Considering Your Health Future When You Have a Parent with Dementia

Rachel and Shoshawna explore the genetics of dementia, particularly the ApoE gene, and discuss proactive health strategies, ethical considerations, and future planning for those at risk.  We also say farewell for now to Rachel as the co-host and discuss the future of Hope Floats.

Key  topics

Genetics of dementia and Alzheimer's

The ApoE gene and its variants

Preventive strategies for brain health

Ethical considerations in genetic testing

End-of-life planning and medical aid in dying

New chapters for Hope Floats 

TOOLS: 

https://www.lisamosconi.com/

https://ApoE4.co

Transcript

TRANSCRIPT:

Shoshawna Rainwater (00:26)

Welcome to Hope Floats, a podcast for people who are caring for a person with dementia. I'm Shoshawna Rainwater, clinical social worker and dementia consultant based in Portland, Oregon. I'm also the daughter of a parent living with dementia.

Rachel Coady (00:42)

And I'm Rachel Coady, a professional certified coach, caregiver and   daughter of a person who had dementia.

Shoshawna Rainwater (00:48)

It's good to be back with you, listeners. I invite you to stay tuned for an important announcement at the end of this podcast episode today. Rachel, you ready to jump in?

Rachel Coady (01:00)

Yeah, it's good to be here and good to be together.

Shoshawna Rainwater (01:03)

Good to be with you today. So, Hope Floats listeners, you know by now if you've listened to our podcast that Rachel and I are both people who have had parents who have experienced dementia. And many of you are also people who are caring for an individual with dementia. And this is what has brought us together in this podcast is this common experience.

And one of the things that's long been on my mind, and I know on your mind, too, Rachel, is a question about–I would even say a worry about–whether or not having a parent with dementia is genetic destiny for ourselves. What does this mean for us as people who have, in our genes, a potential for developing dementia ourselves as we grow into older adulthood.  

Rachel Coady (01:58)

Mm-hmm.

Shoshawna Rainwater  (02:00)

And I think it's really normal for caregivers. I don't think it's just us that wonder that. I think it's really normal for people to wonder if that is true for them, as well.  And “will I develop dementia? and if I do, what would I want for myself?” And I think a lot of us are thinking about our futures informed by the experience of having cared for an individual going through it.

Rachel Coady (02:26)

Mm-hmm.

Shoshawna Rainwater (02:27)

And realizing that although we don't know a lot yet about the disease of dementia, we are still in sort of the infancy of understanding what causes dementia, how to treat dementias of many different subtypes. We've talked on this podcast, there's now over 100 different types of dementia. So even though we don't know a lot about the disease, I think we can think about things that we can do for prevention and considerations that we would want to make for ourselves and plan for ourselves if we were to receive the diagnosis; and to take advantage of this time to put into action a plan to live well into our futures.

Rachel Coady (03:16)

Mm-hmm.

Shoshawna Rainwater (03:16)

So we do have choices and some agency as individuals in terms of proactively learning about brain health and our own genetic markers And then working on changes to support our own brain health;  and also just those considerations about what we would want for ourselves while we are still cognitively sort of neurotypical or cognitively well.

Rachel Coady (03:44)

Yeah.  One of the things that was happening for me once I got to know the dementia experience and caregiving for dementia, was that I heard a lot of people around me who understood that disease say things like, “Oh if I ever got it, I would…” or, you know, “I tell my kids, if I ever get that, just do this.” 

Shoshawna Rainwater (04:06)

Mm-hmm.

Rachel Coady (04:07)

And, a lot of the ways that those sentences are finished are actually not realistic, real choices–

Shoshawna Rainwater (04:11)

Yeah.

Rachel Coady (04:12)

They're kind of extreme or dramatic soothing answers to what you would do if your cognitive ability changed. 

Shoshawna Rainwater (04:18)

Mm-hmm.

Rachel Coady (04:20)

But when you have been a caregiver for someone with this disease, or you're adjacent to loved ones with this disease, you do start to have opinions about what you think you'd want for yourself, kind of inevitably because you're witnessing the struggle, you're witnessing the changes, you're witnessing the uncertainty, you know, sometimes you're witnessing the playfulness or the silliness of what changes in our memory, but it's really normal. Like you're saying, to start to have a point of view, like “if that were me, I would want X.” 

Shoshawna Rainwater (04:49)

Yeah.

