| Abstract: | Summary At the heart of needs-based assessment is an uneasy tensionbetween agency-centred and user-centred objectives. Using casematerial from an ethnographic study of the process of assessmentfor older people, this paper looks at what happens when practitionerstry to understand the needs of individual elders through a processdominated by agency agendas. By marginalizing the older person'sinsights, the risk of unwelcome or inappropriate interventionmay increase. A user-centred approach, by contrast, requiresinformation gathering and provision that is meaningful to theolder person and sensitive to their efforts to analyse and managetheir situation. These efforts are often revealed in narrativeform as the person tells their story which, in an agency-centredassessment, is easily overlooked or even ignored. |
