confused.
At bedtime, she’d be up asking, What’s for dinner? What’s for breakfast? I’d have to explain to her that it was 9 p.m. and time for bed, but she just couldn’t grasp it.
After about a month of this, I realized something had to change. I wasn’t getting enough sleep to function at work, and more importantly, I wasn’t present for my daughter.
Then, whether it was divine intervention or not, my mom got sick. I had to take her to the hospital, and at that moment, I already knew I couldn’t do this alone anymore.
But in our culture, we don’t put our mothers anywhere—we take care of them at home.
When the hospital staff told me that my mom couldn’t go home without 24-hour care, I was completely unprepared.
I had flashes of memories—her leaving the stove on, opening the door and forgetting to close it, banging on the window, and the neighbors calling me.
It all made sense now—she needed full-time care.
But my biggest question was: How am I going to afford it?
Kristie: Yes, and that’s the reality that so many caregivers face.
Natalie: Exactly. So from the hospital, she was transferred to a long-term care hospital for observation.
This is where my frustration with the system started. The hospital checked her in as an outpatient, not an inpatient—even though she was there for 24 hours.
From an insurance standpoint, this meant she wasn’t eligible for certain resources.
In order to access those resources, she had to be reclassified as an inpatient. With the help of a great social worker, we were able to transfer her to another facility.
She had to stay for at least five days as an inpatient before I could figure out what came next.
During those five days, I kept asking myself:
I had never been through anything like this before. And no one in my family had either—because most of them had siblings or spouses to help share the responsibility.
I felt completely alone navigating the next steps.
Kristie: And then came the biggest decision—what happens next?
Natalie: Yes. I had to come to terms with the hardest realization—I was going to have to place my mom in a skilled nursing facility.
But how do I tell my daughter that Grandma is never coming back home?
How do I explain to my family that I had to make this decision—even though none of them stepped up to help?
At that point, I knew, I can’t do this alone. I have to take care of myself too.
Natalie: But I would definitely say that if anybody finds themselves in this situation, they should talk to the people in these facilities. They are the experts. They know how to—I'm trying to be very careful with my wording here—navigate certain bureaucratic red tape within the system because, honestly, the system does not work in favor of the caregiver or the one receiving care.
Kristie: How did COVID impact this journey, this transition, and everything that needed to take place?
Natalie: Well, as I mentioned, my mom passed in January 2022. At that time, she had been in the facility for a little over 18 months—essentially, all through COVID. It reached a point where everything was shut down, and I couldn't visit her.
If I wanted to see her, they would have to bring her downstairs outside, which was incredibly difficult. I emphasize this because, as I mentioned, my mom had dementia, and she was in a locked-down unit. Bringing her out of that unit took a lot of effort, and one of the worst things you can do for an individual with dementia is abruptly change their environment.
Bringing her out of her unit, putting her in a wheelchair, and taking her outside—it just wasn’t good for her. I only did that twice, and I could tell right away that it wasn’t the best decision. The last time I did it was in late October, and the weather was starting to change. They bundled her up in blankets since she didn’t have a coat, and it hurt me to see her like that. She was only outside with me for about five minutes before I told them to take her back inside.
During COVID, we also tried FaceTime calls, but she didn’t understand them. She didn’t grasp why she could see me on a screen but not in person. After a while, she refused to use the iPad altogether because it was just too confusing and upsetting for her.
Eventually, my only option was to call the facility regularly and pray that the staff would be honest with me about how she was doing. But they also knew that if I wasn’t comfortable with their responses, someone—whether it was me or one of my friends—would be at the front door.
And honestly, I think they realized early on that I was a no-nonsense caregiver. Within her first week there, I had already called the state because I don’t play when it comes to my mom. I remember one of the staff members telling me, "We haven’t had a visit from the state in a long time," and I knew exactly what they were implying—I was the reason they got one.
At that time, I was also working for a governmental agency. One day, I went into the facility wearing my badge, and I could tell it changed the way they saw me. Suddenly, they didn’t know who I was or what kind of influence I might have. And I used that to my advantage.
After that, I had a greater sense of comfort knowing they understood I was going to hold them accountable.
COVID, in many ways, was both a curse and a blessing for me. It forced me to detach, which I had no choice but to do. Before COVID, I was visiting my mother every day, taking her laundry home to wash, feeding her, and ensuring she was well taken care of.
Even when I had to go out of town for work, I made sure my friends went to visit her in my place. One of my girlfriends, knowing that I always did her laundry, started taking her clothes home to wash them for me. Another friend, who is a nurse, went to visit and used all the medical jargon with the staff—just to remind them that someone was always watching.
That worked in my favor.
Eventually, even before COVID, I had to start cutting back on my daily visits because it became too much for me. My daughter was only eight or nine years old at the time, and I had responsibilities to her as well. I couldn’t be everywhere at once.
So first, I went from visiting every day to every other day. Then, to every third day. Then COVID hit, and suddenly, I couldn’t visit at all.
That was an adjustment.
