Bridging the divide: Elders and the assessment process

Abstract

At the heart of needs-based assessment is an uneasy tension between agency-centred and user-centred objectives. Using case material from an ethnographic study of the process of assessment for older people, this paper looks at what happens when practitioners try to understand the needs of individual elders through a process dominated by agency agendas. By marginalizing the older person's insights, the risk of unwelcome or inappropriate intervention may increase. A user-centred approach, by contrast, requires information gathering and provision that is meaningful to the older person and sensitive to their efforts to analyse and manage their situation. These efforts are often revealed in narrative form as the person tells their story which, in an agency-centred assessment, is easily overlooked or even ignored.