The process of ageing is frequently described in terms of decline and deterioration. Limited attention is paid to the gains in later life. Studies among self‐defined healthy American‐born elderly and ill‐healthy British‐born older persons, indicated that the perception of health was determined by many dimensions other than the absence of disease and illness. The older the person, the more emphasis was placed on health as a state of mind, even in situations of a gradually failing body. It was evident that these respondents, among them the ill‐healthy elderly, challenged the current beliefs of health and illness as perceived by health providers.

Some general thoughts on the use of the quality concept as a means to structure critical reflection on patient-client care and health services is discussed. The continuous request for more health care facilities and quality of services occupies not only the minds of the health workers, but also of the consumer who is becoming more aware of his rights and privileges. Health care should not be identified with curative care only. It involves prevention and promotion of people's status of health as well. Nurses have an important contribution to make in the promotion of health. The paper deals also with the evaluation of quality of care. If nurses become involved in the evaluation of nursing care they should have a clear concept of what nursing is. The nursing profession has a responsibility to develop standards and criteria for the evaluation of nurses' contribution in patient care. An example of a well-tested monitoring quality instrument is given. In the last part of the paper some practical suggestions for managers who are responsible for the quality care improvement in their own health care institutions are given.

The discipline of nursing is in a process of rapid transition. In this paper, the developments are discussed that have affected nursing in its advancement to a full-grown profession. Nursing and medicine are the products of Cartesian thinking that has fragmented our perspectives on man and his living world. The consequences of this scientific viewpoint are reflected in all aspects of life. Attention is paid to advances in nursing practice and education, the development of nursing research and the emergence of a nursing science. These aspects are discussed in the context of professionalization and the position of nursing in the health care system and in society. The study findings of the Styles Report Project on the Regulation of Nursing (1985) serve as a framework of analysis. Links are made between the recommendations given in this report and the development of primary health care, the new tomorrow of a modern discipline.

The process of ageing is frequently described in terms of decline and deterioration. Limited attention is paid to the gains in later life. Studies among self-defined healthy American-born elderly and ill-healthy British-born older persons, indicated that the perception of health was determined by many dimensions other than the absence of disease and illness. The older the person, the more emphasis was placed on health as a state of mind, even in situations of a gradually failing body. It was evident that these respondents, among them the ill-healthy elderly challenged the current beliefs of health and illness as perceived by health providers.

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