Living with chronic illness is part of everyday life for many Canadians. They must manage their health problems while continuing their normal activities of daily living. This is especially true for individuals living with end-stage kidney disease because the therapeutic regimen is demanding due to the limited capacity of haemodialysis to replace kidney function. Those individuals must make decisions about diet, medication, family and social activities while also monitoring their health status. In order to work with this clientele, we suggest a different focus away from observance or compliance with treatment and self management of chronic illness. We propose a model of self management of health which will be more in tune with a humanistic perspective on care. This model is based on philosophical, empirical and clinical evidence drawn from care experiences with people living with chronic end-stage kidney disease. It should improve the well-being of the clientele as well as that of the caregivers, including the nurses.