Shara Cohen Spills the Tea on Caregiver "Diagnosis" and Support

[00:00:04] [SPEAKER_01]: Welcome to the HITea With Grace podcast where we spill the tea on HITea.

[00:00:09] [SPEAKER_01]: I'm honored to welcome Shara Cohen CEO of Caregiver Diagnosis and Support, HITea.

[00:00:14] [SPEAKER_01]: Thanks for joining us today, Shara.

[00:00:16] [SPEAKER_01]: Thanks for having me.

[00:00:18] [SPEAKER_01]: Tell us about the career path that brought you to your role today.

[00:00:23] [SPEAKER_02]: My first job at a school I worked for a baseball team, and so naturally I'm going to end up here working on

[00:00:29] [SPEAKER_02]: health care topics and caregiving.

[00:00:33] [SPEAKER_02]: But actually the truth is I thought in that time with a baseball team that everybody would always understand my job for the rest of my career.

[00:00:41] [SPEAKER_02]: And little did I know that was the last time anybody ever understood my job.

[00:00:45] [SPEAKER_02]: I grew up professionally in the startup environment of the Bay Area in the late 90s,

[00:00:50] [SPEAKER_02]: and accidentally fell into a business that was focused on educating providers about legal responsibility.

[00:00:59] [SPEAKER_02]: In that time period, it's quite reform and I'll practice with a big topic.

[00:01:03] [SPEAKER_02]: That was my first introduction into healthcare.

[00:01:06] [SPEAKER_02]: A few twists and turns later got hooked on the notion of people as an underutilized, under-engaged resource in healthcare.

[00:01:17] [SPEAKER_02]: At that time there was a lot of discussion about healthcare alignment and that discussion usually began and ended with providers and payers and sometimes pharmacy.

[00:01:30] [SPEAKER_02]: But never the patient.

[00:01:31] [SPEAKER_02]: I got really hooked on that with a company called Emmy Solutions.

[00:01:35] [SPEAKER_02]: We were really one of the early movers on patient engagement, and this notion of if we are going to improve cost and quality and experience of care,

[00:01:45] [SPEAKER_02]: then we really needed to reach people outside of clinical settings.

[00:01:50] [SPEAKER_02]: That's what we did.

[00:01:50] [SPEAKER_02]: We worked with health systems and really built a case and showed outcomes for reaching people with healthcare information that was specific to them,

[00:01:59] [SPEAKER_02]: and improving ROI for health systems.

[00:02:01] [SPEAKER_02]: And so that became a 15-year journey.

[00:02:05] [SPEAKER_02]: And when it was we sold that business to Walters, Cluer Health, and how to great experience there on a global scale of the impact of information.

[00:02:14] [SPEAKER_02]: Good information to patients and then also to providers and to pharmacy.

[00:02:20] [SPEAKER_02]: It was time for me to get back in the trenches of building something again.

[00:02:25] [SPEAKER_02]: And the things that I experienced in talking to frontline staff about patient engagement was they would often say, this is great, but it's not the patient.

[00:02:36] [SPEAKER_02]: I'm worried about we're sending people home and it's the family caregiver that is catching them.

[00:02:41] [SPEAKER_02]: And I have no idea what happens then or if they're prepared.

[00:02:46] [SPEAKER_02]: And so that was the little kernel that when I met the Carol Al Team was enough to push me over the edge to say, yeah this is the next thing that I need.

[00:02:54] [SPEAKER_02]: It's been a lot of time and energy around is how do we engage that family caregiver and make sure that they're supported because they're doing such important work in a really hidden and vulnerable way for the healthcare system.

[00:03:09] [SPEAKER_02]: So maybe more of an answer than you expected.

[00:03:12] [SPEAKER_01]: I think what I wanted and that's fascinating.

[00:03:14] [SPEAKER_01]: I love this path and it's so interesting because I've been in this patient advocacy world and healthcare innovation kind of sitting around doing the same thing, but at a totally different area.

[00:03:24] [SPEAKER_01]: So you I love to hear interesting stories of unique ways that patients and caregiver insight is being utilized for the bigger picture of healthcare.

[00:03:33] [SPEAKER_01]: So traditionally caregiving was seen as a private task right and it's a woman that does this caregiving without outside acknowledgement.

[00:03:42] [SPEAKER_01]: How have you seen that discussion about caregiving change over the last decade?

