In using Orem's self-care framework, the nurse operates within a client-centered system which encourages the individual to be responsible for her own care. The philosophy changes from "I am here to take care of you" (maternalistic) to "I am here to assist you in taking care of yourself" (helping relationship). Even very ill or disabled persons (or their families) can be included in decision-making processes when actual self-care is not possible. Every effort must be made to have the individual's self-worth and dignity remain intact. Perhaps ultimately, credibility may be added to the words "health" and "care" in health-care delivery systems.