This piece was published in the Pasadena Star-News on June 7, 2009.
He struggled with the shovel and my husband offered to help. He declined, intent on his task, wanting to do it himself. He was giving up so much and this was just one more piece of the life he was about to leave behind.
Finally, the mound of dirt was dug out and my husband dived under the tree and retrieved the desert tortoise our neighbors called “Speedy” for twenty-seven years. A few days earlier, our neighbor told us he was moving. He and his wife were both retired and ready to move, but stayed put until Wilbur’s mother passed away.
Wilbur drove daily to the nursing home to give his mother dinner. Towards the end he had to spoon the food into her mouth. Finally, she stopped eating. For Wilbur, it was another routine that came to an end.
We had moved to our home twelve years earlier, leaving our small, empty nest for a much bigger one in a neighborhood with high block walls enclosing the yard. After gardening for many years on a yard the size of a postage stamp, I now had lots of space for my tomatoes, herbs, flowers and perennials.
I spent many happy hours on the top terrace of our yard where I could observe Wilbur, a fellow gardener, meandering around his yard. My two dogs stood on their hind legs, stretching as high as they could, trying to peer over the big block wall. They yapped their heads off, trying to get his attention because he always appeared with doggie treats in hand.
When I first spotted Speedy in Wilbur’s yard, I missed the tortoises I put up for adoption many years ago. When our children were small we inherited a tortoise and took good care of her for years, registering her with the Fish and Game Department, supplementing her calcium and keeping her burrow dry on wet winter nights.
After I took in a male, nature took its course and the pair started to reproduce. Not wanting to raise hatchlings, I placed my fertile pair in the capable hands of a tortoise lover who wanted to take on that responsibility. I missed the slow but sure example of the desert tortoises. I forgot the lesson they teach us, day-by-day, of the need to slow down.
Wilbur told me he wanted to live closer to his wife’s family so they could help him take care of her. She had been chronically ill and housebound for many years. I could tell he didn’t want to leave his home, but he needed help. I told him I was sorry to see him go and offered to adopt Speedy. A spry old guy, Wilbur jumped for joy.
On that overcast day, while my husband and I watched Wilbur struggle with the shovel to unearth the shelter he built so many years ago, I knew that Speedy was soon to be displaced. Unlike Wilbur, Speedy was unaware of her displacement and didn’t know she would resume her leisurely life in a new back yard.
Two years after Wilbur moved, his wife died. He followed her a couple of years later. A family with two young children moved in next door and occasionally I retrieve a ball that flies over the block wall that separates our yards.
Speedy is still going strong. I built a burrow for her under the orange tree. She appears in the spring and forages around the yard all summer. In addition to reminding me to slow down, I also think of Wilbur when I see her and remember his devotion to his mother and wife.
My husband and I plan to stay in our house indefinitely, but we are smart enough to know that life can through curve balls and I may end up passing Speedy back over the wall to the care of the family next door. If we, and Speedy, are displaced I’ll try to take it with the grace and style Wilbur did so many years ago.
This piece was published in the Pasadena Star-News on May 1, 2009.
Parents, untrained and unprepared to raise children, do their best in spite of the incredible odds that are stacked against them. In the darkness of a winter night, or in
the dappled shade of a picnic ground, sperm meets egg and a whole bunch of DNA gets mixed together to produce a brand new human being.
Even the cold, sterile environment that is the average delivery room cannot dampen the rapturous joy that heralds the arrival of a newborn child. The doctor catches the newborn babe, nurses scurry around to weigh and clean and tidy up. New moms and dads shed tears of joy as they gaze at the tiny miracle. It goes downhill from there.
If you look up “mistake” in the dictionary, buried deep in the definition you’ll find “well meaning but inexperienced parents.” We parents make huge mistakes as we try our very best not to. Sometimes we do it right but we don’t know it at the time.
One of the things I got right was Mommy-and-Ben Time. When I came up with the idea my son was just seven years old and had been subjected to upheaval that I had visited on him and another upheaval that life cruelly bestowed upon him. I tried to cushion the blows.
Ben’s father and I divorced when Ben was just four-years-old. I remarried two years later and we moved with my new husband to another state. Ben left behind life as he knew it, along with his best buddy, Matty. The week before we moved, I watched my broken hearted six-year-old son put his feet up against the wall in his bedroom and wail, “I’m going to miss this wall.” It went downhill from there.