Rachel Coady (04:50)

And I think what's important about today, like you said, is we both have experience supporting people in this journey; we naturally both have opinions or ideas or thoughts about what we think we would want in that situation; We're both cognitively fully-abled right now.  

But there's another piece to it, which is realistically, if I really sat down and thought about this, which is kind of a scary thing to confront for people–whether you're related to someone with this disease or not–”if this were to be my future, what could I actually do? What would I want?”  And I think that's a valuable thing to think about. Not because I hope anyone has this disease, but because I'm a believer that having a sense of what you would want is a good thing for your loved ones and the people who will be around you. 

Shoshawna Rainwater (05:36)

Yeah.

Rachel Coady (05:37)

And then the second thing I really want to just name as we get started is that we really don't know very much about the brain. We don't know very much about this disease or this disease journey. We know more right now than we have. There's a lot to learn, still. And so today I want to talk about some actions or behaviors or things that I might be choosing to do based on what we do think we know right now. And I also want to talk about choices that I think I want to make based on my experience as a caregiver and witnessing my mom's disease journey. 

But this is not advice. This is not medical expertise. This is you and I kind of vulnerable sharing where we are with this question for ourselves. And, I guess, in that, extending the listener to, to consider or think about their own journey with this question, if they're having it. 

So, just want to say again, we're not doctors, we're not scientists. I wish we had a cure for this disease; we don't. So we're trying to figure out, personally, what that means for us in this journey. And, that's what we want to share today. 

Shoshawna Rainwater (06:43)

Yeah.

Rachel Coady (06:44)

And I do so on behalf of trying to be helpful and generous, not on behalf of trying to advise or judge or have any feelings about what every individual gets to choose this for themselves.

So, one place to start, I'll say is, there are some markers that you can learn about in your own body–”they” being medical professional/scientists are saying could be helpful in understanding probability of getting dementia or Alzheimer's. And the big one that I hear about in follow and track since my mom's disease journey has been looking at this thing called apolipoprotein E or ApoE is what they call it for short. And it's a gene that provides instructions for making a protein that transports cholesterol and fats through the bloodstream in the brain. There's a lot more to it. You can learn a lot more about it, but very basically there are four variants of ApoE: one, two, three, and four, and we each get one of each of those from our biological parent. 

So there's different combinations; you could have any combo of the different four,  based on your parents, but whatever one you have, one of your parents definitely had it. 

Right now, as of recording, ApoE-4 for gene variant is widely considered the strongest genetic risk factor for the most common form of dementia, which is Alzheimer's. And getting your ApoE tests done is a part of a standard blood test that you can do just to determine what variants you have. 

One of the questions that comes up for people who want to do this test is why would you want to know like— 

Shoshawna Rainwater (08:24)

Yeah.

Rachel Coady (08:25)

–what's the, what's the benefit or like, if you find out that you have a combination variant that has a higher risk for Alzheimer's, what are you going to do with that?

Shoshawna Rainwater (08:34)

Yeah, what are you going to do with the information that you get from that? I think it's a question that should be asked of all testing and health care, but…

Rachel Coady (08:42)

Yes. Yeah. 

Shoshawna Rainwater (08:43)

But I think it's relevant. Yeah, it's a good question. 

Rachel Coady (08:45)

And I have friends who've been caretakers for someone with dementia and they feel very strongly that they don't want to know that they wouldn't want to know that information because they'd be so worried that they'd be potentially getting this disease journey outcome. 

Shoshawna Rainwater (08:58)

Yeah.

Rachel Coady (08:59)

I want to iterate one thing that we know right now is there are people with high-risk variant combinations for ApoE and there are people with low-risk Alzheimer's combinations of ApoE, and both groups can have and not have dementia. So having a combination of ApoE genes–which the highest risk group that we know of right now would be people with the combination of two ApoE4 genes–there are many people with double four that do not have Alzheimer's; 

Shoshawna Rainwater (09:35)

Correct. 

Rachel Coady (09:36)

There are many people who don't have any 4’s and do have Alzheimer's. So it is not a clear determination at all; it is about the potential to know that you may or may not be at a higher risk and a higher risk group. 

So I personally chose to take the test very early on. I took it in my late 20s to learn what genes I have. So that was even before my mom's disease diagnosis. As her disease journey started, I started paying much closer attention to my combination because I learned I have two ApoE4s. And actually two to three percent of the population has a double copy of this variant. And again, that doesn't guarantee that I'm going to have Alzheimer's someday, but it does mean that there are parts of me that might be more susceptible to having Alzheimer's disease journey. So, they say it puts me at a significantly higher risk.

