Our HABIT Healthy Action to Benefit Independence and Thinking program for patients diagnosed with Mild Cognitive Impairment and a partner has always been an on campus, face to face, group-based treatment. With the COVID pandemic, we first put our treatment program on hold, but then the directors at all Mayo Clinic locations began discussing telemedicine modifications for the HABIT program in order to continue reaching patients with MCI but with safety as a top priority. I’m excited to report that our first virtual HABIT program was a great success!
We ran the virtual HABIT program at the Mayo Clinic in Scottsdale, Arizona, from June 15, 2020 through June 25, 2020 with five couples. These visits were live video visits where each couple met with a HABIT clinician alone and then all the couples met together as a group with the HABIT team via video. Despite some technical difficulties early on, everyone soon got used to connecting to us through virtual video visits via Mayo Clinic Connected Care and Zoom platforms. The couples participated from their homes in California, Oregon, Arizona, New Mexico, and Idaho! Although we missed seeing everyone in person, it was nice to see one another virtually during COVID-19 pandemic where we need to physically distance but find ways to stay socially connected.
Each partnership participated in the memory support system (MSS) training, wellness discussion, and support groups. The gentle yoga and brain fitness components of our in person HABIT were addressed in the wellness discussions and through homework assignments and supplemental resource materials sent to the couples ahead of the program (e.g., our HABIT yoga DVD).
Here's a peek into how the sessions were run. Each partnership needed a computer, a computer camera/web camera, and internet that is fast enough to connect to the video platforms used. We encouraged a private area in the house as the preferred meeting location. For memory support system training, the HABIT clinician used the web camera to see and interact with the participant and partner. The provider could see the participant’s book when it was held up to the camera but the partners also played an important role of being the provider's extra set of eyes on the other end of the video camera helping further guide the participant. The HABIT provider used this information to further instruct the participant on how to use his/her memory support system so that it was tailored to the participant’s individual needs.
Wellness discussion was done via HIPAA compliant secure Zoom connection with all the couples together. Dr. Locke led discussions first using slides by sharing her screen and then we facilitated group discussion with just video about those topics and implementing action plans for the topic. After the wellness discussion the patients with MCI stayed on the video for their Zoom support group while the partners were temporarily excused. At the end of the patient support group they were excused and were asked to invite their partners in for their Zoom support group. The couples were all respectful of giving each other privacy during their individual support group sessions. Most couples were in a room where the door could be closed to insure greater privacy. This seemed to be a positive learning opportunity and environment for all involved.
Here are some comments we received the last day of our virtual HABIT session:
*The memory support system (MSS) is simple and it makes my life easier. There is beauty in it's simplicity!
*This virtual program allowed us to participate in HABIT despite the COVID-19 pandemic. I was afraid if we waited too long to participate in the program it might be too late for my partner who has MCI. I was so grateful you decided to open this up--Otherwise we'd have had to wait another year probably to travel and I just can't image that!
*Virtual HABIT allowed me to connect to people in other states. It was amazing! My support network has expanded. I could stay socially connected while still remaining physical distant during COVID-19.
*We didn’t have to travel to attend the program and could do it out of the comfort of our home.
*I’m proud of myself and more confident in myself.
*I have some helpful tools that I can use to help me and my loved one through this journey.
*HABIT got us on the right track.
*I can continue to live a good life despite MCI.
Dr. Locke and I want to extend our gratitude and a huge round of applause for these couples who did a fantastic job participating in HABIT! Your tenacity in conquering the technology (which we have to be honest was a new challenge for us all!) was amazing. We also want to thank Mayo Clinic Connected Care staff who really helped triage technology problems with our patients as well. We learned so much from all of you through this virtual experience and we believe that we can continue to run HABIT successfully in a virtual format, especially during this COVID-19 pandemic when in-person HABIT is not feasible. We should be on day 2 of our next virtual HABIT in Arizona as you read this! We are looking forward to developing virtual follow-up groups to help people continue the habits they have learned in the program and help them reconnect with these couples they've met from all over the country!