Erikson described the late life developmental task as a complex and dynamic dialectic between ego-integrity and despair with substantial impact on older adults’ functioning. Limited knowledge is, however, available on how older adults cope with this task within the existentially challenging context of nursing homes. A person-oriented perspective within a longitudinal approach is implemented to test Erikson’s premise, offering insight into how old and frail adults come to terms with this task and how this process is related to better or worse psychological functioning. Three hundred twenty-seven adults living in nursing homes were interviewed three times by means of structured questionnaires, every 6 months. Typological methodology (latent class growth modeling) was used to reveal specific profiles of ego-integrity and despair and to test relations between profiles and psychological functioning over time. Three specific groups emerged (Despairing group, Struggling group, and Integrated group) and each group was associated with a unique pattern of psychological functioning (depressive symptoms, life satisfaction, subjective health). The Integrated group showed the most optimal functioning whereas the Despairing group, and to a lesser extent the Struggling group, showed suboptimal functioning. Furthermore, in the Despairing and Struggling group, different trajectories for subjective health were present, as compared to the Integrated group. Older adults in nursing homes handle the developmental tasks of late life in distinct and dynamic ways over time and these different trajectories are related to their psychological functioning. Our findings emphasize the need to focus on developmental psychological aspects in long-term care for older adults.

中文翻译：

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在诚信与绝望之间寻求平衡：老年人在居家护理方面的挑战性工作

埃里克森（Erikson）将后期发展任务描述为自我完整性和绝望之间的复杂而动态的辩证法，对老年人的功能产生了重大影响。但是，在养老院存在挑战的背景下，老年人如何应对这项工作的知识有限。在纵向方法中采用了以人为本的观点来测试Erikson的前提，从而洞悉老年人和体弱的成年人如何完成这项任务，以及这一过程与更好或更差的心理功能之间的关系。每六个月，通过结构化问卷对居住在疗养院中的三百二十七名成年人进行三次访谈。类型学方法论（潜伏类成长模型）被用来揭示自我完整性和绝望的具体特征，并检验随着时间的推移，这些特征与心理功能之间的关系。出现了三个特定的组（绝望组，挣扎组和综合组），每个组都具有独特的心理功能模式（抑郁症状，生活满意度，主观健康）。综合组表现出最佳的功能，而绝望组和苦苦挣扎组表现出次佳的功能。此外，与综合组相比，在“绝望与挣扎”组中，存在主观健康的不同轨迹。随着时间的流逝，疗养院中的老年人以截然不同的动态方式处理晚年的发展任务，这些不同的轨迹与他们的心理功能有关。我们的研究结果强调，在老年人的长期护理中，必须关注发展中的心理方面。