Ben started first grade in his new school. As children must do, he adapted to his new environment and found a new best buddy.The cruel part came when Ben’s new best buddy, who had a heart condition, died on the playground after running too hard and too long with his little friends. Ben was bereft.
It broke my heart to see my young son cope with so much loss. I wanted to give him extra time and attention, so I invented Mommy-and-Ben Time. Every Saturday morning we got up and decided where we wanted to go – just the two of us. We went to the magic store, the zoo, hiking, the mall. We always went to a fast food restaurant for lunch, capping off our morning together with curly fries. I didn’t know then that our time together had a deep impact on my young son.
When Ben was twenty-five he married a lovely young woman. It was my daughter-in-law who told me that my invention worked.
“Ben and I are so busy all week, we hardly have time to see each other,” she said. “He
told me about Mommy-and-Ben time, and he invented Ben- and-Claire Friday. At the end of the week, we have our time together, just the two of us.”
All these years later, I was filled with joy at the thought of my young son who was coping with so much disruption and loss, got strength from his time together with me, his mom.
The best insurance against parental failure is time. Mommy-and-Ben timetaught my son that spending time with loved ones is the best antidote to a cold and often cruel world. As he raises his own children, he will also make the inevitable mistakes parents make, but he’ll also give them all the time and love they need.
This piece was published in the Los Angeles Daily News on July 19, 1998.
A fellow baby boomer told me that our generation will be the first to care for our aging parents longer than our parents spent caring for us. It is a frightening thought for most boomers, who are now in middle age. I wonder if we are up to it.
My friend spent several years caring for his father, who suffered from dementia and spent the last several years of his life in a nursing home. His parents divorced when he was young, and his elderly mother lives alone in an apartment near his home. He looks after her.
Responsible parents who bring children into the world expect to care for them for the first eighteen to twenty years. They drive them to lessons, help with homework and provide guidance and love. As each child reaches adolescence, all parties involved begin to accept the idea that the child will soon be an adult and on his way.
These days it is not unusual for a couple to become parents, grandparents and even great grandparents, watching three generations grow up. Advances in medicine keep senior citizens alive for many more years than just a few generations ago.
A child growing up today will be cared for by her parents until she is an adult. After she has raised her own family, she can look forward to taking care of her parents indefinitely. When their responsibilities end, hers begin.
I sat by the bedside of both my parents as they struggled through major surgeries – one for cancer, one for heart trouble. I always thought I would turn and run when my parents got needy. Indeed, three of my four siblings have.
My sister and I are our parents’ caregivers now. Even though we are grateful that our parents have enough money to hire help with medical and custodial care, emotionally the complete role reversal is unsettling and hard to accept.
The people who had all the answers when we were young look to us for answers now. The parents who stood tall when we were children shrink before our eyes. We find them asking for advice, seeking our guidance. We are the ones who consult with doctors about their care.
I hope my fellow boomers will consider the challenge of caring for elderly parents to be an opportunity for growth. After her surgery, my mother was on life support for three agonizing days. During that time I grew in ways I never imagined.
In cardiac intensive care, my mother was on a respirator, with her mouth taped shut. Tubes sprouted from all four of her limbs and a really nasty one went right into her guts. Desperate, I asked her if she’d like me to swear for her. Her lids lifted, our eyes locked, and she nodded, “yes.”
Bent over her bed, I began to swear like a sailor in loud, salty language, under fluorescent light in the tiny hospital room. I voiced her frustration and expressed the indignation she felt but was unable to express.
Five years later my mother is going strong. She tells me often that my swearing pulled her through. I gave vent to my mother’s fear and gave her my confidence and strength, which reinforced her own will to survive.
Parent and child relationships are never easy. For most of history, parents were dominant. After leaving home to start their own families, children often buried their parents before they reached their own middle age. Having parents around for several generations may be a mixed blessing.
Hopefully, parents and children will rise to the occasion and learn to love one another in ways none of us could have imagined mere generation ago. Most of us will someday be that be elderly parent, feeling displaced and in need of love. May we learn as fast the changes demand and provide our parents, late in the day, the patience and love they require.
This piece was published in the Los Angeles Times on August 10, 2009.
My father died peacefully in his sleep at home not quite 10 years ago. Ever since, I tell people how incredible the experience was for my sister, my mother and me.
