In New Orleans, at the ANA Convention in June, 1984, The Journal of Gerontological Nursing had the opportunity to talk with Martha Rogers, ScD, RN, FAAN. Dr. Rogers' concept of the Unitary Human Being is a controversial framework of increasing complexity and has direct bearing on the aging populus.
JGN: Your framework of the Unitary Human Being has caused quite a stir in the nursing community. There are those who feel it is THE theory to be applied to aging. In your opinion, how does your framework relate to aging? Rogers: One of the first things I would point out is that science has many theories. I don't have a theory, rather I have a conceptual system from which to derive many theories. The concern of nursing, now and always, has been, as far as I can see, people and the world they live in.
Now, what I've done is simply to move into greater clarity of definition, and to develop a conceptual system from which to derive theories. Some might call it a new world view a paradigm framework. If one looks at the whole system, I'm talking about Unitary Human Beings. I use "unitary" because the term "holism" has become jargon. Everybody is talking about being holistic, and I don't mean just nurses, 1 mean the term has become almost anything anyone wants it to mean. Most often it means adding up some parts, which are not the whole. I changed the term in an effort to get greater clarity, not because there is anything wrong with the term holistic. I'm telling you about people and their environment, and people are irreducible fields. I also talk about some principles that have been derived from this system. It's evolutionary, developmental, and nonrepeating.
Aging within this system is not a running down. It isn't a disease, it's a developmental process. Aging, of course, starts with conception. Living, dying, is a rhythmical process and I'm talking about irreducible energy fields and we are the fields. We don't have them. It's not a separation. The literature frequently talks about people having fields or an aura. Within this system, that isn't true. Rather, we are energy fields and are in continual process with the environmental field and in the process of change. The human and environmental fields are integral with one another and changing together so that, in the process of change, there are many potentialities. Some of these are going to be actualized. Whatever is actualized at that point, we tend to put values on. Either we may say "I like that change" or "I don't like it." Then we try to intervene in ways that will hopefully participate in change we like better.
Aging is a very positive thing and I think we're seeing more emphasis on aging as a positive factor rather than emphasis on the so-called youth culture. For instance, the Today Show, on NBC, says happy birthday to centenarians every morning and it is handled very nicely. The Grey Panthers are doing a great job.
As far as nursing is concerned, it's quite different to perceive aging as developmental instead of a de-escalation process. The whole pattern of our society has been that "sooner or later, everything is going to run down." This grows out of our closed system model of the universe. There is substantial evidence that within our universe there are no closed systems. We are bound to be continuously integrated.
This means changing a great many attitudes. We know that people grow in cognition, that their capacity for taste increases in diversity People need (ess sleep and the diversity of the sleep/waking changes. Time is experienced as moving faster. The direction of change is toward higher frequency patterns. Chronological age is untenable as diversity grows.
An example of the changing patterns of sleep/waking I often use is that if an older person wants to go look at the moon at 2:00 am, it's called "crazy." But, if an 18 year old wants to do the same thing, it's called "romantic." Another example is that older folks living alone at home can go and get a cup of tea at midnight and no one cares, but let one of them try it in an institution and they get labeled. Rhythms change and when we start accepting people and letting them fulfill their own rhythms, we'll have healthier people, at all ages. This has major implications for the aged.
JGN: What made you decide to change the name of your framework from "Unitary Man" to "Unitary Human Being?"
Rogers: Oh, that's an easy one. Man is a nice generic term that has been around a long time but it was offensive to people who wanted to change to a nondiscriminatory term and I happen to agree with that I didn't change it for a long time because I couldn't think of anything better.
Finally, about three years ago, I agreed to do a chapter for a book and the publishers had a policy at that point that whatever their writers were doing, they couldn't use the generic term - man. As a result I just settled on unitary human being as being as appropriate as I could come up with to get away from the sexist aspect.
JGN: We published an article in December, 1983, that attempted to explain the use of your framework in clinical practice We had as many letters from those readers who understood the concept as explained, as we did from those who did not. What would you say to help those who did not understand the framework?
Rogers: well, the first thing I would suggest is to buy my new book as soon as it comes out! Then, there are organizations around the country who sponsor seminars and workshops about my concepts and I am willing to accept invitations to speak.
People seem to get more out of it when I talk and where they have the opportunity to raise questions. Last Spring (1984), I gave sessions in 13 states.
JGN: What instructions would you give our readers in applying your framework in their practices?
Rogers: First, of course, is to understand the concepts. Presuming this, they must change their attitudes about older people. We don't run other people. We have the capacity to participate knowingly in the process of change, but we are just that-participants.
JGN: As opposed to controllers?
Rogers: Yes. We do not control anything. We participate in the process of change. If you treat people as though they are healthy and can do things, I notice that they accept this as fact which I think is fascinating. We need to a value diversity and we need quit labeling people. We need to let them make their own choices. Make the choices positive ones. Don't say 'You have to do this," but instead say "Which would you rather do?"
JGN: What are the most significant health problems facing the aged today?
Rogers: Our biggest health problems in this country today are iatrogenesis, nosocomia, and hypochondriasts, and I think the health professions generate most of the hypochondriasis. People are not dying at as fast a rate as they used to. Many of the health concerns popularized by the media are those that have grown out of some insurance company's life expectancy tables somewhere. I have talked about what I perceive as criminal malpractice - running around taking blood pressures all of the time. The AMA gave some group of health practitioners an award for teaching third graders to take blood pressures. If that isn't hypochondriasis, I don't know what is!
There are going to be so many changes before the year 2000 that think we can't even imagine what those changes will be. The practical indications for working with the aged are exceedingly great. Telling the aged that they are "worn out" is for the birdsl Telling them to put on their new duds and get out and dance the night hours away is great! They wouldn't have to jog!