Mother's Day

Below I have posted a link to the video shot this morning at the Jameson Family gravesite where Mother is now buried.

The music heard throughout is a recording of the bagpipe introit "Amazing  Grace" performed at Mother's Memorial Service in January and again at her Committal Service in late April.

The Gerber daisies sitting atop her grave are but a few of the artificial flowers which were eventually suspended from the ceiling directly over Mother's nursing home bed when she was no longer able to walk and, thus, to work in her gardens.  She truly loved these flowers ~ artificial or not.

The beautiful flowers surrounding the central family marker were planted by our sister in the days leading up to Mother's Committal Service.  After scrubbing each of the family markers clean, our sister wanted nothing less than to make certain another beautiful garden ~ of sorts ~ awaited Mother at her final resting place alongside four generations of her family.

The gardener made assurances the flowers would survive but a week; Sister was prepared for this eventuality.

No one could have been more surprised, however, to arrive at Mother's burial site to discover that her pansies had not only survived ~  they are thriving!

I don't know how anyone could have doubted this outcome;

Surely, Mother had a hand in all of this!

Happy Mother's Day, Mom!

We love and miss you ... to the moon and back!

Should you go first and we remain

to walk the road alone,

we'll live in memory's Garden Mom,

with the happy days we've known.

In Spring we'll wait for roses red,

when faded, the lilacs blue.

In early Fall when brown leaves fall

we'll catch a glimpse of you.

We'll hear your voice, we'll see your smile,

though blindly we may grope,

The memory of your helping hand

will buoy us with hope.

Should you go first and we remain,

one thing we'll have you do:

Walk slowly down that long long path,

for someday we'll follow you.

We want to know each step you take,

so we may take the same.

For someday down that lonely road

you'll hear us calling your name.

(Borrowed from "Should You Go First" ~ A Rowsell)

http://youtu.be/ikxfo3qGNTw

Momento Mori

“She has changed a lot since the last time I saw her.”

For some reason, Linda’s words immediately threw me off balance. I have been listening to quite a few medical professionals coldly discuss Mother’s condition for the past two weeks, but this aide’s words struck a discordant chord with me. It then suddenly dawned on me as I looked again at Mother …

I have been in denial. Or, at least, in part.

That’s alright isn’t it? I am her son, after all. No one would expect me to see all the changes coming to Mother clearly; I’m not an objective observer. And … no … I am not so blind I haven’t recognized the changes of recent months ~ I’m not completely shut off from reality.

But, there was something so simple, honest, and unaligned about her words that made me stop for a moment and think; in the end, it seems hers was the one authentic voice I needed that allowed me to confront the truth that Mother’s life is surely fading away.

~~~~~~~~~~

Mother has been under the care of hospice for almost two years. During the intervening time, we have all witnessed many horrific changes that have come to her. My response to anyone who asks is that Mom continues on a downward physical spiral but that we do enjoy even the increasingly transitory benefits of “ups” that come (with downs) along the way. We all try to take every measure of joy from these good moments while simultaneously maintaining a firm grasp on a realistic understanding of her condition as well as her prospects for longevity.

Time is not on her side

Over the twenty months or so since Mother was introduced to hospice, our family has been informed by care providers that her death has been imminent no less than two times ~ perhaps three. Every time these pronouncements have been made, family members were left to struggle with an impending “reality” which has long been “assured.” To date, each of these prognostications has been proven false and wantonly premature.

How does this happen?

“Hospice kept talking about the quality of my father’s life. My father, even though he was not able to walk around and talk to people, certainly got a huge grin on his face whenever he saw my children,” the woman said. “And that was a couple times a week. He still had joy in his life, and who had the right to take that away?”

This represents but one woman’s final account of her father’s death; suffering with Parkinson’s for many years, he died after only thirteen days in Hospice.

Since the Hospice movement first made inroads within the United States during the 1970’s, these organizations have faithfully served more than a million patients at the end of their lives by providing a wide range of services which include the management of pain and physical symptoms as well as psycho-social concerns.

Unlike this woman, many families who have previously engaged hospice would gladly sing the praises of their personal experiences ~ especially as they related to hospice helping them with difficult circumstances when traditional medical practices seemed to fail them. But, since the 2005 controversial, court-imposed starving death of Terri Schiavo, reports have increased dramatically speaking to the alarming growth of a very dark side of the hospice movement known as “terminal sedation.”