[00:03:47] [SPEAKER_01]: This caregiver thought leader now that you are in the company that you're in.

[00:03:52] [SPEAKER_02]: Another big question grace. Yeah absolutely so private task because I think in part because it hasn't had a name people don't identify as caregivers generally still although I do think this is changing so I appreciate how you set up the question.

[00:04:11] [SPEAKER_02]: People typically identify as a husband or a wife or a partner or a driver or a son or a daughter you say are you a caregiver and they say no I'm just I'm just doing this thing for my friend.

[00:04:25] [SPEAKER_02]: So I think maybe to start I would say let's define what caregiving is to me family caregiving is about all of the informal supports that we rely on as we age as we confront serious illness or as we deal with an injury.

[00:04:41] [SPEAKER_02]: And so it encompasses a lot for some people it's the day to day groceries and medication management and cleaning and driving for some of its paying bills and making doctor appointments finding professional care options helping with ADLs.

[00:04:59] [SPEAKER_02]: We often say it's everything from the janitor to the CEO right you're lifting and helping use the toilet and also becoming a health advocate and figuring out insurance and financial supports for something that's getting really expensive and.

[00:05:17] [SPEAKER_02]: Over 50 million people are doing this every day what I think has changed in the last decade are some fundamental things we're getting old.

[00:05:26] [SPEAKER_02]: I'm sure there is a more elegant way of saying both you're getting old health care is strapped and the system is strapped and then you have this out of the blue thing that happened which was coven so getting old right by the end of this decade.

[00:05:42] [SPEAKER_02]: And every baby boomer will be over 65 and 20% of Americans will be over 65 a few years after that older adults will outnumber children.

[00:05:58] [SPEAKER_02]: And so we have a lot of people who are over 85 will triple so we are living longer.

[00:06:05] [SPEAKER_02]: We have this increase in chronic disease so even though a lot of us are living healthier longer we do have that crisis and over half of the people over 65 have multiple chronic conditions.

[00:06:16] [SPEAKER_02]: So that is you just talking about an older population that has a bigger number of sick the health care system isn't prepared for that we have shortages in primary care we have shrinking numbers of gerontologists.

[00:06:29] [SPEAKER_02]: We have shortages in home care skilled nursing providers and home health aids and we have a more and more fragmented health care system that's difficult to navigate and access.

[00:06:41] [SPEAKER_02]: So with this pandemic of chronic illness it's left to the family caregiver to figure it out and it's exacerbated by all the social disparities that have rightly and importantly come to the for in the last decade as well.

[00:06:56] [SPEAKER_02]: I think it's probably becoming obvious that it wasn't already how all of those pressures mean that as we age, as we get sick more and more of the gaps that need to get filled have to get filled by family and friends.

[00:07:09] [SPEAKER_02]: And so what's changing is that regardless of age and socioeconomic position and where we live caregiving is coming for all of us and the children of boomers we are all moving into positions of influence where we lead organizations and so we're feeling it personally.

[00:07:31] [SPEAKER_02]: And figuring out what to do about it professionally and so then COVID comes in and there's a silver lining here one of the few silver lining for COVID I like to clean to is that we all got to peer into each other's home life over zoom calls and see what our coworkers and colleagues are grappling with and juggling the pressures of caregiving.

[00:07:55] [SPEAKER_02]: Also juggled with young children back to your comment about women who shoulder the bulk of that responsibility there's increasing recognition and awareness and then you have people who are raising that awareness and telling their stories.

[00:08:12] [SPEAKER_02]: Public and private sector organizations start to respond the VA has amazing resource around caregiving CMS has created more and more incentive first it was.

[00:08:24] [SPEAKER_02]: And a supplemental benefit that Medicare Advantage plans could offer now they've introduced the CMI guide model for dementia care these are that actively recognizes the role of the caregiver their nonprofits like the caregiver action networks that have stepped up and then organizations like Carol who are part of this care economy that's emerging.

[00:08:44] [SPEAKER_02]: And we've got a flywheel of activity to hopefully confront that wave.

[00:08:51] [SPEAKER_02]: I can talk about this for many more.

[00:08:53] [SPEAKER_01]: I love it that's what that's all what all of our listeners want to hear about we obviously are very interested in hearing about how caregivers are impacted because they're us.

[00:09:04] [SPEAKER_01]: Yeah, all of us in some way are part of the sandwich generation people taking care of their kids and their aging parents etc.

