This study, based on constructs from Roy’s adaptation model, examined the relationship between cognitive adaptation processes and self-consistency in hearing-impaired elders (N = 130). Data were collected through survey ques- tionnaires. Major research hypotheses were formulated and tested. Results of this study supported Roy’ s theoretical proposition of cognitive adaptation processes and their role in the maintenance of self-consistency. Three cognitive processes (clear focus and methods, knowing awareness, and self-perception) significantly contributed to the main- tenance of self-consistency. Understanding these cognitive processes helps nurses to promote effective adaptation in older persons.