~~~~~~~~~~

Stephen Connor, Vice President of Research and International Affairs for the National Hospice and Palliative Care Organization, is on the record stating, “Hospice neither seeks to hasten nor prolong dying.” “Any family engaging the services of Hospice needs to know, from the onset, who is in charge, what protocols are routinely followed, and where a particular group stands on the important issues of food, fluid, and the practice of ‘terminal sedation.’”

Food and Water

Connor stated his organization’s standard for medically administered food and hydration is that “people have a right to decide whether they want those interventions or not. And a decision about whether they should have them or not resides with the patient, usually made in the context of a family system. Families ought to decide if they want it or don’t want it, and those wishes should be respected.”

Mr. Connor also went on to add that hospice does allow for the withdrawal of food and hydration, even when the patient is not in immediate danger of death, keeping in mind that individual hospice programs vary in their policies with regard to medical nutrition and hydration. Some go so far to as not allow patients to have intravenous fluids or feeding tubes, as an example, while others may opt to permit their use.

Former hospice nurse, Ron Panzer, agrees that hospice is “a wonderful service if done with integrity and morality. But since Schiavo’s death in March of 2005, he has heard from an increasingly vocal group of patients, families and caregivers who are raising grave concerns about their hospice care ranging from overmedication to the limitation or refusal of food and water.

Panzer, who now is employed as a home health care nurse, is not alone when stating his belief that hospice groups DO now increasingly engage in the practice of hastening death while fighting almost every attempt to prolong life. “The current tendency is to interfere at almost every step in ordinary care.” “They’ll pull the rug out from under a patient by limiting food, removing adequate hydration and essential medications, as well as refusing to provide treatment for easily treated infections.”

Terminal Sedation

Some bioethicists and physicians have proposed “terminal sedation” as a legal, ethical alternative to assisted suicide and euthanasia.

Terminal sedation is defined as the “deliberate termination of awareness for relief of intractable pain when specific pain-relieving protocols or interventions prove ineffective.” Essential components of terminal sedation also include withdrawal of most, if not all, treatment for medical disorders; limiting fluids and some, if not all, foods ~ all so that death occurs as soon as possible.”

With an alarming reported increase in frequency over the past five years, patients enrolled by Hospice are dying as a result of the implementation of terminal sedation. Cloak the process any way one might choose, but the ugly truth behind terminal sedation is that death is ultimately achieved by circulatory collapse brought about by a lack of adequate hydration.

Mandatory subsistent hydration has long been considered a standing order for critical care physicians who treat the terminally ill; any notion of withholding hydration as the process of death ensues is generally considered unconscionable. In the setting of “terminal sedation,” potent sedatives are also employed to mask the very real symptoms of iatrogenic (induced) suffering brought on by the limitation of fluids, the resultant dehydration, and the inevitable circulatory collapse.

Those who support terminal sedation view this as an “innovative” way of getting around the “sticky” problem of the euthanasia movement’s general inability to convince the voting public and legislatures to enact assisted suicide laws. So, increasingly, terminal sedation is being incorporated into the practices of hospice and other end-of-life programs even though, as pointed out by author Brian Johnston, euthanasia supporters openly admit that “terminal sedation is tantamount to euthanasia or, at least, a “slow” kind of euthanasia.”

It is generally believed that terminal sedation is not a “rarely used option of last resort” as many of its supporters maintain. The current reported prevalence of terminal sedation ranges wildly from 3% to 52% in terminally ill patients. But, when one stops to reflect on the unknown incidence of “terminating awareness” ~ or to put it bluntly, “ensuring unawareness” ~ calculating the use of terminal sedation as a form of “comfort care” may very well be approaching epidemic proportions, even outside the realm of the hospice movement.

It should also be noted that some physicians who otherwise condemn “assisted suicide” actually embrace the notion of terminal sedation as an “ethical alternative.” Dr. Robert Kingsbury, Director of Sister’s of St. Mary Catholic hospice in St. Louis, wrote recently in support of terminal sedation calling it “comforting and critical for patients who are profoundly fearful of terrible suffering at the end of life.” He went further to reject the generally held medical view that withdrawal of food and water results in undue suffering.

