Shortly after I began graduate studies in nursing, I came across a statement made by our sixth president, John Quincy Adams. These remarks were especially significant to me as I searched for a more complete understanding of man and of nursing. This elderly stateman's stubborn insistence on considering himself well in spite of obvious disabilities heightened my curiosity for the true meaning of health and well being. I pass these remarks on to you, the reader, with the hope that you too, will be stimulated by this man's awareness of himself and of the meaning of life. On his 80th birthday, John Quincy Adams responded to a query concerning his well-being by saying, "John Quincy Adams is well, but the house in which he lives at present is becoming dilapidated. It is tottering upon its foundation. Time and seasons have nearly destroyed it. Its roof is pretty well worn out. Its walls are much shatterd and it trembles with every wind. I think John Quincy Adams will have to move out soon. But he himself is quite well, quite well."
How many of our older people, experiencing the same problems as Mr. Adams, would consider themselves well? Furthermore, would there be many health professionals who would agree with Mr. Adams' perception of his state of health? I am concerned that Mr. Adams' concept of health is the exception, and not the rule.
Perhaps we should look at what our former president is trying to tell us. He admits that his physical body has deteriorated with age. There is even an inference that his mind is becoming afflicted with the ravages of time. Outside influences, he hints, are beginning to take their toll and he is no longer as able to withstand their pressure. In spite of this, he contends that the man, John Quincy Adams, is well, quite well!
What, then, makes Mr. Adams believe he is well? In my work with the elderly, I have observed, as I am sure most of you have, others, who in spite of disability, illness and multidimensional problems, seem to be like Mr. Adams. Likewise, we all have seen people who, with or without physical and mental frailties, tend to be self-deprecating. They center on their illness and their problems and express dissatisfaction with their life in general.
I believe Mr. Adams is trying to tell us that being well has nothing to do with the presence or absence of pathology. He seems to be saying that well-being depends on one's own awareness of the meaning of life and one's ability to grow in consciousness as life unfolds. I believe that Mr. Adams was well because he had developed a pattern of living that was in harmony with his body and with his surroundings. He had come to realize that man is more than his physical body, more than his mind, more than his accomplishments or his lack of accomplishments. Mr. Adams, the man, was well because he had an opportunity to become aware of himself and of the meaning of life.
I feel that as nurses we too often overlook the real meaning of health and instead busy ourselves with treatment regimes directed toward disease and disability. If humans can be well in spite of physical and mental frailties, ought we not also to look at ways to foster well-being of the whole person? Nurses need to look at the whole person and recognize patterns of interaction with the environment. We should understand that attempts to intercede in disease processes without taking into account the phenomena of the human-environment relationship will often do little to promote well-being.
We as nurses must find ways to help others approach the last days of their lives in a state of health and well-being. It behooves us to promote an expansion of consciousness and a pattern of living compatible with the environment. We need to explore the impact of our ministrations on the total person. Do we dwell on the disabilities and the negative aspects of life rather than promoting an atmosphere of wellbeing? Do we, because of our nurturing role, tend to foster dependency and decrease self-concept? Do we offer spiritual guidance and comfort as older persons attempt to wrestle with their own mortality? Do we give older persons the encouragement and the opportunities to utilize their time in exploring the meaning of life?
I believe that the nursing profession can make a positive difference in the health and well-being of our older population. Through research, through education and through practice, more persons can be helped to develop a pattern of living in harmony with the environment and approach the last days of their life with an awareness that they are well, quite well, indeed!