Wednesday, July 21, 2010

Hmmm... Chocolate!

Food of the Gods

Hmmm. Truffles or chips, mousse or bars. No matter how you like it, there is nothing else like chocolate. But that delicious slice of cocoa-laced cake is often served with a helping of guilt. Maybe you shouldn’t feel so bad after all—it turns out chocolate has a good side.


We all know it can soothe the soul, but did you know chocolate can also lower blood pressure and reduce the risk of heart disease and blood clots, according to a study published by the American Heart Association. Flavonoid compounds in dark chocolate are also the same healthful antioxidants found in fruits, vegetables, tea, and red wine. Chocolate even appears to reduce bad cholesterol (low density lipoprotein) while increasing good HDL (high density lipoprotein) cholesterol.

Chocolate also contains tryptophan, an amino acid that increases levels of serotonin, a natural antidepressant and stress reducer. And eating chocolate increases the body’s endorphin levels, thereby elevating mood and reducing pain. Dark chocolate also seems to improve the body’s use of insulin and glucose sensitivity, and it is rich in potassium and magnesium, and contains vitamins A, B1, B2, D, and E.

The Downside

Of course some of the benefits of eating chocolate are offset by its high fat, sugar, and calorie content. For example, a cup of broccoli and a cup of sliced apples have 20 and 57 calories respectively, while a cup of chocolate has 1,000 calories or more.

Not All Chocolate is Equal

The amount of beneficial flavonoids in chocolate depends on the type of cocoa bean and the methods used in processing. For instance, Dutch process” greatly reduces flavonoid content. White chocolate has no flavonoids since it has no “cocoa mass” and is not technically chocolate at all.

Dark chocolate, on the other hand, has fewer calories and two to four times the amount of flavonoids found in milk chocolate. Milk binds to the beneficial antioxidants, making them unavailable. To get the full benefits of antioxidants, you should avoid drinking milk with your dark chocolate. The ideal dark chocolate will have a “cocoa mass” content of at least 70%.  With chocolate—the darker, the better.

Thank the Mayans

2,000 years ago the Mayans of Mexico and Central America began cultivating the pods of the cocoa tree that grew wild in the jungle. When mixed with water, chili peppers, and cornmeal, the ground cocoa beans made a spicy, frothy drink. Later the Aztecs adopted the bitter cocoa drink, usually enjoyed only by royalty and the privileged class. Spanish conquistadors brought cocoa beans to Europe in the 1500s where experiments with adding sugar to the new product flourished. The rest is history.


So next time you want to indulge your sweet tooth with the silky, smooth, velvety texture of your favorite chocolate, enjoy it without guilt—you could be lowering your blood pressure!

For more information about Pathways Home Health, Hospice & Private Duty please visit our website at

Friday, July 9, 2010

Swearing Makes Pain More Tolerable

Uttering a curse word when you stub your toe or hit your thumb with a hammer could actually make it easier to bear the pain. Swearing is a common response to pain, but until now there has been no research looking into this. 

"Swearing has been around for centuries and is an almost universal human linguistic phenomenon," said Richard Stephens of Keele University in England, and one of the authors of the study.

Stephen’s team thought swearing would exaggerate the pain and people would tolerate it less.  The opposite turned out to be true.

The researchers had 64 university students put their hands in a tub of ice water for as long as possible while repeating a swear word of their choice.  The experiment was then repeated with the volunteers repeating a more common word that they would use to describe a table.

Contrary to what the researchers expected, the volunteers kept their hands submerged longer while repeating the swear word.

A Primal Response

Stephens says that swearing comes from deep-seated, primal, emotional brain centers.  Just as a cat would screech if his tail as stepped on, a primate would make a noise, and in humans our language ability often transforms the screech into a swear word. 

The researchers think that the increase in pain tolerance occurs because swearing triggers the body's natural "fight-or-flight" response. Stephens and his colleagues suggest that swearing may increase aggression (seen in accelerated heart rates), which downplays weakness to appear stronger.

"Our research shows one potential reason why swearing developed and why it persists," Stephens said.

The results of the study are detailed in the Aug. 5, 2009 issue of the journal NeuroReport. This article is adapted from the Live Science website.

For more information about Pathways Home Health, Hospice & Private Duty please visit our website at

Wednesday, July 7, 2010

When Capacity Is In Question

Let’s say your patient is in the earlier stages of dementia when a malignancy is discovered. Who decides his treatment options? Despite his dementia, it’s possible that it should be the patient himself.

Decision-making capacity is defined as “the patient’s ability to make his or her own decisions about accepting or rejecting medical procedures or treatments,” according to an article in the Journal of Palliative Medicine (November 2009). Author Frank Clore, a hospice spiritual care counselor, lists five considerations for the healthcare professional:
  1. Does the person understand the facts involved in making the decision?
  2. Does he “have an appreciation of the nature and importance of the decision to be made, including potential alternative choices?”
  3. Does he understand the benefits and risks of the decision?
  4. Can he communicate the decision to others, including the reasons for making the decision?
  5. Can he “deliberate based on consistent personal values?”
Clore suggests that you may be able to elicit the answers using these assessments:
  • Ask the patient to explain what he/she understands about his/her illness and about the proposed treatment.
  • Ask what the patient thinks about the proposed treatment, how it may help him/her, and what will happen if the treatment is not chosen.
  • Ask the patient to repeat his/her choice; answers should be consistent over time.
As with all patients, but especially those whose capacity for decision-making is in question, Clore reminds us the patient should be properly informed and free of coercion, and that the patient be “assessed in relationship to a specific decision, at a specific time, and in a specific context.”

For more information about healthcare decision making visit or visit our website

Sunday, July 4, 2010

Spiritual Support in Hospice

Meaning of Life

When a patient may be facing the end of life, spiritual issues often begin to surface—people begin to ponder the meaning of their lives. Hospice is intended to care for not only the physical wellbeing of the patient, but the emotional and spiritual aspects as well. Toward that holistic end, Medicare mandates that hospices provide spiritual support (as they do in the military, another place where death is a possibility).

Spirituality is about those aspects of life that are not material; it is about relationships and finding meaning. Each of us has a spiritual side; some express it through religion, some in other ways.

But when faced with life-threatening illness, many experience feelings of fear, powerlessness, helplessness and despair, which are often expressions of spiritual distress.  Hospice spiritual care counselors are knowledgeable about a wide range of religious and spiritual traditions. They may be a presence in the home, or they may be the connection to the patient’s own faith tradition.

A Pathways Hospice Spiritual Care Story

Years ago, Pathways had a Vietnamese patient who had emigrated after the Viet Name war, in which he was an army colonel. His cancer pain was never seemed completely managed, despite multiple approaches.

One day he mentioned he wished he had not stopped practicing his Buddhism and wanted to pray with priest, however he was too weak to leave home. A hospice spiritual care counselor began networking until he found a Vietnamese Buddhist nun who came to pray with the patient.

Interestingly, not only did the patient’s anxiety decrease dramatically, but his pain was gone after these visits.

How Spiritual Support Can Help

Some of the many ways that hospice spiritual care counselors can help as requested by the patient or family are by:

  • Giving unbiased spiritual or religious support for patients or family members
  • Helping to identify and resolve spiritual concerns affecting the patient or family
  • Exploring the “meaning of life” questions
  • Administering sacraments
  • Caring listening
  • Contacting clergy or a spiritual leader of a specific faith community for the patient
  • Exploring ways to prepare for “letting go” of this life in preparation for another
  • Being another caring presence in times of need or distress

For more information about Pathways Hospice Services, please visit our website at or email: