ego integrity or despair?

[momandsn]

If a client is a 92 year old female, unable to communicate, bedridden, totally dependent for ADL's, and has contracture's, which would she be considered- ego integrity or despair? And why? I was thinking despair, but if she could communicate would she agree?

[Daytonite, BSN, RN]

look at erikson's older adult stage of (ego) integrity vs despair where the person reviews life accomplishments, deals with loss and preparation for death. that is what they are referring to.

• http://en.wikipedia.org/wiki/ego_integrity - "psychosocial theory describes ego integrity as the ego's accumulated assurance of its capacity for order and meaning. this experience of consistency leads to the development of a reliable sense of self, a reliable sense of other, and an understanding of how those constructs interact to form a person's experience of reality."
  
• http://www.haverford.edu/psych/ddavis/p109g/erikson.stages.html - gives you a little breakdown of what each goal is within each of erickson's stages. for integrity vs, despair it says:
  
  • ego integrity is the ego's accumulated assurance of its capacity for order and meaning.
    
  • despair is signified by a fear of one's own death, as well as the loss of self-sufficiency, and of loved partners and friends.
    
  • healthy children, erickson tells us, won't fear life if their elders have integrity enough not to fear death.
    

why would she be in ego despair? she does not seem to be afraid of death and certainly is not adverse to being totally cared for, is she? she isn't resistive to care, is she? if not, then she would be ego integrity. she accepts what is done for her. her life has order, meaning and reality within her sphere of understanding.