1414: Recognizing Early Signs of Alzheimer’s and Dementia with Behavior Specialist and Best Selling Author Lisa Skinner

Robert Plank 0:01 Dementia doesn't just steal memories, it leaves families overwhelmed, confused and second guessing every decision, but luckily, we have an expert on the show. It's Miss Lisa Skinner, who brings over 30 years of experience and behavioral insight to help families respond with clarity instead of panic. So we're here to talk about caregiving, about Alzheimer's, about false beliefs, and about clearing those and focusing on some fixes, some solutions in the future, and just getting better and making the best of it. And so Miss Lisa Skinner, glad to see you, glad to be speaking with you.

Lisa Skinner 0:37 Thanks, Robert, thanks for having me. I'm really excited to be here with you today.

Robert Plank 0:43 I love your excitement. It's contagious. It's making me happy as well. And so what are you all about? We introduced you, but you tell me, what's your focus and passion? Why should we be paying very close attention to you today?

Lisa Skinner 0:56 Well, I am unique to this topic for a couple reasons, and the first one starts with my own personal family history. So dating back 50 years, I went to visit my grandmother. One day I just got my driver's license. I wanted to show it off to her, and she only lived a couple miles from me. So I told my mom that I was going to drive over to Grandma's on my own. I was so proud to show her that I got my driver's license. She invites me in as normal. I visited her all the time, and this particular day, we sit down and right out of her mouth. She starts telling me about these birds that were living in her mattress. They would come out at night and peck her face. She told me she was terrified. She couldn't sleep, she couldn't eat, and I didn't even have a chance to respond to that outlandish story when she moves on to the next one about the rats that are running all over her house, and points to her floors and her walls. See them. See them. She says to me, of course, I didn't say anything, and she said they were invading her home, and she was scared of them, too. And then her last story was to tell me that there was these men who were constantly breaking into her homeand stealing her possessions. They were eating her food. She was scared to death, and she didn't know what to do anymore. And by this third story, my jaw literally was down to the floor. And as it turns out, this was my very first experience witnessing somebody that was having a delusion or a false belief. That was the bird story. I was witnessing a hallucination. Those were the rats running all over the house, and paranoia and suspiciousness telling me about the men that were constantly breaking into her house, and unbeknownst to me, I was staring at the in the face of Alzheimer's disease, but I didn't know it. And the thing is, I told my mother I was going over there, and she didn't say anything about it. So what I did, and this was not due to knowing any better, I had not chosen Alzheimer's disease and dementia as my professional career. I was 16 years old, but what I said to her, and this was only because I came from the generation where you do not contradict your elders. You don't argue with them. You respect everything they say, whether you agree with it or not.

Lisa Skinner 4:05 So I said, oh my goodness, grandma, this sounds horrible for you. I said, I'd really like to help you with this issue, with these issues that you're having. Let's start with the birds. So I took her into her room, and I asked her to show me in her mattress where these birds were coming in and out of and of course, I couldn't find anything. She insisted that they were there. So I said, Well, I really want to help you. I want you to I don't want you to be scared anymore. I want you to be able to sleep. So can you show me specifically how they're getting in and out of your mattress. She thought for a minute. She looks at me and she said, Oh, Lisa, they're there. They're just very, very clever. And I learned later on that that was a brilliant and classic response. Coming from somebody who's living with Alzheimer's disease and dementia, they become masterful at explaining away the things they're telling you. So we visited for a little while longer. I went home. It was really upset with my mother. I said, Why didn't you tell me. Why didn't you warn me? I was completely caught off guard. I didn't know what to do. I didn't know what to say. What is wrong with grandma? Says, Oh, your grandmother's been diagnosed with what they called back then, senile dementia. They didn't even call it Alzheimer's disease, 50 years ago. And I said, well, thanks for the heads up. And she says, Lisa, we're just not going to talk about this anymore, you know now, and the subject is off the table. Well, that was a very common attitude back then to have when you find out that a relative, a loved one, is has been diagnosed with. Actually, what this is, is a brain disease that causes these signs, symptoms and and behaviors. But back then, people really regarded it as a mental illness like schizophrenia, and their stigmas attached to that so nobody was willing to talk about it, especially if it touched their family. And then, since that first experience with my grandmother, I actually have had seven more family members that have lived with one of the 200 brain diseases that caused these similar signs, symptoms and behaviors, and five of those were blood relatives, so obviously it does run in my family. And then after I graduated from college, I had an opportunity to go to work as a counselor to help families who recently got a diagnosis and kind of, you know, help them understand what to expect. And that's really what led me to doing this professionally. In addition to having it, you know, pretty significant in my family, and I know what people are going through, I've been through it as a family member, I've helped care for family members with dementia. I know what a struggle it is, and I decided after that first job, that I wanted to dedicate myself to being a resource for people to help them better understand it and not be caught off guard necessarily, with if and when they do get the diagnosis. Because what I've seen over the 30 years that I've been doing this professionally is Nobody's expecting it, and then after they do receive a diagnosis, they don't know what to do, they don't know who to turn to, they don't know who to believe. So I wanted to be that reliable resource for people and help them through it and save them a lot of the you know the agony that it goes along with finding out that your loved one is going to live the next eight to 15 to 20 years declining in their mental capacities. And this is for caregivers, too, people who actually physically take care of people, because so many unexpected things show up that they're not expecting because they don't necessarily associate the things that they're seeing, like my grandma all of a sudden telling me about birds and the mattress, etc, etc. A lot of people aren't expecting those types of behaviors, and they don't know how to respond to it. They don't even realize that it's part of this disease that they're witnessing. So that's kind of my story, and I'm sticking to it.