Based on roughly what we know right now, inheriting two copies of the ApoE4 variant can increase the risk of developing Alzheimer's by eight to ten times compared to those with neutral ApoE3. It means that I have a higher risk of an earlier age of onset. So people with two ApoE4 copies tend to develop Alzheimer's symptoms earlier than those with one or no copies. 

But maybe most importantly is that I know this is not a guarantee that I'm going to have this disease. So having two copies is a major risk factor, but it's not a deterministic cause. 

Shoshawna Rainwater (11:10)

Can I pause and ask you about that's a significant move to make in one's late 20s, especially not having walked yet through the dementia caregiving experience. And in some ways, it's kind of unsurprising to me as someone who's such a knowledge seeker and someone who really wants to be their best self. It doesn't surprise me necessarily that you sought out clarification about your status.  But I'm curious how you felt, if you're willing to share, how did you feel when you got the results?

Rachel Coady (11:46)

I had a pretty comprehensive blood workup done in my late twenties because my dad died of heart disease. 

Shoshawna Rainwater (11:52)

Hmm.

Rachel Coady (11:53)

And my sister and I both wanted to know as much as we could about our heart health as early as possible because we realized that we probably had some genetic markers for heart disease, too. And we do. So in that comprehensive exam, they identified that I had two ApoE4s. I didn't do anything particular to that information until I got much closer to my mom's disease journey. 

Shoshawna Rainwater (12:18)

Yeah, which is not a bad thing given that those two things are connected heart and brain. 

Rachel Coady (12:22)

It turns out a lot of their preventative health measures are very similar. So when my mom's disease journey started and I reviewed that information and realized, “oh, I do have a double four variant,” this conversation was starting more in culture around looking at these things. And, if you get into medical conversation around Alzheimer's, you'll hear more and more about ApoEs. 

So to answer your question, when I learned that that was my profile, I was already working with some medical professionals who were helping me monitor and kind of proactively build health. And I said, “we need to look specifically at this part of my profile, and I need to know what I need to do if this is a part of what's within me and what's going on in my body.” 

Shoshawna Rainwater (13:13)

That was brave.

Rachel Coady (13:14)

Yeah. People feel like it's brave were like, “Oh man, you know that after going through everything your mom?” But it's, I come from a different place, which is I'd rather know the cards in my hands than not.  And I can honestly say I carry these genes in me. I believe in working with my body, not fighting with it. I'm not… I'm not angry about it. I'm like, “this    who I am. This is where I am.” 

I think what I get from both of my parents is a significantly earlier heads up than they got about their health by knowing. And I think both of my parents thought they were living pretty healthy lives and both of them probably had shorter lives because there was no way for them to know all the ways they could have been healthier. So that inspires and motivates a lot of my interest in my internal health and well-being.

But I still live my life. I'm, I'm definitely not here saying I have a perfect practice down and I'm beating the odds or whatever that would be. I just walk through life knowing this, these parts of my body and my health, and make choices with that in my pocket–some days better than others. (laughs)

Shoshawna Rainwater (14:21)

Yes, right? Everything in moderation, including moderation, is that what they say? What are some of the things that you've begun to incorporate as part of this wanting to optimize your health and well-being? 

Rachel Coady (14:34)

You know, for me, it's about kind of ongoing learning and trying to make lifestyle adjustments as possible to hope to avoid Alzheimer's in the future–not unlike many people do without this genetic combination. I started looking for more resources online and through my medical team. I've talked with all of my doctors about this. I just started with a new doctor, like two weeks ago. I'm like, “here's my profile. Here's my gene set. These are the things I'm working on.” And I've also made some really obvious behavioral changes for my brain health. So I'm sober. I used to drink and love wine. I've kind of let go of that because there's a lot of evidence that alcohol consumption is not great for our brains.

I'm eating mostly plant-based and try to eat organic food because that seems to work for my health profile and my body type and the way my body processes cholesterols and nutrients. I take supplements on a regular basis that I was given through advice, again, from my medical team that support my brain health. I'm doing limited eating–so I'll eat during particular hours of the day and let my body fast and burn the fuel from food during other times. I try to cut down on sugar, which again is kind of a bummer in some ways, but honestly, I think my energy is better. I think it generally probably helps most of my health, not just my brain health. And then, you know, the big stuff is like a middle-aged person probably is like focusing on exercise and lifting heavy weights and practicing good sleep hygiene and actively working on stress management.  And for me, that looks like getting a lot of time outside. 