Dad had non-Hodgkin's lymphoma and was given four weeks to live without treatment. After three weeks of radiation, his throat was swollen shut and he couldn't eat. His doctor said a stomach tube would enable him to continue radiation treatments. I looked at my father, who was very clearly dying, and knew that further treatment would condemn him to a tortured death in the hospital.
We told the doctor we wanted to take Dad home. Although the physician didn't initiate the discussion about stopping treatment, he was supportive after we made it.
Dad lived for 29 days after we took him home. The swelling in his throat subsided, he was able to eat normally, and my sister and I had time to help him put his financial affairs in order to provide for our mother after he was gone. One of the last times I saw him, I spooned ice cream into his mouth. Our memories of his last days are ones of solace, not regret.
Not only was Dad spared intense suffering, Medicare was spared more expense when we opted for at-home hospice care.
Our family's end-of-life discussion was excruciating. At first, Dad didn't want to admit he was dying because he was fighting the cancer as hard as he could. He had withstood three grueling weeks of radiation so he could get better, but it wasn't working.
Verbalizing it -- acknowledging out loud that he was dying -- was the hardest thing for our family to do. Dad's physician helped us discuss the hospice option with him. The doctor came to Dad's hospital room and told him, man to man, that guys in his condition were considered terminal. The doctor told him in the way Dad liked to get information: straight up, with little show of emotion.
What families don't know is that once this fact is discussed and accepted, everyone can move on. All the pretense of trying to get better is gone. We helped Dad get his earthly affairs in order. Two of my siblings hadn't spoken to Dad for twelve years. When they found out he was in hospice, they came to see him. They wouldn't have been able to do that if he had continued the radiation and died in the hospital.
A study by scientists at the Harvard-affiliated Dana-Farber Cancer Institute in Boston found that patients who had an end-of-life conversation had an estimated average of $1,876 in healthcare expenses during their final week of life compared with $2,917 for those who did not. Continuing treatment amounts to a 36% increase in costs. Everyone wants to lower healthcare costs, but not by cutting short a loved one's life, of course. This study also showed that patients typically didn't live longer if they received intensive treatment and that palliative care (providing comfort, not treatment) led to more comfortable deaths.
My father's peaceful death came as a result of his family's commitment to see that he was well cared for at home. The hospice professionals were with us every step of the way and helped us cope. Caring for my father, even with the help of professionals, was the most difficult thing I have ever done. My sister and I devoted ourselves to his care for those twenty-nine days, but neither of us has any regrets. We know we did the right thing.
When I told my father I named my goldfish after the custodian at my elementary school, he laughed. I was surprised by his reaction, because I meant to express my admiration for Mr. Butler by naming my fish after him. My eight-year-old sophistication wasn’t developed enough to understand the nuances of racism.
This was published in the Pasadena Star-News on January 21, 2008.
As I watched my black goldfish swim around in its little bowl I felt proud to have named it after Mr. Butler. I had a vague idea of why my dad found it humorous that I named my black fish after an African American. Growing up in a small town in the Midwest in the 1950’s, I was not exposed to much racial prejudice, mainly because I was not exposed to anyone who wasn’t Caucasian. Everyone I knew was white, Christian, middle-class and had a mom and dad living under the same roof.
Most of us can recite the names of our elementary school teachers long after our childhood is over because their names are buried deep in our memories. I can recall the good teachers and the bad, but it is Mr. Butler, a man I later found out who shouldhave been a teacher, that I remember with fondness and respect.
After I was grown, my mother told me that Mr. Butler had a teaching certificate but in the middle of the 1950’s in a small Ohio town, an African American male would not be hired to teach. When people despair of our culture today and wish to return to the good old days of the 1950’s, they must remember that those old days were not good for everyone, especially qualified African Americans who were denied the opportunity to teach.
All the kids liked Mr. Butler. He was friendly and funny and seemed like a regular person to me. As a very young child I was told that I should not breathe the same air as black people. This was explained to me, along with other tidbits of wisdom -- like holding my breath while driving by a graveyard or I would die. When you are a kid, you take these things as facts. When I was about ten-years-old I got on an elevator with an African American elevator operator. I prepared to hold my breath, as I was advised. Instead, I looked into his eyes and saw a regular person, like Mr. Butler. Figuring I had nothing to dread, I took in a deep breath of air and wondered where my friends and family got such crazy ideas.