[00:09:13] [SPEAKER_01]: So what kind of digital technologies exist to help us as the sandwich generation.

[00:09:18] [SPEAKER_02]: Yeah, I think what I just want to note is when I you know I spent 15 years in patient engagement and I remember walking into any executive room at a health system.

[00:09:32] [SPEAKER_02]: We've all been patients people have to associate with this.

[00:09:37] [SPEAKER_02]: The last word to now and talking to executives at health plans and health systems.

[00:09:44] [SPEAKER_02]: I am shocked to spill at how different it is and how I cannot do a presentation or a meeting without somebody pulling me aside and saying.

[00:09:55] [SPEAKER_02]: I'm going through this with my mom and I don't know what to do here.

[00:09:58] [SPEAKER_02]: I am at a large health care organization with the network and the resources and I am totally overwhelmed in a very different way.

[00:10:07] [SPEAKER_02]: Nobody said that to me about patient being a patient.

[00:10:09] [SPEAKER_02]: I am heartened by thinking that we just care more about our loved ones than we care ourselves perhaps.

[00:10:16] [SPEAKER_02]: But association that you just had, I think is super common maybe as a little bit of background on Carol and how we come to this.

[00:10:23] [SPEAKER_02]: We are a tech enabled service in which we provide the guidance of caregiving experts to support and coach and help people on their own personal caregiving journey.

[00:10:36] [SPEAKER_02]: We marry that with a technology platform that is digital tools and education and resources for what we call a circle of care to collaborate around the health and wellness of a loved one.

[00:10:50] [SPEAKER_02]: I say that less as a commercial and more as a sort of entry point to how I come to this.

[00:10:55] [SPEAKER_02]: What has emerged I think is a pretty wide variety of tools and particularly on the digital side there are a lot out there in terms of helping people access information helping.

[00:11:12] [SPEAKER_02]: I mean, that sort of caregiver circle of care helping them find goods and resources so marketplaces where you can make purchases tools that help with advanced care planning or getting more resources into the home.

[00:11:29] [SPEAKER_02]: I was just doing a panel with a company that I love called jukebox health that does OT assessments in the home for home safety and then project managers the home modifications for a family because there are benefits and resources out there but it is a cottage industry and it's very hard to get reliable evaluation plus the actual work done.

[00:11:53] [SPEAKER_02]: Independence in the home comes down to simple actions like that in many cases.

[00:12:00] [SPEAKER_02]: So there's a lot out there I think what is challenging and one of the things that we're really focused on helping family solve is it's a lot of stuff all over the place.

[00:12:10] [SPEAKER_02]: And so one of the things that we're really trying to think about is part of caregiving is like a part time job the average caregiver is spending 24 hours a week on their caregiving responsibilities.

[00:12:22] [SPEAKER_02]: So what people don't need is more homework or a list of phone numbers to call and so how do we bring some of that or a lot of that together for them.

[00:12:32] [SPEAKER_02]: What I am really excited about is how do we create a hub where people can navigate everything from the janitor work to the CEO work.

[00:12:41] [SPEAKER_02]: The day to day tasks to the more complex advocacy task with a very healthy dose of self care and support for the caregiver what makes caregiving hard is not just the logistics of it, not just the expense of it but the emotion of it the stress and the exhaustion of it.

[00:12:59] [SPEAKER_01]: What's interesting, can you talk more about these stressors I love that you're bringing in all together for these folks because the last thing they need is one more thing to look for.

[00:13:09] [SPEAKER_01]: So if they have one place to have all of these opportunities it's a great way to relieve some of those stressors but traditionally we're seeing a lot of these caregivers having tremendous financial issues with their physical and mental health overall livelihood and more.

[00:13:24] [SPEAKER_01]: So what are some of the stressors that you find you're hearing over and over that you feel need to be solved like yesterday.

[00:13:31] [SPEAKER_02]: Yeah, I think it's a wide range and I think what is I like to associate caregiving almost as a diagnosis in and of itself because it is so far ranging.

[00:13:44] [SPEAKER_02]: So you named some important ones there are financial stressors there are time stressors just think about I've got it I am working I have a kid who needs a lot of stuff.

[00:13:59] [SPEAKER_02]: I've got a parent who needs a lot of stuff I've got a spouse who needs a lot of stuff and how do I juggle all of those things and find some time to recharge for myself.