Robert Plank 9:09 It's wonderful that you turn what could have been a bad into a good, right? You said, I'll rededicate my life and making sure that we get the education out there that way people can get the help they need. Because you hear about what you said a lot of like, the kind of old ways of thinking from decades ago is, hey, if there's a problem, just sweep it under the rug. Don't deal with it. But then now, hopefully we're in a more enlightened age, right, where you can detect the warning signs and you can say, Okay, well, you're not the first person to have a parent or spouse or a family member that shows these beginning signs of dementia, you're not alone. There's help, there's techniques, and there's things that you can learn so that way you don't have to just start from scratch and feel so alone. And like you hear all these stories, don't you hear stories about how, like the the lifestyle creep keeps taking over, and the next thing you know. Know that the elder parent needs, like, 24 hour care and all this in home stuff, and it just becomes, without a plan, just a complete and total nightmare. And so do you think is there like a missing piece as far as what the average person sees or believes about recognizing Alzheimer's or, like, what to do in those first steps, like what's not spoken about enough, you are

Lisa Skinner 10:24 100% right on everything you just said. And that's the observation I made decades ago. That was the missing piece when people came to me, I have helped 1000s of families understand this disease and what to expect and how to respond to, you know, far fetched stories that are coming out of your loved one's mouth or the person you're caring for. And to be honest with you, Robert, it's only been as recently as like right after covid, that people are showing more of an interest and a willingness to learn more about it and to talk about it, and I really give credit to the media for bringing to our attention all of these celebrities that have been diagnosed with it. Most of them have passed on, and it's finally becoming a topic that people don't want to just stick their head in the sand. I mean, the honest truth and the sad truth is this can be compared to an elephant in the room. It's staring us right in the face, and it's not going anywhere. As a matter of fact, the World Health Organization and the Alzheimer's associations and societies all over the world are telling us that by the year 2050 and if we do the math, that's 25 years away, the number of people who will develop Alzheimer's disease worldwide is expected to triple from the number of people who are living with it today, and from What I have seen in 30 years, we as a society are not prepared to take care of that many people, and the resources are still very limited, and there's still a lot of stigmas out there. There's still a lot of myths that need to be busted, and, you know, allow people the authentic information so they can, like you say, have a plan, which is imperative. So that's kind of been my observation, and that's why I wrote the books that I wrote, and I do a weekly podcast, and all we talk about is Alzheimer's disease, anything related to it. And I did notice that, you know, for so long, people were really willing to talk about it, unless they knew what I did for a living. And then they would say, Oh yeah, my mom has it. And it turns out, most people out there already have experienced some kind of Alzheimer's experience. But there's, there's more of a willingness to to acknowledge it and ask for help than there's ever been before. And so I wanted to be a reliable resource people can believe what I'm telling them, about it and kind of not get caught up in the myths and the disinformation that still exists out there about these diseases.