Also, I think it's really important and probably something we'll learn more about going forward around managing your emotional hygiene. So really working on processing feelings, not carrying heavy things, addressing trauma in my family, like looking at things that went on and trying to go through the healing journey of those so that they're not suppressed in my body. And then, again, I advocate for myself, for my brain and heart health and well-being with all of my doctors.  And that's not throwing shade at doctors. I think being a medical professional is really hard right now, but it does mean that I show up with a pretty clear, as clear as possible story about where I am and what's going on in my body. And then ask them to think about that when they're giving me advice or suggesting solutions for me. 

So, you know, overall, this is a pretty good plan for my health period. But I think that it's become more real. Yeah. I think I'm motivated by some data that I have on myself that really makes me feel like these are easy trades to make if they're happening on behalf of me having a future.

Shoshawna Rainwater (17:24)

Well, and I really appreciate what you said about you've been given clarity and an incredible heads up that was not available to your mom or your dad in the same way. And when we get clarity, we can understandably feel bummed out. 

Rachel Coady (17:43)

Mm-hmm.

Shoshawna Rainwater (17:44)

But you know, I stand by this, this idea that getting more clarity about what lies ahead–I think about this in the context of helping people understand the dementia disease trajectory–that most humans cope better when they know what's coming and they have support and guidance through the experience. And I see you working really hard to take what could have been just a feeling of gloom and doom. It is what it is, right? And seeing it, looking at it squarely in the eye and doing everything you can to manage, like you said, the cards that you've been dealt, which are not bad cards, right? You know, overall.   

Rachel Coady (18:30)

Right.

Shoshawna Rainwater (18:30)

You're a healthy person. But you're also realistic. What I hear in this is a lot of willingness to be realistic.

Rachel Coady (18:37)

I think so, but I also… I don't think of it as that challenging of thing to do. Sometimes I talk to people about this, and I’m met with this like, “Oh, God, you have to give up that and that and that” like this loss. And I'm like, “yeah, but I don't think of it that way.” I think about like, for me, I'm a person who needs to do this. Do I nail it all the time? Absolutely not. But I try to and I'm supported by my family and people around me to do that. And it just looks a lot right now of like less Friday nights in bars and more Saturday mornings hiking and, you know, things that just kind of, you know, you just modify. But if you're doing it on behalf of hopefully living a healthier, longer life, regardless of your disease journey potential, like that's an okay trade.

Music transition

Rachel Coady (19:30)

There are a couple interesting things that have come up at this point in time for me in this journey. And again, this is not medical advice, but I just want to offer this in case this is helpful to any other listeners.

I am working harder on following leaders in research and science around women's health who focus on the relationship between midlife for women with perimenopause and menopause and its relationship potentially to Alzheimer's and dementia. And one in particular that I found very helpful–she is Googleable, she is found on a lot of podcasts, and she has multiple books out. Her name is Lisa Mosconi.

And then the other community I've recently found is called the Phoenix Project. It's led by Dr. Kevin Tran, and he's specifically creating a community of people who are double ApoE4 carrier. 

Shoshawna Rainwater (20:20)

Mmm.

Rachel Coady (20:21)

And together, they're sharing information, they're sharing hacks; he's interviewing scientists and doctors.  There's a lot of good practices, interesting conversations. You can join the community and kind of participate and share your data. And, it's all about trying to help support one another in avoiding dementia and Alzheimer's. So, if you're interested, those are two good sources. 

Shoshawna Rainwater (20:40)

Rachel, has Dr. Tran shared their own Apo status that they carry?

Rachel Coady (20:47)

Yeah, he started it because his parents had this disease journey and he's carrying a double 4. All the people involved in this particular group are double 4 candidates like me. 

Shoshawna Rainwater (20:57)

Got it.