To my way of thinking, the evolution of terminal sedation and its incorporation into the practices of hospice proves that proponents of euthanasia are nothing if not creative and persistent. There are many people who are convinced that tolerating even a “little bit of deliberate death” will eventually afford them control at the end of their own lives. But if a growing culture of death is allowed to continue seducing even well-meaning patients, families and medical professionals into making death decisions that are based on the problems of health care cost containment, stressed and overburdened caregivers, as well as fear of suffering or diminished quality of life rather than following the traditional principles of “not causing or hastening death,” we are all ultimately at serious risk of being compassionately rationalized to the notion of death.

~~~~~~~~~~

Each of us, unfortunately, has but one final debt to pay for the privilege of living this life; the joy of viewing the beauty of another sunset or the wonder at the moment of the birth of a child each carries with them the seldom considered cost of the death each one of us will eventually owe (momento mori). While none of us is ever guaranteed another moment of life, time and circumstances point to the undeniable fact that Mother’s days are certainly numbered.

The image of that grieving woman’s father who was only capable of smiling a “huge grin” every time he saw his beloved grandchildren haunts me. I choose to believe, as did she, there must have truly been joy at the heart of his smile, even at the very moment a biased observer declared his life to be at an end.

Mother recently looked at my sister and declared no less than three times, “I don’t want to die.” What was my sister to think?

Mother looked at a brother and made a request for the joy of a summer strawberry; when he returned with his store bought harvest of berries, her words and smile spoke volumes, “Ohhh … they are delicious!” What was my brother to think?

Mother looked at me, adjusted my hat and shirt, and then admonished me not to be gone for long because, “I will miss you.” What was I to think?

I’ll tell you.

Hospice does have a place in Mother’s life as she approaches her final days; I whole heartedly welcome the services hospice was initially intended to provide both to Mother and her family. Our situation being as it is, I have absolutely no say in the matter ~ nor would I want the burden of such responsibility. But if I were given an opportunity to simply be heard on the matter of terminal sedation, I would state, unequivocally, I have no use for any organized process that might serve to make a calculated, capricious or dispassionate decision as to Mother's fate.

While it represents simply one son’s opinion, this is where I would choose to draw the line.

Allow Mother all the days or hours she is due. Give everyone, including Mom, the opportunity to enjoy even the smallest wonder each of those days or hours has the potential to bring.

Enjoy the gray-blue intensity of her eyes as they bore into your soul.

Live vicariously as she revels in the simple pleasure of a strawberry ~ not to mention, chocolate.

Sit, listen, and allow yourself to become captivated by her rambling conversations. Then watch the fluid movement of her hands as she sews an invisible dress from her memory of years gone by.

Oh, and lest I forget to mention ...

You don’t want to miss a Mother's smile.

Last Dance

I looked at Paul as he went through the motions of the morning and couldn't help wonder what he was thinking. There is no way I can yet understand how he felt.

~~~~~~~~~~

Imagine...

... a progressive disease has robbed you of the very essence of your being. Indeed, every semblance of the life you now enjoy ~ not to mention, the dreams envisioned for your "golden years" ~ have been quashed. Instead of trips planned to visit family and friends, foreign principalities or even a local grocery store, you one day find yourself in a strange, if not, foreboding place. Adding one last insult to injury, you are confined to a wheelchair, robbed of what may well have been the last vestige of any control over your life.

Where are you?

The place into which you have landed is foreign, yet somehow familiar. There is some vague similarity to the sights, smells and pace of hospitals previously visited but there also remains something that is simply ... different.

You soon realize the place is devoid of the normal, comfortable sounds of home ~ no children laughing and squealing while at play, no dogs barking, no water boiling over a stove, no televised football, no music, and not even the curiously familiar sounds of a furnace or dishwasher at work.

Yet, there is a cacophony that percolates through every corridor of the place; it also seems it will never stop.

Call lights blink and "buzz," aides noisily transport metal carts heavy with the smell of food along uncarpeted halls; invisible, unanswerable telephones ring; televisions blare uncontrollably; and, sundry voices ~ not family ~ cry for attention.

"No," you are certain, "this most definitely doesn't feel like home."

Given enough time, you will awaken to a dawning realization the life you once cherished is past.

And, true to the unsettling promise of Thomas Wolf, you eventually understand, "you can't go home again."

~~~~~~~~~~

Mother made this same unhappy transition to a new life within a nursing home two years ago, July 7. Oddly, the intervening years since that somber summer day passed with the "blink of an eye" while also managing to feel like an eternity. I recently came across photographs taken when she first arrived, and found myself shocked by the change that has been visited upon Mother since arriving at GVM. The woman who spends most of her days confined to a bed in Room 807 bears little resemblance to our Mother who, some seven hundred days ago, walked into the nursing home on her own steam. Now confined to a wheel chair, Mother will surely never walk ~ or dance ~ again.