Robert Plank 13:49 Ooh, and that's important, the getting past the myths and the disinformation. So let's say we visit mom or grandma, and she says, there's the birds coming out of the mattress. And how do you know if that's just a kooky old lady who's just joking around, versus there's a serious problem, and especially if she's kind of have has the weird logic to help it make sense, she might not be very open to going to the doctor or getting a test. So what is there to be done when you say, I'm not even sure if there's a problem, and if there is, I don't think she'll be cooperative.

Lisa Skinner 14:26 People don't normally tell far fetched and wild stories like that, unless they are experiencing damage to their brain from one of these brain diseases, as far fetched as they are, and I, you know, knowing my grandmother, for as long as I had known her, growing up with her, I had never, ever known her to tell a lie to, you know, exaggerate anything. She was a very sweet, conservative. Little lady, and it was so obvious that something was wrong. So, I mean, that's one way to tell that. You know what's changed here? I've never heard, you know, incredible, unbelievable stories like this out of her mouth before. So you know, my instinct, of course, told me, uh oh, there is definitely something seriously wrong with my grandma. I don't know what it is yet, but it's not like her. It's out of character for her to sit there and tell me those stories. So that was like my first clue, even though I went in there clueless. But these types of behaviors that I described with my first experience with my grandma are very typical, and they're very common, and they are part of the disease. So these are some of the things that if people were aware of that are part of the disease. Not everybody who lives with dementia experiences hallucinations, experiences false beliefs or delusions, experiences the hundreds of symptoms and signs and behaviors that accompany living with dementia, but when these kind of stories start coming out of their mouth, I think it's a pretty good indication that there's something serious going on. And it's, you know, this came out of nowhere. For me, I never heard stories like this from my grandma before, but typically the progression of the disease to this point, which is about mid stage, when these types of things start showing up, you start to see other signs and symptoms and see other behaviors that you know. Raise your eyebrows and go, Hmm, I wonder why she said that. I wonder why she doesn't remember that. And then all of a sudden, when something as bizarre as birds living in the mattress come out, you start thinking back and going, oh, you know, there were some signs, but I dismissed them because I just thought it was part of her normal aging. But when things get to this point, when you start to see here about things that don't exist, things that they believe are true, that couldn't possibly be true, their personalities start to change in ways that you've never seen before. They look they their ability to reason things out and use logic and perform even the most basic tasks that they've been performing for decades, they start to lose that ability. Those are sure red flags that there's something more serious going on than just normal aging forgetfulness, which happens to all of us, sure, but the root cause for normal aging forgetfulness is not a brain disease.

Robert Plank 18:10 Okay, so you're saying you look at what behavior has changed. Are the stories getting more outrageous? Is the logic getting stretched more and it might be cumulative over time. Might be this, all these little minor incidents, until once it becomes the birds and the mattress story, it's like, hey, you know, now this is all added up to a lot, and so at that point, what are the next steps to be taken? Because, because then I can imagine how the denial can can really be there, right? Of like, you know, mom or grandma's in denial and the other family members in denial. No one knows what to do. So you as the expert, like, what would you say is or the first couple of steps into looking into this?