Many of us grew up in towns like the one I called home, where racism was part of the fabric of every day life, taken for granted and mostly unchallenged. I grew up and moved away and decided to live in a more diverse community. I watched brave African Americans fight for the right to vote, to live in society without fear and to be hired for jobs for which they are qualified. Dr. Martin Luther King admonished us to judge one another by the content of our character and not the color of our skin. The power of his message transcended the racist messages I had got from people I was supposed to believe and trust as I was growing up.
When I see Barack Obama on TV, I sometimes think about Mr. Butler. I wonder if he is still alive and imagine that he is gratified by the changes he has seen in his lifetime. I wonder if he spent his career as a custodian or if he ever found a place to teach. I have to wonder why he stayed in my little town, with its racism so entrenched and seemingly insurmountable.
As we remember Dr. Martin Luther King, we recall his famous “I Have a Dream” speech and the power with which he delivered it. He spoke for all the Mr. Butlers who were judged by the color of their skin and not the content of their character. When I think back to my childhood I remember the strength of Mr. Butler’s character and hope he found a classroom in which to share it.
My book, Loving Choices, Peaceful Passing: Why My Family Chose Hospice, will be available on Amazon and other online book sellers soon.
There is no guidebook on when, and how, to stop treatment of a terminal illness. Offered here is an intimate account of how the myriad end-of-life decisions affect a family. Bob Vallee had the courage to accept his impending death and lived out his final days at home in his daughter’s care. He passed peacefully, in his sleep, twenty-nine days after entering hospice.
At the heart of this deeply reflective narrative about choices in living and dying, the reader finds a story of acceptance, forgiveness, reconciliation, and finally, awe for the fragility of life.
Peace is a place that lies between what is lost and what still remains. Kathleen Vallee Stein presents a lens-shifting view of role reversal as she takes on more, and sometimes unexpected, responsibility for her parents. Her service to her father was a gift of love and gave him the dignity we all deserve in the last days of our lives. Stein’s attention to detail sensitively recaptures events, without falling prey to nostalgia.
Read this book to consider choices you may make for yourself or the ones you love.
This piece was published in the Los Angeles Times on December23, 2000.
My coworkers and I were subjected to a very convoluted office gift exchange for many years. We finally eliminated it after the lone worker who kept it going finally retired. Her concept, which involved giving a gift every day for four days, got very expensive. Her system was laced with guilt and peer pressure and was way out of sync with the spirit of the season.
Late last October we sat together in a staff meeting and lamented the waste of giving one another tiny packages of “joy” that didn’t really elicit said emotion. Most of us wanted to wish our coworkers well by word of mouth, perhaps by a kind deed, but certainly not by material possessions. There seemed to be no way out of this holiday quagmire.
After the organizer’s retirement, we all agreed not to continue with the current system, but stone silence greeted the call for what to do instead. Finally, one soul spoke up.
“We are all blessed,” she declared, “but others are not.” She wanted to “adopt” a a family. We could visit our largess on them, the truly needy, and not on one another.
The rest of the staff members chimed in. Yes, yes, yes. Through the Salvation Army we received the names and ages of the children in our adopted family, along with their wish list. They didn’t ask for much: a coat, shoes, hats, a toy car. We quickly divided up the list and went shopping. We bought what they wanted, and more.
This, we quickly concluded, was fun. When we shopped for useless but cute gifts for our fellow staffers, it was stressful, a chore to complete. When we tried to select just the right gift for a child who needed our help, we reveled in the true spirit of the holiday. The stack of gaily wrapped gifts grew higher and higher each day.
We adopted the entire family and bought gifts for everyone – mom, dad and the four children. Gifts for the dad came as generously as gifts for the three-year-old.
The team spirit that came from our holiday project didn’t come from an outside trainer or hired consultant. It didn’t happen in a classroom or during a retreat but came from the best part of every employee.
Our staff is very diverse in religious backgrounds and faiths but we all caught the spirit of the holiday. It didn’t matter if we celebrated Christmas or not, we all wanted to buy a gift for the family. We all wanted to donate food and other staples to lighten their load and brighten their holiday. We all preferred to reach out to the family rather than purchase a gift that is not needed or appreciated.
