Editorial

‘Doing for’ people is what nurses dobest. However, the negative connota-tions that are associated with suchactivity usually equate with paternalisticnursing practice, whereby the olderperson is passive and the nurse is active.It often implies that the nurse is in thebest position to make decisions forthe patient and can therefore performthe activity on behalf of that person.Having a clear goal of care that isunderstood by the patient, family andsignificant others is central to a person-centred approach. This active involve-ment provides a form of rehabilitationthat is aimed at improving functionalindependence, improving competence inself-care activities, preventing secondarycomplications and promoting psycholo-gical well being, confidence and selfesteem. Continuing assessment of peo-ple’s needs should include an evaluationof how the person could or does func-tion in a socially productive manner, inaddition to the typical focus on prob-lems, pathology and losses.

Restoration of self-worth through theexperience of respect from others canbring about a form of healing in itself.Confirming another’s self-worth, alsoincludes recognizing the health potentialof the person irrespective of their cur-rent health state. Health seen as ‘poten-tial’ prevents fatalism in approaches tocare, demonstrated through negativenursing behaviours of apathy and neg-

lect, with the underlying assumptionbeing that as older people are unwill-ing/unable to change old behaviours orlearn new ones, health promotion is notrelevant. The environment of the caresetting should avoid making prematureassumptions about people. The settingshould offer a stability in which theperson can find his or her unique indi-viduality within it. An objective under-standing of the ageing body, anunderstanding of the individual’s sub-jective interpretation of their own age-ing journey and the individual meaningsattached contributes to a sense of whole-ness and allows the nurse to enter thesubjective world of the older person tomeet care needs. Acceptance of the olderperson’s life ways is perhaps one of themost humanistic qualities shown innursing care. The older person is mind-ful of the many roles played during lifeand the losses suffered over the years.To have a nurse show, through accept-ance of the person, an empathic under-standing of the patient’s losses andpresent limitations, is to establish atherapeutic relationship which is direc-ted at gaining an effective outcome fromcare that is centred on the person’s needsand life perspectives. This understand-ing of the person’s self-worth directs thenurse towards a flexibility in nursingcare, that seeks to preserve the integrityof the person. It also, through the appre-ciation of the individual’s uniqueness,

makes explicit to the nurse, the limitsbeyond which the person cannot betaken and prevents the setting of unre-alistic objectives. If nursing older peopleis to be directed towards a humanisticphilosophy, then as many opportunitiesas possible should be made available forthe older person to exercise freedom ofchoice, take risks, express opinions,make decisions and be listened to! Theaccording of such respect to the olderperson can in itself offer an approach tothe ‘healing’ of the body and the restor-ation of individual self-worth.

In this edition of the InternationalJournal of Older People Nursing, thepapers reflect a range of activities thatnurses are initiating to enable olderpeople to maximize their potential andfor nurses (including student nurses)working with older people to developan acute awareness of the need toembrace a range of opportunities tosupport active participation in caredecision-making. Whether it is palliativecare, acute care or the support ofstudents in their learning about effectivecare delivery models, every opportunityto maximize the potential of the indi-vidual need to be embraced.

Brendan McCormackCo-EditorIJOPN

� 2007 The Author. Journal compilation � 2007 Blackwell Publishing Ltd 1