Lisa Skinner 18:51 Well, if that experience happens, or similar experiences start happening to other family members out there with their loved one, I would definitely say it's time to get a medical assessment and determine whether or not your loved one is still safe. To my grandma lived by herself. Her husband had passed away. She clearly wasn't taking care of herself. She said these men were coming in and eating all her food, but she seriously was not eating and had nothing to do with men coming into her home. She just wasn't eating because she would forget that she didn't eat. You know, she would forget, and when we really looked into this more seriously, she might have a loaf of bread in her bread box, and that was like it, and that's kind of surprising for as close as we live to her, and my mom and her siblings were not checking in with her more regularly. So. So it kind of escalated to become a very, very serious situation. So if that happens, the first thing I recommend is figure out a way to get your loved one to the to their primary care physician and talk about the things that you've noticed, and I think in most cases, you can persuade your loved one to go to the doctor, even if it's just for a regular exam. There you go, really far from the truth it is an exam. So that's a place to start. And then if you do get the diagnosis after there's a series of testing, there's really no conclusive way to diagnose Alzheimer's disease today, but there is a process that clinicians do go through to eliminate what it's not, and then kind of narrow it down. And this, this includes all kinds of testing blood panels, and, you know, they look for what it could be, and then eliminate it, and then finally, narrow it down to, well, if it's not any of these other things, then I'm suspecting that we're dealing with Alzheimer's disease or maybe a different brain disease, but they all the signs, symptoms and behaviors that you see with any of these brain diseases are interwoven. They they they're similar to one another. They differ in each person, but the ones that we see, there are common things with all of them. So like I said before, each person processes these diseases differently. So my grandmother, for example, she showed the gamut of the of the symptoms, everything, but other people don't. So if you suspect that there are memory issues happening with your loved one or a person that you're caring for, to the point where you know, I really think that this has got to be something more than just normal aging forgetfulness, which we all have experienced. We put our phones down and can't remember where it is. We have to call it to find it, or we put our keys down or, I mean, this happens to me. I walk into a room and go, you know, I can't remember why I walked in here, turn around, walk out, oh yeah, now I remember. I mean, seriously, that happens to all of us, and it's not necessarily a sign of something as severe and serious as Alzheimer's disease or fronto temporal dementia or Lewy body dementia. It's way beyond that, and it does progress. There's no known cure for it, and it is a progressive these are progressive diseases, and it progresses over an extended period of time. So if you do have a loved one that does is experiencing a brain disease that causes these signs and these symptoms and these behaviors, it will they will get worse unless a cure or treatment is found, and right now we don't have anything, so you will, as a family member, be in this really long term relationship with your loved one, and while they're declining, and We all want the best for our loved ones. So the things that we know now that we didn't know I don't know 3040, years ago, best ways to respond to birds in the mattress, best way to respond to false other false beliefs like them telling you that their spouse is still alive because they honestly believe it to be true. But you know, it's not what's the best way to respond to something like that without making the situation worse for the person with the dementia. So there are very specialized skills to learn. It's like retraining your brain, because our instinctive response to these situations is counterintuitive to the best practice the most effective response. So let me give you one quick example. I've had this happen to me with my own family members and lots of people who I've worked with with dementia, all of a sudden, just out of nowhere, kind of like my grandmother telling me about birds living in her mattress and rats and so on and so forth. You'll be sitting there, everything seems fine, and all of a sudden they start asking you. Where their husband is, and you happen to know maybe you're the daughter, and you know that dad passed away four or five years ago. It's like, why is mom asking me where dad is? So our instinctive reaction to that, or response to that would be, and it's very normal to be Mom. What are you talking about? Don't you remember dad passed away four years ago. Why are you thinking that he's still alive? So that's our instinctive response, right? We want to fix people. We want to correct them. We want to steer them back into our reality, but her reality of believing that her husband is now alive and well and somewhere, and she wants to know where he is, is her reality. And we learn through trial and fire that no matter what we say, to convince somebody that what they believe is not true does not work. So just think of it this way. Let's say I insisted that her husband was no longer living my dad and I just insisted and insisted that she's wrong and that actually could send her into a panic, because it might come across to her like she's hearing it for the very first time that her husband died because she doesn't remember that he's no longer alive, and she could react very severely, like, What are you talking about? When did this happen? Why didn't anybody tell me what's happened? I can't believe this because she in her mind. Her truth is that he is still alive. But these false beliefs are temporary, until the very end of the disease, and then once the short term memory really stops functioning, then they typically go back to another timeframe of their life, and whatever their life was like, let's Say, 30 years ago, 50 years ago, it's different for every single person. Some revert back to childhood, and they walk around asking where their mommy is, and others revert back to like when they were young wives and mothers, and all of a sudden telling you, oh, it's time for me to go pick Charlie up if he's getting out of school, because they've reverted back to a different time frame of their life because the short term memory stopped functioning. Does that make sense? Yeah, it's a lot to take in. Yeah, it is a lot to take in, and it's things that people really don't associate as being part of a dementia disease. And so this is why it's so important to be aware. So if you go visit your grandma and she starts telling you about these birds that live in your mattress, you you proactively could expect it instead of just reacting to such a far fetched story and either arguing or trying to correct her, you'll know what you're looking at is the disease talking and not your normal grandma,

Robert Plank 28:36 right? And it seems like there's just a lot of ways to make the situation worse, right? If you try to correct or you're or you react badly, versus you say, hey, well, I'm identifying the situation, and here's the rules, or here's what's been figured out about Alzheimer's. She's in this reality, so don't mess with that too much. And there's, there's so much to get into, and I can see why you have this book and this podcast, because I imagine that there are many techniques, many problems that people have right? There's, for sure, the guilt about putting the loved one in the in the home where the medical attention is better. I'm sure there's the like, that emotional component of like, seeing that family member slip away. But as far as us being in our final few minutes of our conversation, it's up to you to tell us what we think we need to know, to maybe encourage us to pursue more education through your book and your podcast and your website. So in this conversation that we're have Miss Lisa Skinner, because we've only just met, I don't know exactly the ideal question to ask you at this point. So what is the missing hidden question in our conversation? What should I be asking you? I just don't know to ask you.

