Chocolate Therapy

January 13th, 2011 by Andrea Bennett

A news story on dementia garners overwhelmingly positive reader reaction.

Brought to you by Liberty Mutual's
The Responsibility Project

A recent New York Times article was nearly as notable for its comments as for the content of the actual piece; all 121 reader comments were overwhelmingly in favor of what the story seemed to advocate.

What kind of article could elicit such a universally positive response? The story, entitled “Giving Alzheimer’s Patients Their Way, Even Chocolate,” profiles Beatitudes, a facility for dementia patients in Phoenix that has ditched historically accepted treatment methods while allowing patients to keep baby dolls and eat whatever and whenever they feel like – including unlimited amounts of chocolate. “’Dementia patients at Beatitudes are allowed practically anything that brings comfort, even an alcoholic ‘nip at night,’ said Tena Alonzo, director of research. ‘Whatever your vice is, we’re your folks.’” According to Alonzo, the state had tried to cite the program for having chocolate on the nursing chart. “’They were like, ‘It’s not a medication.’ Yes it is. It’s better than Xanax.’”

The story, part of a Times series called “The Vanishing Mind”, reports that there is actual science behind the nursing home’s approach. Indeed, a piece published nearly 15 years ago in the Gerontologist (a subset of Oxford Journals) suggested that a “Pleasant Events Schedule” creates positive emotional experiences for Alzheimer’s patients and diminishes distress and behavior problems.

A common response to the story was surprise that the approach was based on scientific research, since it seemed more like common sense. In fact, “Megan,” a Boston reader, found the article “horrifying,” because…” this means that 99% of the nursing homes out there are not like this? That's awful. If a 90-year-old woman who's not all there wants a doll, give her the darn doll. And what is restricting bacon supposed to do at this point?” A comment from “Utahreb” in Fort Mohave, Ariz., similarly drove the point home: “Respect for the patients – what an original thought! Dignity for patients – another original thought!...I am only 73 and have decided to go to the dessert bar first at the local hotel/casino buffet – even if friends and I go there for breakfast. Does this make me crazy? No – seems like I really enjoy dessert more before a meal….”

Even Beatitudes’ liberal (for a nursing home) policy on alcohol made perfect sense to some readers. Of her 96-year-old aunt who had suffered dementia before her death in a private care home, “Nancy,” a Vermont reader, wrote, “We thought she had lost the ability to speak. One day we decided to bring her a nip of Canadian club, which had been her favorite cocktail. We snuck it past the nurses, and as soon as she smelled it, she brightened. After she took her first sip, she looked up and spoke her first sentence in years. ‘Where are we?’ When told she was in Phoenix, she responded, ‘Well, isn’t that nice!’…So bring the patients chocolate, and whiskey, and babies. They are still there, inside their brains, and any peaceful, happy moments they can enjoy are priceless.”

If comments suggested anything negative, it was the implication that drug companies had something to lose if facilities were to employ this kind of ad hoc treatment. According to “JScottK,” a reader in the Philippines, “The drug companies will be so disturbed by this NYTimes story, they will surely find a way to legislate and regulate out of existence Beatitudes-style nursing home in as many states as possible.”

For now, however, it seems to be providing a template for wider adoption among nursing homes. Hundreds of Arizona physicians, medical students and staff members at other nursing homes have received Beatitudes’ training, and several Illinois nursing homes are adopting it, according to the Times.  And so, it seems, are readers, like “Beth” in Boston: “Such a great article on an intuitive approach to care. My Mom is always talking about a baby she can’t find and I’ve been thinking I should get her a doll. I’m getting her one this week.”

The New York Times isn’t accepting more comments, but you can sound off here. Are you in agreement that making life agreeable for dementia patients just sounds like basic common sense…or is the story missing a point you want to make here?