Integration: The final developmental challenge of older adults

According to Erik Erikson, a person’s last developmental task in life is to overcome the psychosocial task of “integration and despair.” Either you integrate your life experiences and rise above them or become desperate for failing to meet the challenge.

I have read Erikson’s writings about the psychosocial task of old age. I have even discussed his perspectives in an assignment for a master’s course I took. But do I really know what integration means?

Does it mean making meaning out of one’s entire life experience? Does integration require us to determine what achievements we have made in our long life? Or to accept the fact that we really are small beings and have led ordinary lives? Does it involve finding out which relationships still bother us and settling all grudges with those we dislike? If that is not possible, does it mean we accept that we will never be able to make peace with those people we can no longer reach, to let it go and not let it bother us again? Or is it about forgiving ourselves for being silly, cruel, vain and stupid at various times in our lives?

What is integration, really? Is it possible? How do you forgive yourself for the tempers you have thrown and the cruel things you have said or done to people? How do you integrate odd and unsettling experiences that, over the years, you purposely have tried to forget? How can things be put into perspective when you cannot make sense out of these weird experiences?

Can integration occur if, after long introspection, you don’t like who you are or have far too many regrets? Can it happen only when you can see yourself in a positive light?

How, in old age, do we integrate all the things that have happened to us over a lifetime? As a gerontologist and a person, I am intrigued. I realize that I don’t really know.

Older people have a lot of work to do in meeting this developmental challenge. And only they can provide firsthand knowledge.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

You only know it when you've gone through it

We learn about sandwich generations from books and by talking with friends and patients, but unless you have become one of those being “sandwiched,” you don’t really know what it means. Being sandwiched means not only that you have to look after your older and younger blood relations; it also means constant worrying about your parents and your younger ones, be they nephews, nieces or your own children.

At the moment, my mother is frequently on my mind. She has fallen four times since June. This is worrisome, indeed, but there is nothing much I can do. She lives with my brother in Toronto. My brother has been taking good care of her, but she is getting older and frailer each year.

I didn’t realize there is a comparative advantage of living in a smaller apartment. (Again, like I said earlier, learning has to be experiential.) When my mother visited me in Hong Kong just a few months back, she remarked that it was good that my apartment is small. She could quickly find something nearby to hold onto when she felt dizzy or when her knees gave way.

I didn’t think much about growing old when I was younger. I didn’t worry about saving money for the future when I was decades away from retirement age. In fact, retirement, secured old age, and so on, were not words and phrases found in my vocabulary when I was young.

There is a growing trend for people to say that we need to teach young people about growing old and getting prepared when they are still young; we need to plan for a secure old age decades ahead of time. As a gero nurse, I am not so sure about this. People grow into their own age. Learning has to be experiential. And where is the fun when, say at age 20, you have to be mindful of what you will become at 65?

Would continually thinking about old age take away our drive to move forward, to explore the world, to dream big dreams? Would teaching our young and making them think of old age prematurely rid them of the innocence of a full and “invincible” life ahead? What joy will it bring if we have to calculate risks when we are still young? We need to be responsible for our lives but not to that extent. At least not for me.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.