Lisa Skinner 29:50 I start off pretty much advising everybody if this, if these diseases that we put into a bucket that we call dementia, i. Referring to the signs, symptoms and behaviors show up in a loved one, or if you're caring for somebody that displays these types of experiences, I recommend 100% 1,000% if I could, to learn about the disease and things that show up unexpectedly, so you can be prepared, more prepared, and you're not constantly in a state of chaos and not knowing, oh my gosh. How do I respond to that? How do I deal with this? Because there are so many triggers that, as they decline, their mental faculties decline, and they lose a lot of them, and they're really responding to day to day life on raw emotion, no more logic, no more rationality. So if you, if you start off by learning what to expect, and like you said, Robert, to recognize these things that you're witnessing as being part of the disease. That's the first step. The second step is learning the skills, the techniques, the reasoning behind why this is a best practice response versus something else that can escalate the situation and turn it into what we call a catastrophic reaction. That means that, you know, the person will end up having a major meltdown, and we don't want that. We want to create as positive an outcome and an environment that we possibly can for people living with dementia, for people caring for people living with dementia, and for family members. And it's very possible to do I have seen unbelievable miracles happen if you have the right information and the right tools. And it's the best. It's a win, win for everybody, for everybody, wonderful.

Robert Plank 32:14 And it's just, it's good life advice in general, to get educated about whatever problems in front of you. Read a book about it, never stop learning. And especially you mentioned there about figuring out those triggers that maybe you have or that are common or that to be avoided or dealt with, so that, that way you can have a more calm, logical reaction, because somebody has to be right. You say that that that Alzheimer's patient, the the logic is kind of slowly deteriorating. You're becoming more emotional, and that's just it is what it is. But if you also are overly emotional and not logical, then it's just two people dragging each other down, right? So it's like your loved one depends on you being calm about

Lisa Skinner 32:55 this, yes, and it makes all the difference in the world. I have personally witnessed it 1000s of times, but it's not, you know, it's a specialized skill. We really have to retrain our brains to understand the why behind this is a better way to respond to that situation, or this is a good tool to try, because it's not our natural, the natural way we think we should be responding, of

Robert Plank 33:26 course, and you get any kind of disease, right? You get diabetes, you should learn about blood sugar. You get cancer, you should learn about chemotherapy. So it makes complete sense that if a family member gets this ailment, get yourself educated and figure out those skills, because there are best practices from over the decades, many MDs, PhDs, researchers, psychologists, they figured these things out. So why not follow that already blazed trail, instead of you trying to blaze your own trail? Who knows how far you'll get with that? So as far as as us getting educated in this way. It's great that there's people like you out there who have the podcast and the book, because it can be overwhelming, and you get, like, the kind of the daily influx of information, conversations and stories. So can you tell us about if someone says, Okay, I've I've got, like, the very bare bones basics about Alzheimer's figured out, but I know I'm only just scratching the surface. What are some next steps? Where should someone go?

Lisa Skinner 34:28 The book, The my most recent book, the best selling book, is you can find it on Amazon. It's called Truth, lies and Alzheimer's. It's secret basis. And the secret basis, really is referring to all these things that are part of the disease that show up that people aren't expecting. They're not thinking, What's wrong with her. It's part of the disease. So that'll give people kind of a foundational basis to understand and raise their awareness about it. It does not go into a lot of detail, as much detail as my training program does, or as I go into on in the podcast. It's a weekly podcast. I think I'm on my 120/7 episode. My podcast has been rated in the top 10% of most popularly listened to podcasts worldwide, and I talk about everything under the sun, so that's a great resource for people to tap into. And you can actually go back and listen to previous episodes. All the the prior episodes have titles and summaries of what they contain. So that's a great resource for people to lean on, lean into, if they are trying to, you know, really educate themselves and be more aware of the things that come up, the things they can expect. And also, I go into a lot of detail about triggers and best responses and the skills that we need to learn. You can learn them all through my podcast.