Rachel Coady (20:58)

The other very important person that's done a lot in culture for this conversation is the actor Chris Hemsworth, who has a National Geographic show, I think called Unlimited.  And he also is a ApoE double 4 carrier. And so he's been very open and generous and talking about how that's changed  his point of view, his behaviors, his goals, priorities, and the things he's doing for his own health. So, if you haven't watched that episode, we'll also put a link to that in the show notes, but it's very cool to see him bringing this conversation into culture and talking about what it means for him and his family. And it's so cool because he's like this hero and he's a very famous actor. So, I appreciate anyone that uses their platform to kind of bring this to the table for people. 

The other piece of this, that we talked about at beginning of this episode is also considering, you know, as people who have been frontline caregivers, considering what we think we would want to have happen if we were to get this disease diagnosis and really looking at what we think we'd want for ourselves and what we would want the people around us at that point in life to know. 

I have tried to learn about how to put into action my wishes and wants if I should have this disease outcome. And the best practices I've seen–and you can jump in with the ones you know of–are that actually, while we have, full cognitive ability right now to put in writing for families, doctors, lawyers, and in your will/end-of-life paperwork, I'll just say, what you would want to have happen. And I've also heard that people do this through video recordings that are timed and dated…

Shoshawna Rainwater (22:37)

Mm-hmm. Yeah.

Rachel Coady (22:38)

… so there's evidence of consistency through our adult life of what we want at the end of our life with this disease. And that does two things. One, if we're ever in a future scenario where you could have a case to have compassionate death with dignity with the cognitive impairment, maybe this could help. But secondly, and this is the greater gift, I think, your loved ones and your caregivers and the people around you will know what you wanted when you are no longer able to share or be aware of what you might want in that disease journey.

And I was really moved by some of the case studies that I found of people who had really organized and written out and described what they wanted, and that being able to be honored by their loved ones and support once they were in the depths of this disease. 

And I think it can also be how I would want my family to allow me to get help outside of them. Our parents always told us growing up, “we don't want to be,” (they said the word burden.) “We don't want to be a burden to you. We want, you know, we bought long-term healthcare insurance. We don't want you to have to give up your life to take care of us.”  That's not every family situation. That's not every family's resource. That's not culturally appropriate for some people I know. But my sister and I both knew from a very young age what our parents wanted as they aged and got older. I would not want the people in my life to feel the burden of trying to figure that out when I am not able to articulate or be aware of what I need anymore. And I can talk about that with my partner, with my family, but what is great is to have it all written and put in documents so that they don't have to kind of piece it together, but that it’s a very clear sense of, “hey, if this is what happens and this is where I go, this is the kind of care that I want you to welcome, these are the kinds of support pieces that I do and don't want, these are the things that matter most to me about the end of my life” and let them have that way upstream.

Shoshawna Rainwater (24:46)

Mm-hmm.

Rachel Coady (22:47)

Cause this disease journey is so complicated and changing and… 

Shoshawna Rainwater (24:52)

And long. 

Rachel Coady (24:52)

… ridden with anxiety and uncertainty. Yes, that like you just, I would want someone to have as much as they could have in terms of direction and clarity for me. I want to try to make it easier if they're going to have to go through this.   So, I am working on my end-of-life paperwork, but also just getting this together. And the other piece is, letting the people in my life know that this exists. 

Shoshawna Rainwater (25:16)

Mm-hmm.

Rachel Coady (25:16)

So, telling my partner, telling my sister, having other family members aware of it so that they can be the team I know they're gonna need if this were to ever happen. My lawyer has it, my doctors have my advanced directive like, y ou just do all this stuff because you want to be really clear. Like “in my life, this is how I want this to go to the extent that I have control on input on what happens.”

Overall, when I think about where I am with this, what I know, what I don't know, most of all, it kind of reaffirms my commitment to live life as fully as possible and take of this life that I have as much as I can while I'm here. And I really believe my mom did that, too. Like I think she had a very full, rich life.  And I want that regardless of my probability for getting dementia or Alzheimer's. I want that for all of us, but I think this gives me some peace of mind about that potential while I work hard at taking care of the body and the life that I have.

Shoshawna Rainwater (26:20)

Yeah, it's a really thoughtful, intentional way to move through this life you've been given.  It's really beautiful. And I really appreciate just your authenticity and openness to sharing today. 

Rachel Coady (26:36)

Yeah, I feel like it's important to bring awareness to it and to let some listeners out there know, like you can learn a little more if you want to about your own body and your own genetic makeup. And that could lead to making some good changes in behavior that could help. You know, who knows?

