As the practice of geriatric rehabilitation grows, so does the importance of understanding the psychosocial theoretical constructs that frame our practice. Erik Erikson sets forth the conflict between integrity and despair as the eighth and final developmental task of the lifespan. The adaptive strength that emerges from this struggle is wisdom. Erikson's developmental approach is examined as it relates to rehabilitative interventions in the geriatric population, with particular focus on use of imagination, acknowledging the potential value of patients' dysfunctions, and attachment. Treating patients in the larger context of Erikson's psychosocial theory is explored as a means to achieve optimal physical rehabilitation outcomes.