~~~~~~~~~~

One December weekend, I made a decision to bring my portable Bose stereo system to the nursing home. My initial intent was to provide an alternative diversion for Mother who spends most days bored within the isolation of her room. At noon, as a private duty aide arrived to sit with Mom for a few hours, I packed up my "music" and headed for the front door. Having befriended many residents over time, however, I stopped by the dining hall to greet a few friends and fetch coffee. I was almost immediately struck by the din within the dining room; hearing only the sounds of low murmurs as well as the metallic clank of silverware on china, the dining room ~ in the midst of a holiday season ~ was nothing short of oppressive. Not needing permission, I unpacked the Bose, started my iPod and activated a playlist of holiday music.

The effect was nearly instantaneous.

The pall over the room lifted. Most smiled. Many began moving their feet uncontrollably. Some laughed as others cried. And, while a few residents eventually began to sing, others raised their hands overhead in rhythm to the music...

... and one...

Lena, at 95, had been living in the nursing home for many years. Most days it was hard to get even a single syllable response out of her; while she was most always attentive to welcoming "hellos," she rarely offered much in return. Her beloved son, Paul, who had been attending to her daily concerns for years, was understandably one of the few people with whom she would routinely interact but now those moments were becoming rarer with time.

Until that December afternoon...

Lena clearly discovered a wellspring of renewed life within the music that afternoon. This seems to be what happens with most people when exposed to music they truly love. If a person happens onto the classical music listened to by the parents of their youth, the popular music of a bygone era, or even a particularly sentimental favorite holiday song ~ if it was embraced by a person long ago, she will most certainly welcome it with renewed fervor on hearing it again.

Listening to the music that day, Lena's entire countenance suddenly changed. She sat up in her chair, lifted her head, smiled beautifully at Paul and then ~ unexpectedly ~ held out a tiny hand to him. Paul instinctively understood ~ it was not simply a gesture but a request.

Taking a firm hold of Lena's weakened hands, Paul gingerly lifted his frail Mother from the cuirass of her wheelchair,

and then ... they danced.