My coworkers and I will awaken on Christmas morning, safe and secure in our homes, watching our children or grandchildren’s joy. All of us will pause at some point on that dear morning and imagine the face of a child we will never meet, tearing the wrapping paper off our personally wrapped present that contains her dearest wish.
We didn’t save the world or the city or the community, or even this particular family. We saw a need and filled it; we adopted a family and embraced the season as we saw it. And along the way, we had some fun.
This piece was published in the Los Angeles Daily News on Dec. 3,1999.
The fish was the ugliest I had ever seen. I actually recoiled as my son proudly pointed him out in the aquarium. He loves fish. Most boys want a dog or a cat. Fish, it seems, capture my son’s imagination.
“Fish,” he told me, “don’t bark or jump on guests.”
“You can’t pet them or teach them tricks,” I replied.
They look at me sometimes, he claimed, and that was enough.
He brought the ugly fish home on a cold, dark December day. Jet-black, just like the winter night, the fish’s eyes were perched on the ends of hideous balls protruding from his unfortunate body. The rest of him looked like a regular black goldfish, but the awful eyes made me cringe. He was quite out of place in the aquarium.
After a few visits to the tank, I began to admire the fish’s moxie. We bonded and I started to call him Bugsy. He glided past the more elegant fish, ones with tiger stripes and brilliant dots of color, with his big baseball eyes held high. He found his way and found his place in the underwater world.
A few days before Hanukkah began, my son came to me, expressing concern for Bugsy. It appeared that the black scales around the horribly shaped eyes were coming off. We looked at Bugsy and felt a terrible sadness. We turned away.
My son felt the fish was looking to him for help. He didn’t know what to do. Although I appreciated his concern, I knew that his beloved pet was a $2 fish and could be easily disposed of. He rejected that idea immediately and said he would call the fish supply store for advice.
He got busy with school and work and didn’t consult the store. When the other fish began to nip at Bugsy, he removed the fish from the tank and put in him in a big jar of water.
Bugsy was on death watch. We could not know for certain if he suffered, but nonetheless, we felt his pain. Darkness descended.
The next day, after his geography final, my son planned to release Bugsy into a fountain in a park to let him die with dignity, but first he promised he would stop at the fish store to see if anything could be done. I said goodbye to Bugsy as my son walked out to his truck, gently cradling the big glass jar in his arms with the fish swimming blissfully in tiny circles.
Less than 30 minutes later, my son returned, holding the big glass jar aloft. Bugsy, it seems, had contracted a virus. All he had to do was put some pills in the fish tank for a period of time and Bugsy would recover quite nicely.
He showed me the pills, eight in all, in a tiny plastic packet. Eight pills, eight days.
Hanukkah! Bugsy was our Hanukkah miracle . . . his recovery lit the night. A tiny fish that could have been tossed out when in distress was given a second
chance by a compassionate young man. Bugsy is holding his own and we are quite optimistic.
We hope he will survive the odds and light our winter nights, as the lamp lit the dark nights of the Jewish people centuries ago.
We light the Hanukkah candles to keep away the winter darkness and find our miracles where we may.
This piece was published in the San Gabriel Valley Tribune on December 22, 2010.
This is the time of year when we get in touch with people we only get in touch with
once a year. Many people I send cards to are in that category. Still, I want to let them know how I am doing and hope they will also send a card to me. Most of them are people I knew in the past but they still matter today.
One of those people is a co-worker I knew twenty-five years ago. I worked with her at a retirement community in Van Nuys. We were called retirement counselors but we were really rental agents. Betty had been in the business for a few years; I was brand new. She quickly became my teacher and I learned as I watched her gain the confidence of the most skeptical and worried adult child of a frail senior in search of a safe place to live. She would be there the day they moved in and hovered like a mother hen until the tenant was settled.
When we weren’t showing apartments, we worked together in the rental office. After dealing with stressed out families all day we often found humor in the absurdity of life and often laughed so hard we cried. We worked with people who were nearing the end of their lives, living in one room, often ill and alone, having outlived most of their friends and family. We admired them in many ways and treated them with utmost respect and affection, but we needed our downtime too.
Betty had been happily working at a state-of-the art retirement community in Montana but moved back to Los Angeles because her thirty-something daughter, her only child, was ill. Her daughter’s health was precarious and she had to be hospitalized from time to time. I came to understand that Betty’s job was a respite from her difficult home life with her daughter.
