Erikson’s Stages of Development
Key Points
- Erikson describes eight age-linked psychosocial conflicts that shape identity and coping.
- Successful conflict resolution supports strengths, while unresolved conflict increases vulnerability and distress.
- Developmental-stage awareness improves communication and individualized CNA support.
Pathophysiology
Erikson’s framework is a psychosocial development model, not a biologic disease pathway. It explains how individuals build identity, relationships, purpose, and life meaning through recurring age-specific conflicts.
Each stage includes a central tension (for example, trust vs mistrust or integrity vs despair). Outcomes are not fixed; supportive environments and adaptive coping can improve progression even after difficult earlier stages.
In nursing care, developmental mismatch can appear as anxiety, withdrawal, anger, dependency, or low participation in care, especially during illness and loss of independence.
Classification
- Infancy: Trust vs mistrust.
- Toddlerhood: Autonomy vs shame and doubt.
- Preschool: Initiative vs guilt.
- School age: Industry vs inferiority.
- Adolescence: Identity vs identity confusion.
- Early adulthood: Intimacy vs isolation.
- Middle adulthood: Generativity vs stagnation.
- Late adulthood: Integrity vs despair.
Nursing Assessment
NCLEX Focus
Questions often test which intervention best matches developmental conflict and preserves dignity.
- Assess age-related priorities, preferred level of independence, and response to assistance.
- Observe behaviors suggesting unresolved conflict, such as shame, role confusion, isolation, or despair.
- Identify life-stage stressors that may worsen coping during illness or institutional transition.
- Report persistent psychosocial distress that interferes with ADLs, safety, or care participation.
Nursing Interventions
- Offer choices when safe to support autonomy and reduce shame.
- Use encouragement and achievable goals to reinforce competence and purpose.
- Protect identity by honoring routines, personal history, and meaningful roles.
- Promote social connection and family involvement to reduce isolation.
- Support life review and dignity-focused communication in late adulthood.
Developmental Incongruence
Tasking residents without regard to developmental needs can increase refusal, helplessness, and emotional decline.
Pharmacology
| Drug Class | Examples | Key Nursing Considerations |
|---|---|---|
| antidepressants | SSRIs, SNRIs | Psychosocial support and therapeutic communication remain essential alongside medication. |
| anxiolytics | PRN anti-anxiety agents | Monitor for sedation and fall risk while reinforcing nonpharmacologic coping supports. |
Clinical Judgment Application
Clinical Scenario
A resident in late adulthood repeatedly states, “My life has been a failure,” and declines social activities after hospitalization.
Recognize Cues: Hopeless statements, withdrawal, and reduced engagement. Analyze Cues: Integrity vs despair conflict may be intensified by illness-related loss. Prioritize Hypotheses: Psychosocial risk for despair is affecting recovery participation. Generate Solutions: Use dignity-preserving communication, structured reminiscence, and family-supported engagement. Take Action: Report mood trend to nurse and implement supportive interaction plan. Evaluate Outcomes: Resident expresses more meaning, participates more consistently, and shows reduced withdrawal.
Related Concepts
- human-needs-and-developmental-stages - Integrates developmental theory with bedside care priorities.
- maslows-hierarchy-of-needs - Motivation and development frameworks are complementary in care planning.
- communication-process - Developmentally appropriate communication improves trust and participation.
- caring-for-clients-with-developmental-disorders - Developmental context supports individualized interventions.
- psychosocial-adaptation-to-parenthood - Stage transitions influence coping and role formation.
Self-Check
- Which signs suggest unresolved developmental conflict in late adulthood?
- How can CNA communication support autonomy without compromising safety?
- Why should developmental stage be considered when planning ADL assistance?