Over the next few minutes, the entire dining hall was transfixed by what they saw; other family members, residents, and staff watched, applauded and cheered as Paul took the opportunity to share a December dance with his Mother ~ temporarily awakened from a slumber by the effects of the God given wonder that is music.

~~~~~~~~~~

Yesterday, at the base of a gently sloping hillside, Lena was laid to rest, her grave adorned with dozens of pink and white roses.

I looked at Paul as he went through the motions of the morning and couldn’t help wonder what he was thinking. There is no way I can yet understand how he felt.

At the conclusion of the service, Paul, eyes brimming with tears, came to thank me for attending the commemoration of Lena’s life.

And as he walked away, Paul suddenly stopped, turned again to me, and smiled a knowing smile. Since that December afternoon so long ago, he has never failed to remind me of the “last dance” shared with his Mother. It was a moment none present will soon forget ~ nor was it a dance family members will ever have an opportunity to share with our own Mother.

Lena and Paul danced for all of us that day.

I understood the gratitude behind the smile on his face yesterday; he need not have spoken another word.

Popcorn Sky

“How are you doing, Mom?”

Slowly turning her head, she stared vacantly in my direction as though seeing me for the first time; confident in the belief that no son of hers would have ever asked such an inane question, she, nonetheless, offered an extremely sane reply,

“I am going crazy! That’s what I am doing! All I do – ALL day – is lie here staring at this ridiculous ‘popcorn sky!’”

2008

Arriving at the nursing home in the summer of 2008, some were convinced Mom wouldn’t live to celebrate Thanksgiving – let alone Christmas. The statistics were certainly not in her favor; number crunchers in lonely cubicles had coldly calculated a life expectancy of between “six to nine months” for nursing home residents in the final stages of neuromuscular disorders.

By October, hospitalized for the third time in a month, two neurologists spent perhaps fifteen minutes – collectively – making separate evaluations before brashly pronouncing she was in the final stage of her Parkinson’s disease and would not live to see another Spring. (“Sorry, thank you, here’s my bill, goodbye.”)

As if slapped, we had been assured – in unambiguous terms – Mother’s clock was rapidly winding down.

On her discharge back to the nursing home, no time was wasted; Hospice was initiated immediately.

I fast became a living, breathing contradiction: I absolutely wanted Mother’s suffering to come to an end, but would have gladly admitted I didn’t care at all for the prospect of losing her in the bargain. Given time, however, I drank the “kool-aid” becoming convinced that once the chain of events with Hospice was set in motion, Mother would be transported on a conveyor belt toward certain demise.

Our death watch began.

Halloween gave way to November. Days slowly became weeks and, miraculously, Mom seemed to thrive as we eventually managed to celebrate the holiday season that culminated with the arrival of a New Year. Mom was fighting and I allowed myself to hope.

January 2009, however, dealt Mother a severe blow.

A particularly vicious bug made the rounds at the nursing home and didn’t stop at Mother’s door; bedridden for nearly three months, she valiantly fought a respiratory infection that had succeeded in taking the lives of more than a few residents.

By mid-February, a hospice nurse abruptly declared Mother would live no more than two weeks; touting a “95%” accuracy with similar pronouncements in the past, she made a request that all medications be halted and palliative care initiated.

This “nurse” and others had apparently failed to factor Mother’s dogged determination and resolve into their equations.

Thankfully, the grossly inappropriate and premature directives were not carried out by her physician of record; more than a year later, Mother is still very much alive.

But, she is certainly not the same.

Weeks confined to bed recovering from the infection had left her extremely debilitated. Her right foot had become permanently plantar flexed and was beyond the scope of physical therapy. So, in the span of three months, her life was dramatically transformed; no longer able to run the halls of the nursing home trying to find her way “home,” Mother had become effectively bedridden.

October 2009

“I am going crazy! That’s what I am doing! All I do – ALL day – is lie here staring at this ridiculous ‘popcorn sky!’”

Looking up, I immediately understood. Every minute of every wakeful hour of every day confined to that damned bed, Mom had no choice but to stare at the blank canvas of her textured ceiling that had – over a period of several months – become her entire world view. Who wouldn’t go stark raving mad?!

With a wheelchair now her only means of mobility, we took Mother outside later that morning hoping she could enjoy the beautiful fall day. The leaves had reached the peak of color with their resplendent shades of red, orange and yellow; it was the season at its visual best.

With Mom’s frustrating admission still fresh in my mind, it suddenly dawned on me that Nature had provided a possible solution. Gathering up a few handfuls of the brightest, most colorful leaves, I returned to her room. Standing on her bed, I then taped an assortment of the leaves to her barren ceiling, hoping beyond hope the small change would somehow help to break up the monotony of her days.

It worked.

While the change in her affect once she noticed the leaves on the ceiling was not dramatic, at a minimum, she certainly became engaged with “her leaves.” She might speak one moment of the need to “rake the leaves,” then immediately order us to “leave them alone!” She described them in detail to aides, and even counted them for me on occasion.

It amazed and pleased me that a ridiculously simple idea could have affected a difference for Mother as she spent hours alone in silent contemplation of the leaves; most poignant for me, was when she would lie completely still in her bed, smiling and staring endlessly up at her colorful Popcorn Sky.

Emboldened by this minor success in the Fall, December ushered in the anticipation of yet another Christmas season and an even greater transformation of her ceiling for the holidays. A nursing student, Tracy, and I spent a Saturday morning listening to holiday music while hanging a colorful assortment of ornaments throughout Mom’s field of vision; a woolen Santa and Snowman, mittens, snowflakes, and shiny, colorful balls were suspended at various levels about her bed.

It was pure fantasy and she loved it.

April 2010

Winter finally seems to be giving way to a much anticipated Spring.