Several years earlier, Betty’s husband was tragically killed on the job as steelworker due to negligence on the part of the company. After a protracted lawsuit, Betty received a settlement but she was still alone in the world with her daughter to care for. I admired
her resilience, her constant good humor and positive outlook.
Eventually I moved to another job and Betty followed her heart and moved to Arizona with a man she had become reacquainted with through mutual friends. We talked on the phone occasionally and exchanged Christmas cards.
After a couple of years passed with no phone calls or cards, I called Betty’s daughter a few times but never got a call back. Her number in Arizona was disconnected. I called the corporate headquarters of the retirement community company and spoke to the marketing manager, who knew Betty too. He had lost touch with her as well.
It has been more than a decade since I heard from Betty and I have assumed the worst. I have to conclude that her daughter never let any of her mother’s many friends know what happened to her. I don’t know why her daughter didn’t go through Betty’s address book and call her friends. When someone passes, lots of people who knew them well, even if it was years ago, still care.
In this electronically connected society there is no excuse for not letting people know when a loved one passes. It leaves a gap in the relationship that can never be filled.
When a former neighbor passed, his son stopped by to tell me in person and I was very grateful. I wasn’t family, or even a close friend, but it gave closure. When a loved one passes, it is better to err on the side of giving their friends a call or email. It is best to let people know, especially at this time of year when people stop to think about old friends and miss them still.
This piece was published in the the San Gabriel Valley Tribune on Dec. 24, 2006.
This is the season that we remember people who have taken care of us all year –
people who cut our hair and our grass, pick up our trash and deliver our mail and
newspaper. If your paper appears at the top of the step every morning and not in the
grass next to the sprinkler head, you know that someone who began his workday at
4:00 a.m. is doing his job right.
Two years ago my sister and I gave a Christmas bonus to some very special people
who helped us immeasurably by taking care of our mother as she lived out her last days
in a board-and-care home. I don’t want to minimize the importance of my hairdresser,
gardener or paper carrier, but the people who cared for my mom every day,
twenty-four/seven, were extraordinarily kind and did work that few of us could handle.
As we hired people to care for both our parents in their declining years, we became acquainted with professional caregivers. The ones we met were patient people with a temperament that enabled them to meet the physical and emotional needs of very frail, very old people.
Every time I visited Mom at the board-and-care home, I came away with a renewed
appreciation for the people who sat in the living room of the large house with the residents, watching g-rated movies with them, cooking their meals and making sure they took their pills on time. The caregiving profession is largely unregulated and offers low pay and few benefits.
The facility my mom was at was owned by a very compassionate woman who provided as best she could for her staff as well as the residents. She struggled to provide insurance and other benefits to the staff and still make a living.
My sister and I took this into consideration when we sat down together to decide what to give the caregivers, with Mom’s blessing, as a Christmas bonus. Mom had been in the board-and-care for a full year and most of the staff had taken care of her on a daily basis. She could do almost nothing for herself and was incontinent.
The staff delivered her meals to her room, bathed and changed her and kept her spirits up. Mom was mentally sharp and often discussed politics, books and the weather with
her caregivers. She kept chocolates on her bedside tray and would teasingly accuse her favorite caregiver, Tony, of sneaking a few when she wasn’t looking. Tony always denied it in mock horror and called her “Trouble” with a large and gentle smile.
We decided to give each of the staff $100. I put fresh, crisp one hundred dollar bills in each of greeting cards that we gave to the staff. Tony told me that the bonus enabled him to buy gifts for his family. He had only enough money to go home for Christmas. Now he could buy gifts for his nieces, nephews and his parents. He told me this through grateful tears.
Mom died three months later. Tony attended the service and he had tears again, as did we all. He told me he thought of my mother as a friend. Then he said he wanted to get out of the caregiving business because it was too hard. I told him he was exactly the type of person who should be a caregiver, as difficult as it was at times.
Few people in the personal care business are paid as little as care givers of the elderly. I was grateful that my mother had the financial means to give Christmas bonuses to the people who cared for her. It was a small gift in return for their daily gifts of kindness, care and companionship.
As we think of those who we notice only when they don’t do their job, it is a perfect time to stop and think what their efforts really mean to us, how best we can show our appreciation and what it may mean to them.
Kathleen Vallee Stein