Health care in the twenty first century is facing demands that are not only financially restrictive but also greatly influenced by intervening variables such as increased life span, an awareness of advanced treatment programming, and better quality of life. Unfortunately, however, with better health care there exists a void in the availability of trained professionals who are qualified to provide the necessary medical service, especially trained nursing professionals who are trained in, and receptive to, patient interaction in healthcare. In fact, according to Buerhaus (2000) by the year 2020 there will be a 40% shortage of required nursing professionals. Being a nurse in the twenty first century will undoubtedly become more complex and demanding than in preceding decades. With the advent of even greater technology, higher medical costs, and other better paying professional careers available, the nursing community requires an immediate infusion of interest, compassion, understanding, and acknowledgment for the services their profession provides. The remainder of this paper will examine the structure and purpose of one nursing theory applied to a particular cultural group and one specific problem of that group, namely, the elderly and depression. Both these situations have been identified as being more relevant than evaluating the nursing theory from a broad-based point of view. The report will pay particular attention to the Orem self-care theory and its usability in dealing with elderly patients.

             Orem Self Care Theory. Growing old in America is not generally thought of as a gentle process, rather one fraught with higher medical costs, rising inflation, and familial separation and loneliness. Unfortunately the elders in our society are oftentimes forgotten, seldom revered, and generally not appreciated. As a result depression is rampant amongst the elderly. According to Orem (1995) self-care in dealing with patients is pivotal to the health and well being of the individual being treated - both on a preventative and long-term basis.