At first, I insisted on FaceTiming with her just so I could see her. I didn’t even need her to see me—I just needed to see her and know she was okay.
But as time passed, something in my spirit told me to calm down. And as you know, Kristie, I’m very meticulous. Everything has its place. But when it came to my mother, I had no control over what was happening, and that caused me a lot of anxiety.
COVID forced me to step back.
I had heard about people doing drive-by visits at nursing homes—where the staff would bring residents to a window so their loved ones could see them from outside—but I didn’t even want to put my mother through that.
So yes, COVID was incredibly difficult. It was a tragedy for so many people. But for me, it also served a purpose—it helped me detach and embrace my relationship with my mother in a different way.
Antonia: That’s really interesting, Natalie. As you were talking, I kept thinking about how difficult COVID was for everyone, especially for caregivers. Even in my own caregiving experience, it was incredibly hard.
But something else stood out to me—you were not just an only child caregiver. You were also a sandwich caregiver, and that’s something we don’t talk about enough.
You were taking care of your mother while also raising your daughter. You were caught in the middle, balancing both responsibilities, and that brings a whole different perspective to your experience.
You also mentioned the healthcare system, and I can see that you were a strong advocate for your mother. That came through so clearly in your story.
As an attorney, I advocate in a certain way. But you were there—showing up, being present, and making sure your mother got the care she needed. That’s a different kind of advocacy, and it’s just as important.
I want to go back to your experiences with the healthcare system. You touched on some of the challenges you faced, but was there anything else you’d like to share? Maybe some insights that could help our listeners navigate the system?
Natalie: Mm-hmm. And the money I made—it was enough for me to maintain my household, but not enough to cover everything. So, once I had all the applications submitted and in process, it was like I was working on two things at once. I had applied, but I also knew I hadn’t yet spent down the money, so I had to figure out how to do that.
One of the things I found so interesting—something I didn’t expect—was that they came back to me and said, “Oh, your mother has stock.”
Stock?
I had no idea my mother had stock. Apparently, some stocks were left from my father working at Ford for 43 years. And I’m just sitting there wondering, How did they even find this out? I lived with my mother, and I didn’t even know she had stock.
So, then I had to figure out what to do with it.
I had to sell the stock, which, of course, just put me in another Catch-22—more money.
Kristie: Right.
Natalie: So I’m just thinking, I can’t hide anything. They know everything. No matter what I put on paper, they still knew more than I did about my own mother.
I sold the stock, and I would say the next hardest part for me was planning my mother’s funeral—while she was still alive.
That felt... morbid.
I knew her colors. I knew what she wouldn’t want. I knew she didn’t want to be cremated. But still, sitting there, making those arrangements in advance—it was tough.
Then, I had another unexpected issue. While reviewing her assets, I discovered that they counted the burial plots she had purchased over 40 years ago as property.
Kristie: Wow.
Natalie: Right?! I was shocked. That’s not something you typically think of as real estate, but legally, it is.
And that meant it had to be factored into the financial equation for Medicaid.
I had to make sure they understood: You can’t take this property away from her. You can’t take money from her estate because of this. This was part of her final arrangements. That really blew my mind. Because when we think of property, we think of houses, land—not burial plots.
Kristie: Yeah.
Natalie: So, between the burial plots, the money she had, and everything else, I planned her funeral at a moderate cost. I didn’t go overboard because I wanted to make sure everything was covered between her insurance policies, her funds, and other arrangements.
When it comes to the system, you have to work the system. The system is not designed in favor of caregivers.
Once I got through that process, I finally had a sense of relief. I knew my mother was taken care of, her final arrangements were set, and financially, I had done everything I could to make sure she would be okay.
Then, I had to shift my focus back to getting her out of that facility.
And as an only child, there was no one to run this by. No one to help me decide. It was all on me.
That’s when I turned to my village.
I may have even had conversations with Kristie about this. But I remember my close friend, who is a nurse, came over and gave me some perspective. She said, Remember, a skilled nursing facility is a skilled nursing facility. It’s not the Marriott or the Ritz-Carlton.
Kristie: Right, managing expectations.
Natalie: Exactly.
And I was frustrated. I didn’t like going there and not being able to find my mother’s clothes. I didn’t like the smell in some areas. It seemed like my mother was the lowest priority because they had to focus on residents with greater medical needs.
But my friend asked me: Are they taking care of her health? Does she have bedsores? Is she losing weight? Is she being groomed properly?
And I had to admit—yes, they were taking care of her.
Then she asked, Are the nurses approachable? Do they communicate with you? Have you had any trouble getting in touch with them?
Again, my answer was no—I hadn’t had any issues.
And my friend reminded me, You already have relationships with the staff. They know you. They know your mother. If you move her, you’ll have to start all over again. But more importantly—how is your mother adjusting?
I thought about it, and I realized she was doing well.
She asked for her favorite treats, and they gave them to her. She was eating, she was clean, and she had settled into her routine.
And then it hit me—I had said earlier that you shouldn’t change a dementia patient’s environment too suddenly.
