P28 · Loss of sense of identity
Actual Emotions and mind
Definition
The person feels they no longer know who they are after illness, injury, or a change of role.- Amputation
- stroke
- role change
- mental illness
- aging
- Says he does not know who he is
- withdrawn
- lost purpose
- confusion about roles
📋 Scenario
After retirement and illness, a man says he no longer knows who he is.
Subjective (S): "I don't know who I am now."
Objective (O): Retired and ill; withdrawn; says he has no purpose; refuses visitors.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen
Validated scales to consider: PHQ-9, GAD-7, C-SSRS
**CarePath diagnosis:** Loss of sense of identity related to retirement and illness, as evidenced by saying he does not know who he is, withdrawal, and refusing visitors.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Explore values and strengths. | Helping him name what he values and what he can still do rebuilds a sense of self that illness and retirement have shaken, and shows he is seen as a whole person. |
| Encourage meaningful activity. | Taking part in activities that matter to him restores purpose and a feeling of being useful, which counters withdrawal and the belief that he has no role. |
| Link to peer support. | Meeting others who have faced similar losses shows him he is not alone and gives real examples of people who rebuilt their sense of who they are. |
| Offer counseling. | A trained counselor can help him grieve lost roles and abilities and can screen for depression, which often goes along with loss of identity. |
| Praise abilities. | Genuine recognition of what he can still do strengthens self-worth and confidence, helping him see himself as more than his illness. |
**Expected outcomes**
- Within 2 weeks: names one meaningful role or interest, takes part in activities, engages with support.
**Linking the data to the diagnosis**
The patient says, "I don't know who I am now," is retired and ill, appears withdrawn, says he has no purpose, and refuses visitors. These data point to a problem with how he sees himself and his roles, not simply low mood or loneliness, so this statement fits better than a social isolation diagnosis. The problem is already present, so it is an actual diagnosis, not a risk one. The plan aims for him, within 2 weeks, to name one meaningful role or interest, take part in activities, and engage with support, which would show his sense of identity and purpose is returning.
CarePath diagnosis
Loss of sense of identity related to retirement and illness, as evidenced by saying he does not know who he is, withdrawal, and refusing visitors.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Explore values and strengths. | Helping him name what he values and what he can still do rebuilds a sense of self that illness and retirement have shaken, and shows he is seen as a whole person. |
| 2. Encourage meaningful activity. | Taking part in activities that matter to him restores purpose and a feeling of being useful, which counters withdrawal and the belief that he has no role. |
| 3. Link to peer support. | Meeting others who have faced similar losses shows him he is not alone and gives real examples of people who rebuilt their sense of who they are. |
| 4. Offer counseling. | A trained counselor can help him grieve lost roles and abilities and can screen for depression, which often goes along with loss of identity. |
| 5. Praise abilities. | Genuine recognition of what he can still do strengthens self-worth and confidence, helping him see himself as more than his illness. |
Expected outcomes
- Within 2 weeks: names one meaningful role or interest, takes part in activities, engages with support.
Linking the data to the diagnosis
The patient says, "I don't know who I am now," is retired and ill, appears withdrawn, says he has no purpose, and refuses visitors. These data point to a problem with how he sees himself and his roles, not simply low mood or loneliness, so this statement fits better than a social isolation diagnosis. The problem is already present, so it is an actual diagnosis, not a risk one. The plan aims for him, within 2 weeks, to name one meaningful role or interest, take part in activities, and engage with support, which would show his sense of identity and purpose is returning.