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  1. STAGE OF DEVELOPMENT—PSYCHOSOCIAL STAGE: continuation of ego integrity and acceptance versus despair and disgust.
  2. PHYSICAL DEVELOPMENT (see also Chapter 7. Physiological Integrity)
    1. Additional sensory problems occur, including diminished sensation to touch and pain.
    2. Increase in loss of muscle tone occurs, including sphincter (urinary and anal) control.
    3. Individual is insecure and unsure about orientation to space and sense of balance, which may result in falls and injury.
  3. COGNITIVE DEVELOPMENT
    1. Has better memory for the past than the present.
    2. Repetition of memories occurs.
    3. Individual may use confabulation to fill in memory gaps.
    4. Forgetfulness may lead to serious safety problems, and individual may require constant supervision.
    5. Increased arteriosclerosis may lead to mental illness (dementia and other cognitive disorders).
  4. SOCIALIZATION
    1. Few significant relationships are maintained; deaths of friends, family, and associates cause isolation.
    2. Individual may be preoccupied with immediate bodily needs and personal comforts; the gastrointestinal tract frequently becomes the major focus.
    3. Individuals see that they can provide others with an example of wisdom and courage.
    4. Individuals come to terms with themselves.
    5. Individuals are concerned with own mortality.
    6. Individuals come to terms with the process of dying and prepare for own death.