If I had moved her, I might have made things worse.
Kristie: Let me ask you something, Natalie. At what point in this journey did you realize that you were not just her daughter, but a caregiver?
And even more importantly—when did you recognize that you had to start taking care of yourself? Because Antonia mentioned the sandwich generation earlier, and that’s a huge part of your story.
Natalie: I would say I realized I was a caregiver the day I had to take my mother to the hospital.
Before that, I was just… doing what needed to be done.
Kristie: Because before that, you were what?
Natalie: The hamster on the wheel.
Kristie: But also—a daughter.
Natalie: Right. I was just her daughter. Doing what daughters do. Keeping our routine, taking care of her, taking care of my daughter, going to church, going out to eat.
I was just Natalie.
Winnie’s daughter.
Taryn’s mom.
But that day—when I had to take my mother to the hospital—that’s when I realized, Oh my goodness. I’m a caregiver.
And then I thought: And I’m not taking care of myself.
Kristie: Yeah. So how did that change?
Natalie: I had to be intentional.
Whether it was getting a pedicure, taking myself out to lunch, or just unplugging—I had to force myself to take care of me.
And that was hard.
It was easier to unplug from my mom sometimes because she was in the facility. But unplugging from my daughter? That was tough.
She’d say, Mommy, Mommy, can we go see a movie? And sometimes I would take her—just so I could sit in the dark theater and take a nap.
Kristie: Yes!
Natalie: I’d get my popcorn, she’d be happy, and I could just breathe for a moment.
That’s when I realized I was a caregiver.
And that’s when I knew I had to put myself in the equation.
I had to schedule my self-care, just like I scheduled everything else.
Getting my nails done. Going out to eat. Spending time at church.
Kristie: Mm-hmm.
Natalie: And my church was such a huge support system.
At first, I don’t think they realized what was happening. My mother used to come to church with me all the time. People would greet her—Hey, Mother!
And then, suddenly, she wasn’t there anymore.
And people started asking, Where’s your mom?
And every time I had to answer that question, it was like another weight on my chest. Because for us—especially in the Black community—placing a loved one in a facility isn’t always understood.
Kristie: Right.
Natalie: People will look at you differently, like, Oh, you couldn’t handle it? You put your mother somewhere?
But once my church family understood, they embraced me in a new way. Instead of judgment, I felt compassion.
Kristie: And sometimes, that’s all you need.
Antonia: Looking back, is there anything you would have done differently in your caregiving experience?
Natalie: Yes. I would have tried to put things in place earlier. You know, we don’t like to talk about these things. Now, mind you, I had all my mother’s paperwork in order—her will, power of attorney, medical power of attorney—but I never thought about caregiving itself.
That was an aha moment for me.
We need to pay attention and put energy into planning for caregiving expenses before we even get to that point.
And I thought about my own daughter. She’s an only child, just like me. I wouldn’t want her to go through the same struggles I did. Some of the experiences shaped me, and I appreciate them for that, but I wouldn’t want her to bear the burden in the same way.
So, I would say:
And looking back, I wish I had taken better care of myself, both before and during the process.
Kristie: And even before the process, you didn’t realize you were in the process.
Natalie: Exactly!
Kristie: That’s why I asked that question—when did you recognize you were a caregiver? Because one thing we emphasize a lot on this podcast is that people often don’t identify as caregivers.
You hear people say, Oh, I just take my uncle to the doctor once a month.
Or I just drive my mom to dialysis.
Or I help with errands, but I’m not really a caregiver.
But all of those are caregiving experiences.
Natalie, your journey as an only child caregiver has given us so much insight. But I also think that even people who have siblings can relate—because sometimes, despite having a family, you still feel like you’re carrying everything alone.
Your wisdom and reflections today will help someone out there in the caregiving community.
Before we wrap up, how can caregivers who are struggling or looking for resources connect with you?
Natalie: Well, I don’t consider myself an expert—
Kristie: But you are an expert in your own caregiving experience.
Natalie: That’s true. I’ve lived it. If anyone wants to reach out, they can email me at nmdean@comcast.net
But I would also encourage people to connect with organizations based on their loved one’s condition.
For example, my mother had dementia, so I reached out to the Alzheimer’s Association. They helped me a lot, even though she didn’t qualify for some of their programs. They still provided valuable resources.
I also reached out to PACE—they had insights that helped me navigate certain challenges.
So, if your loved one has cancer, Parkinson’s, diabetes—whatever the condition may be—reach out to organizations that specialize in those areas.
They can connect you with resources and help guide you through the journey.
Antonia: Natalie, thank you so much for joining us today. I really enjoyed hearing about your caregiving journey with your mom.
Natalie: Thank you. My pleasure.
Kristie: And thank you all for tuning in to this episode of Caregiver Conversations. Don’t forget to subscribe and share this episode with anyone who might benefit from the insights shared today.
Antonia: We want to hear from you! If you have thoughts or caregiving stories to share, connect with us on social media or through our website.
Kristie: Until next time, take care—and keep caring.