[00:14:10] [SPEAKER_02]: I think there is a lot of recognition around some of those challenges right the spinning plates and keeping them all in the air the financial strats of both of boarding the caregiving and maintaining.

[00:14:20] [SPEAKER_02]: And I think that's a great way to work life particularly if you need the income which most of us do.

[00:14:27] [SPEAKER_02]: But maybe I'll hit on one that gets less discussion which is the emotional and relational connection to the person that you're caregiving for if you are caregiving for a spouse, which in our Medicare customers is frankly we like to talk about sandwich generation and we can all relate to it in our own lives.

[00:14:45] [SPEAKER_02]: But a lot of this is elderly caregiving for the elderly and your relationship to your spouse who is now dependent on you is a massive change.

[00:14:55] [SPEAKER_02]: And just as caregiving for a parent is a massive change and what your relationship is to that person is very complicated.

[00:15:05] [SPEAKER_02]: When you couple that with things like neurodegenerative diseases and dementia where you have those shifts in the relationship you have combat of behaviors to deal with, you have changes in competency to deal with and it is all of the time.

[00:15:23] [SPEAKER_02]: And that level of exhaustion is something that the average caregiving journey is 4 and a half years.

[00:15:31] [SPEAKER_02]: And when you are living with somebody who is not the person that you started with, that takes a significant toll older adults who have their own needs to fill and we see that in the risk on mortality for those older adults.

[00:15:44] [SPEAKER_02]: I think that I don't want to be the doom and gloom session on your series.

[00:15:50] [SPEAKER_02]: I think there are also amazing, we hear them every day. These amazing stories of people who are so grateful to give to the person that they're giving to and the celebrations and the successes that they have.

[00:16:03] [SPEAKER_02]: And they are assuring the highest dignity of care for their loved ones.

[00:16:06] [SPEAKER_02]: I have a toddler and I often describe it to friends who are thinking about kids as it is wonderful and it is relentless and the same goes for the other end of the spectrum.

[00:16:19] [SPEAKER_02]: And so, I think that what we see just to put a cap on it is we measure caregiver burden and caregiver resilience for everyone who uses our services.

[00:16:30] [SPEAKER_02]: They start very high. They start eight on the Zeratburn scale as a high burden our average starting point is around 11 and the same goes for resilience, which is an indicator of depression.

[00:16:44] [SPEAKER_02]: And so I do think we have to think about this as a diagnosis because it does have physical and mental health impact for the caregiver.

[00:16:53] [SPEAKER_01]: And so, caregiving as a diagnosis that is something we all need to sit with for a minute. I don't know if you are a leader at a health system, you're a leader in the patient or caregiving community.

[00:17:03] [SPEAKER_01]: Everybody needs to be screaming this from the rooftops from the boardrooms that help the systems to the boardrooms that payers.

[00:17:10] [SPEAKER_01]: Sister scream it from the rooftops.

[00:17:12] [SPEAKER_01]: Yeah.

[00:17:12] [SPEAKER_01]: These people are being tremendously impacted and not being seen. They're invisible.

[00:17:19] [SPEAKER_01]: What other populations you mentioned the elderly and it's a really interesting thought when you think about that population of the elderly caring for the elderly and how that impact.

[00:17:29] [SPEAKER_01]: But what other populations are really impacted by this caregiver.

[00:17:32] [SPEAKER_01]: And so, I think my norm is underserved communities, LGBTQ rural communities.

[00:17:38] [SPEAKER_01]: Have you noticed any particular areas that where additional support might be particularly helpful?

[00:17:45] [SPEAKER_02]: Yeah. And this really hits close to home.

[00:17:47] [SPEAKER_02]: I think that one of the things that you said earlier it's coming for everyone sometimes I feel like I'm in a game of thrones commercial because it's like winter is coming, right?

[00:17:56] [SPEAKER_02]: The thing about caregiving is universal. The thing that I think is important in your question is it impacts different communities differently and in disproportionate ways.

[00:18:08] [SPEAKER_02]: And so those the rural versus urban we have we're fortunate to work with organizations like independence flu cross where you have a concentration in Philadelphia and people are living in multi generational homes,

[00:18:23] [SPEAKER_02]: which is different than our work with Blue Cross of North Carolina where you got rural versus urban, which is different than what we see with Florida blue where you have retirees whose kids live far away and they've snowboarded to Florida.