In the coming days, the snowflakes and snowman will come down from that ceiling to be replaced by suspended mobiles of pictures from her own gardens as well as much loved Sunflowers.

While Mother had to long ago give up working in the gardens that represented her lifelong passion for toiling the good earth, we are determined to force a Spring of our choosing – once again bringing her beloved flowers within arms reach, suspended from the Popcorn Sky.

January 1941

Doubtless to the eventuality of being dragged into the world wide conflagration, in January of 1941, FDR delivered his famous “Four Freedoms” speech to Congress and the nation; his words would become a clarion call to arms.

Two years later, Norman Rockwell immortalized those four enumerated freedoms ~ Freedom of Speech, Freedom of Worship, Freedom of Want, and Freedom from Fear ~ by crafting posters to illustrate the concepts. After the works were summarily rejected by the War Department (as a donation), Rockwell went on to offer the illustrations to the Saturday Evening Post. When first published in February of 1943, the popular response was overwhelming resulting in thousands upon thousands of poster prints ordered up by everyday people.

The images were instantly iconic.

Freedom from Want.

This poster never fails to capture my interest; it tugs at my emotions. When contemplating the scene, I am at once a guest among a family of strangers, intruding as they gratefully celebrate another Thanksgiving. Yet, even in the midst of these strangers, I can’t help but feel a familial connection, and am instantly transported to another time, place and celebration of my own choosing. This is the essence of the sway this illustration holds over me; it plays on my nostalgia for the days, now past, when an ideal gathering of my family was fully realizable.

For as long as I can remember, Thanksgiving has been spent visiting Mother. This year was no exception. Time and circumstances, however, have changed everything.

My first reaction Thursday when I arrived at Mother’s nursing home was, “Who are all these people?”

Spending time with someone in a nursing home, you gradually become familiar with your surroundings. One aspect of this comes with the eventual recognition of many of those family members who frequently visit loved ones. Over the course of this past four day weekend, however, GVM was replete with people I had absolutely never seen before; seeing them for the first time, I couldn’t help but reflect on the individuals whom my father once derisively referred to as the “ETC’s” of Churchgoers ~ those who only attend services at Easter, Thanksgiving, and Christmas.

I am not passing judgment. I have spent enough time visiting Mother at the nursing home that I have now also come to know and even care for many of her fellow residents. To see so many of the elderly spend days, weeks, and months with nary a friend or relative stopping for even short visits is enough to tear at the most callous of hearts. From my perspective, it is a form of neglect I will never comprehend.

But these folks who were swarming about the nursing home this past weekend, unfamiliar to me or not, had at least made the effort to fulfill a Thanksgiving wish. It was very good to see.

There is a fairly large activity room immediately adjacent to the private residence wing of Mother’s nursing home; there is generally very little interest in it most days. As a result, my family makes great use of the room mainly as a way of breaking the monotony of Mother’s days given that she is effectively bedridden. During the holidays, however, other families sign up to reserve large blocks of time for the room; on these occasions, I will jokingly admit to an ever-so-slight tinge of resentment borne out of a squatter’s sense of entitlement.

The family of one resident who reserved the room this past weekend must have numbered twenty or more. Every generation from infant to great-grandmother was well represented. Chaos was abundant as one might well imagine.

I couldn’t keep my eyes off of the great-grandmother, a fellow resident at GVM, sitting quietly in the midst of all this organized confusion – smiling and happily soaking it all in. She was as much a stranger to me as the Mother in the poster, but just as I am able to immerse myself in the artwork, I instantly understood this grand lady knew exactly how our Mother had always felt when the family was together for Thanksgiving.

Imagine two people living quietly on acres of bucolic terraced gardens, ponds, meadows and woodlands complete with coyotes, deer, and wild turkeys. This was the scene on any Tuesday leading up to the arrival of family before Thanksgiving; twenty-four short hours later, however, several planes, and automobiles always brought new meaning to their understanding of the word “wildlife.”

My family is not shy, for the lack of a better word. We are also – most definitely – not quiet (except for me). We laugh and talk a lot, and since someone invariably feels he/she isn’t being heard, the volume eventually works toward a cacophonous crescendo that can become deafening – even, maddening. It’s family.

Watching the great-grandmother in the activity room, I was immediately taken back to near picture perfect mental images of Mother during our Thanksgiving conversations. She was never interested in being in the thick of these bull sessions or the center of attention. No, Mother always took up an unassuming position at the perimeter of these confabs, sitting quietly, taking in all the noise and general craziness.

It wasn’t until I reviewed some old video from a family gathering several years ago that I first took notice of something curious which had somehow never registered with me before. Seated at a chair in a corner of her formal dining room, Mom was again listening intently to the mayhem surrounding her Thanksgiving table. No matter what jokes were being told or political editorials made, there was Mom – sitting quietly, smiling a smile that spoke volumes.

Her smile was beautiful in its simplicity; Mom was at home with her children and grandchildren. Nothing was wrong with the world.

Our Thanksgiving at the nursing home was a subdued affair this year. The four of us took our homemade meal in her room where there was very little conversation, the only real noise coming from a flat-screen football game.

While I was very happy to have the opportunity to share another Thanksgiving with Mother, I couldn’t help wonder if she might have preferred trading places with the great-grandmother down the hall.

I was also left reflecting on the poster; if given the opportunity, to what nostalgic time, place and celebration would the image transport her?

Whether it was down the hall in the activity room or home, with strangers or family, so long as there were people surrounding a table enjoying each other’s company, free from want, I believe Mother would have simply sat awash in the chaos and smiled.