Music transition

Shoshawna Rainwater (27:10)

As I mentioned at the beginning of the episode listeners, we have an announcement about a new chapter in the Hope Floats podcast. Rachel, you want to share?

Rachel Coady (27:19)

I wanted to share that this is most likely one of my final recordings with Hope Floats as a cohost. I am so grateful for this podcast. And when Shoshawna asked me about starting this a couple of years ago, it felt like such a needed and valuable outlet for my experience in caregiving for my mom. I had all these ideas and experiences, from her journey and the idea of getting to share this while she shared her expertise on the disease journeys just felt like it could be helpful. I hope that it was helpful. It could be helpful to other people and other families. 

And the truth is now that it's been about three and a half years since my mom died of vascular dementia. And I am owning that I have done some healing in that time. And I am not as aware of the caregiver journey and those experiences as I once was. And in that, it feels to me inauthentic to kind of continue to show up and try to build bridges and support for caregivers in an experience that I'm, kind of on the other side of, if that's possible. I'll never forget that disease journey or what it taught me or what it gave me and my relationship to my mom and my family. But I also can look up now and see that I'm in a really different place and that healing is a good thing. 

I want to you know say to people who are listening right now who are caregivers, I could not imagine when I was in the caregiver journey that life could feel the way my life does now and I will take credit for some of that growth and healing and I will give most of the credit to the people around me–Shoshawna yourself included– who really helped me recover my life and get to a different place.  But being here now, I have to own that I don't feel like I'm necessarily the co-pilot for Hope Floats that you could benefit from having. 

So I'm very, very grateful for the episodes that we've done and the journey we've been on. I'm very excited for the future of Hope Floats and your practice and what can come from this, because I think it's so valuable for caregivers. And I'm just honestly gonna admit that I probably am complete with being the co-host now. It's time for some changes.

Shoshawna Rainwater (29:40)

Yeah. This podcast would not have ever gotten up and off the ground without you and your momentum and your energy and your prowess and your enthusiasm. I am very much an idea person. I love the conceptualization and I would still be in this space like, “you know, it would be really cool. You know what I think would be a really neat idea?” Rachel was absolutely the operationalization brain for this. And I'm so grateful to you, Rachel, for everything that you brought–energy, the man, you're just great. You're like conversational glue. You've made everything about this experience better and easier for me. And I get it. And I really love hearing you honor yourself and what you need. And I know our listeners will, too.

Rachel Coady (30:32)

Yeah, this has been such healing and deep work to get to create and discover this podcast with you. And I've always hoped since day one that of any of the experiences I had or my family had could be helpful to other people, I wanted to share them. 

Shoshawna Rainwater (30:49)

Yeah.

Rachel Coady (30:49)

I want to make this journey better for people. And I just think it's really important to acknowledge that like whatever space you're in,  listener, as you're hearing this, it isn't permanent; it will not always be this way. My life looks very different than it did four years ago in a way that still humbles me greatly. And I am better for going through the experience. I'm a bigger, better Rachel for going through the experience of being a caregiver. And it's okay to make changes and move on to the next thing. 

 I'll always be cheering this group on, always be an advocate for this caregiver community. And hopefully we're all walking together towards a future where this disease and the caregiving journey of it are lighter and better than they are right now. But until then, it's always been helpful to know that we're in this together and we don't have to go through it alone.

Shoshawna Rainwater (31:44)

Yeah. Well, deep, deep gratitude for these 25 episodes that we've done. And again, I could not have done this without you. And Hope Floats listeners, my commitment at this time is to continue on. You've heard me and many of the first 25 episodes really share a lot of what I know and understand about this disease experience. And so we will be bringing on more and more experts to have conversations with me and learn from them. And so our episodes will probably get, I'm imagining maybe a little bit more niche. We'll have experts on that specialize in particular subtypes of dementia. Please let me know if there are topics that we have not yet covered that you're hungry for or want to talk about. And yeah, Rachel, thank you for everything. I miss you already. 

Rachel Coady (32:43)

Yeah, thank you.

Shoshawna Rainwater (32:45)

Today, listeners, we were able to hear some really thoughtful and important things from Rachel as she talks about her experience as a person with a genetic marker for dementia.  We   about planning for our future selves. And we talked about the future of Hope Floats and the new chapter that we will be moving into. Rachel, lots of love and gratitude for you.

Rachel Coady (33:15)

Yeah. Thank you.

Shoshawna Rainwater (33:16)

Take care.