[00:18:37] [SPEAKER_02]: So you have these different dynamics how location matters and access to care matters, the proximity of that care matters.

[00:18:47] [SPEAKER_02]: In immigrant communities in black and brown communities and in Asian communities you tend to see higher intensity caregiving in the home because there are different expectations and norms about where and how you age.

[00:19:05] [SPEAKER_02]: And then I think that the LGBTQ plus community is also interesting in a different way because you have less historic recognition by the healthcare system of relationship and you often have non blood related caregiving or non family related caregiving.

[00:19:27] [SPEAKER_02]: And so that also changes the dynamics in discussions around social determinants and social drivers of care.

[00:19:35] [SPEAKER_02]: The access issues and the barriers that people experience in these communities gets a little bit exacerbated because now you've compounded it times two in both what the caregiver needs and can access and what the the care recipient can needs an access.

[00:19:51] [SPEAKER_02]: And that caregiver can be a real navigator and coordinator on behalf of a health plan or a healthcare system, but they've got to be engaged and there has to be particular outreach because there's also the difference there on trust that the healthcare industry.

[00:20:08] [SPEAKER_02]: It is the major factor in how people engage and what they engage about and what what problem solving looks like for each of them given their life context and perspective.

[00:20:18] [SPEAKER_01]: So I'm wondering as we're closing out this part of the podcast what are some ways we can help give a voice to caregivers and honor the hard work that they provide in our communities.

[00:20:29] [SPEAKER_01]: What are recommendations that you give to folks that you're talking to every day, like how do how can we do better.

[00:20:35] [SPEAKER_02]: Yeah, I love that question thanks for that.

[00:20:38] [SPEAKER_02]: I think I think that number one I would say identify as a caregiver.

[00:20:45] [SPEAKER_02]: I think that's number one and I would give that name generously.

[00:20:49] [SPEAKER_02]: There are so many times when I hear people say my sister does most of the work I just do this and this is a team sport everybody can play a different position but be on the team.

[00:21:01] [SPEAKER_02]: And I think that for most of us who are employed in organizations be advocates internally for your colleagues and yourselves as caregivers and recognize that when we name it you can start to advocate for this being a component of life work balance.

[00:21:21] [SPEAKER_02]: And if you're fortunate to be in a place of influence for an organization whether that's for employees or as a healthcare organization thinking about how you deliver better care.

[00:21:33] [SPEAKER_02]: And what influences truly cost quality and experience of care the caregiver needs to be part of that equation and you're dependent on them and you are benefiting from their hard work help them do the work it's a job they didn't volunteer for.

[00:21:50] [SPEAKER_02]: They're not getting paid for they didn't get trained for we need to provide them that support and training and enablement and it will come back in tangible ROI.

[00:22:00] [SPEAKER_01]: It's just putting a name on it really is so impactful and empowering for people to realize oh this is what I'm in it's almost like a self realization to just put an aim on it.

[00:22:11] [SPEAKER_01]: And then encouraging those around you because at some point you're going to be in that position whether you like it or not so change it while you're not experiencing the problem right you should be the one to say something speak up with the people around you I really want to dive into you as a leader as a CEO as somebody who built a company sold a company.

[00:22:29] [SPEAKER_01]: What are things that you do on a daily basis to help work your best and make a difference.

[00:22:36] [SPEAKER_02]: I drink a lot of coffee.

[00:22:39] [SPEAKER_02]: I think that there are three I once had a mentor say to me he divided brain up into three spaces at least as it related to his work one was about his team a third of his brain space needed to be about his team a third of it needed to be what they as an organization deliver it to their market.

[00:22:59] [SPEAKER_02]: And then a third about their customer and really being there to work with them and I would say I'm not great at even distribution on every given day.

[00:23:11] [SPEAKER_02]: But I think that there is particularly at earlier stage companies as we grow the investment in people and customer is almost more important than the work on the product and with all due respect to anybody on my product team who's been listening to this.

[00:23:31] [SPEAKER_02]: Because you have to know what problem you're solving and you have to have people engaged around the right challenges and make them feel like they're supported enough to do that work.

[00:23:42] [SPEAKER_02]: I try to remind myself of those things and I try to get a little fresh air every day to clear the head to come back to those three things.

[00:23:50] [SPEAKER_01]: Oh, I love it. I've never heard it put that way but it does make a ton of sense that you'd want to be able to separate into those buckets and get to know the audience before you really type right in health care is just not easy it's complex challenging.