Robert Plank 36:11 Very nice. And so as far as us getting to those things right, you said that the book is truth, lies and Alzheimer's, it's secret faces, and it has a rich trove of stories cold from your years in the elder care industry. It answers questions like, How do I respond to a loved one's false belief? Are you abandoning your parent if you put them in professional care? And most importantly, how do you make the best of that time left together? So that is truth, lies and Alzheimer's. It's secret faces written by Miss Lisa Skinner, and then that's website. Is that mindingdementia.com

Speaker 1 36:49 Yes, miningdementia.com and there's a powerful guide there for people who have family members who are suffering from Alzheimer's disease, teaching you what to do, how to cope with the difficulties associated with this and some exceptional ideas and questions to answers that most family members ask. And you can click on the Courses tab at the top and get to that training that Miss Lisa Skinner was talking about. And then what's really great is this ongoing weekly intake the stories the podcast is called Truth, lies and Alzheimer's. It features conversations that provide tips for all caregivers navigating these heartbreaking challenges of having a loved one diagnosed with Alzheimer's disease or other dementia. And as you said, there's over 100 episodes. You can start listening now, or you can go back and check out what Mr. Kirk Huntsman had to say, or Mr. William Heckman, or just get these different perspectives from different experts and get yourself educated. Because you're not alone. And it sure does seem Miss Lisa that that education is the cure to anxiety, right? If you're stressed out about anything in life, right? Health, money, the future, just go and look for the evidence, use the logic to beat the emotion, and that especially starts with truth, lies and Alzheimer's. It's secret faces by Lisa Skinner on Amazon, mindingdemensia.com for that course. And then that podcast, which is called truth lies and Alzheimer's, which is on Apple podcast. So you can search that as you're listening, or we'll have the links to those resources in the show notes and as we're going there. But before I let you go, Miss Lisa Skinner, it's time for the scary part of the podcast where I try to stump you. I try to put you on the spot by asking about a fun quote or lesson that has served you. So what comes to mind for a fun quote or lesson?

Lisa Skinner 38:45 Well, I think that relates to what we've been talking about. I like the one because it's pertinent that those who live in glass houses should not be throwing stones. In other words, that's probably one of the most profound things that I've learned in the 30 years that I've been working with families, is try not to judge this can happen to any of us, and I see a lot of judgment going on. Hopefully it's it's improving as people as we start to bust the myths that are out there and the stigmas that are attached to this disease. But I think that's a good place to start, is to not judge and say things like, I've had people tell me this for decades, that, Oh yeah, my mom has dementia, but she's also losing her mind. She's crazy, and that's not the case. What we're witnessing with all the things we've talked about today is part of the disease. It's not somebody trying losing their mind. It's not a mental illness, it's a brain disease. And yes, the behaviors and the things that.

Lisa Skinner 39:59 Happen are bizarre, but they are all part of the disease. So it's easier if we don't try to pass judgment on what we're witnessing and experiencing. We just it's it's healthier for all of us if we just educate ourselves and learn how to properly cope with what we're seeing and what we're experiencing.

Robert Plank 40:23 For everybody, 1,000% agreed, try not to judge, because it seems like that's a coping mechanism, isn't it? It's, well, I'm avoiding my own internal problems and I'm focusing on other things, and that's it's an easy shortcut. It makes me feel better about myself, yeah, but it's kind of not putting good out into the world. And so instead of judging, you figure out your emotions, you get educated. You get to into problem solving mode, which doesn't necessarily mean like fixing and all it means managing, right? It mean, it means being gentle and saying like, Hey, what are some next steps here? How can I help, especially this loved one that I care so much about, that is going through a process that many 1000s of people have gone through, and many more will continue as the as there will only be more physically healthy elderly people out there. And that just means well, you have lots of people in those advanced years this condition will be out there, so we have to manage it, and that begins with these three resources, truth, lies and Alzheimer's, the book by Lisa Skinner, miningdementia.com, and truth lies and Alzheimer's on Apple podcast. Listen to it. You're already listening to the podcast now, so why not one about Alzheimer's? You'll love it. And thanks Miss Lisa Skinner, CDP, CDT, for showing up and helping us out and telling us what you know, I really appreciate what you brought to this conversation.

Lisa Skinner 41:45 So thank you, and thank you again for having me. This is an important message to allow people to be aware of so thanks for supporting that. Very, very much. You.