Maintaining identity in elderly couples with chronic illness.

With the onset of chronic illness, it has been necessary for these couples to evaluate and redefine their separate as well as merged identities. As each of these individuals sought to realize a mature identity, role adjustments were required. Although not every member of the two illustrated couples had been able to accept the effects and concurrent responsibilities of chronic illness, the nurse practitioner was in a unique position to provide guidance. By reinforcing the importance of healthy identity states, these clients were able to merge temporarily and respond to their partner's basic needs, exchanging a sense of mutual satisfaction, and then to separate into distinct individual identity states. A major task of the older adult is to re-evaluate identity in light of the roles currently being played in life. Through this process, a workable philosophy of life and death should evolve. Most older people engage in a life review of accomplishments and failures, seeking to integrate the diverse elements to obtain an acceptable view of their life's worth (Kaluger, 1984). Couples experiencing chronic illness must reconsider the consequences of this illness state to adequately formulate healthy individual and merged identities. The role of the nurse practitioner is essential in providing guidance for adapting to the life changes confronting elderly couples with chronic illness while maintaining healthy individual and merged identities.