[00:24:05] [SPEAKER_01]: How do you manage your own feelings and emotions while executing basically I can only imagine that being a huge challenge and you have to have some skills that you've created over time to help you with that.

[00:24:18] [SPEAKER_02]: Now, I will say most of the credit on balancing that it should be put with our care advocate team who are really talking to caregivers every day and I think we put a lot of effort on giving them time and space together.

[00:24:34] [SPEAKER_02]: And with advisor founding boards to process a lot of what they're hearing, they also have the benefit of making a difference in people's lives and very tangible ways that people are so grateful for and that feels great.

[00:24:49] [SPEAKER_02]: For me personally in my role, I would say one of the things that I underestimated in stepping into a CEO role was the power of personal networks.

[00:25:01] [SPEAKER_02]: I have such gratitude for other CEOs, frankly, who have created vulnerable spaces to talk about how you deal with investors and boards and customers and all of those pressures.

[00:25:14] [SPEAKER_02]: And you realize how nobody takes a linear path, everybody's doing the best they can and we can really help each other if everybody's willing to admit that they don't have all the answers all the time.

[00:25:27] [SPEAKER_01]: Very interesting, I love that it's like the power of community. Why do this alone when I can do this with a crew behind me that can give it for advice and support and have experienced as well.

[00:25:38] [SPEAKER_01]: Do you think advice for women coming into the healthcare health IT space and wanting to grow their careers do you have any advice based on your experience on what they should focus on or what they should think about.

[00:25:52] [SPEAKER_02]: I think that I would encourage two things. One, read study and listen, it is complicated and there's no shortcut for this is a long game right your career as a long career.

[00:26:09] [SPEAKER_02]: Dilotons don't really last it is craft that you need to understand shifting dynamics that are complex and and invest that time.

[00:26:19] [SPEAKER_02]: On the other hand, I go back to community. I think that it is a we're getting prepared for health this year and that is like a massive conference and it's so overwhelming but it is still a pretty small world.

[00:26:33] [SPEAKER_02]: And so you're the people that you meet today are people you're going to see over the course of time and so number one, be kind.

[00:26:42] [SPEAKER_02]: Number two, be reliable and number three support it particularly I think for women it is just a fact that we are invested in less our ideas or companies.

[00:26:54] [SPEAKER_02]: It is further out there and the only way to help each other is to help each other and I've been fortunate that people have given generously of advice and introduction and relationship.

[00:27:07] [SPEAKER_02]: And I try to do that forward because it is impossible to do by yourself.

[00:27:13] [SPEAKER_01]: So that is awesome and I will see you at health I will be there and then I'm thrilled to see you there.

[00:27:19] [SPEAKER_01]: So to finish this conversation off where can our listeners find you online?

[00:27:24] [SPEAKER_02]: They can find me at parallel.com they can find Carol on all the socials they can find me on LinkedIn.

[00:27:32] [SPEAKER_02]: They can find me at sco and at carolow.com happy to chat or interact in the way that they like and are interested in and happy to help in any way I can.

[00:27:42] [SPEAKER_01]: Terrific now before I forget did you happen to bring to you with you today?

[00:27:46] [SPEAKER_02]: I brought some ice water because I know I can be afraid train of talking and in a little water.

[00:27:52] [SPEAKER_02]: So I have my favorite cold and hot mug that my friends at Lucross and North Carolina gave me and keeps them top of mind for me every day on their members and caregivers.

[00:28:03] [SPEAKER_02]: And it is amazing it keeps it cold overnight it's like a miracle.

[00:28:07] [SPEAKER_01]: I love mugs like that and FYI if you want to have the best kind of product placement just give your favorite customers and partners mugs that really work.

[00:28:19] [SPEAKER_01]: That's right.

[00:28:20] [SPEAKER_01]: Thank you so much for joining us today it was just so great to learn from you and I really appreciate you being here and being an advocate for caregivers and their journeys.

[00:28:28] [SPEAKER_02]: Thanks so much Grace it was great to be with you and appreciate the conversation and for what you're doing to give voice to these issues.

[00:28:36] [SPEAKER_02]: Anyway that I can help to continue to support is great and all the best of luck to you as well.

[00:28:41] [SPEAKER_01]: Appreciate that thank you and thanks to you folks for joining us too check out the high-team with Grace podcast cheers.

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