Abstract:

The assessment of need within the context of medicine & welfare is conventionally established through the measurement of agreed criteria of what should constitute problematic circumstances. When placed in the hands of practitioners, they may be given some latitude to interpret these findings & even add observations that may not be objectively measurable. The main burden of decision making about whether to give (or impose) "help" however, is guided by professionally & externally imposed standards, which may or may not be relevant to the person under review. In most assessment-of-need settings, the last people to be consulted are the older people themselves. Yet who is better qualified (not to prescribe particular solutions, though some may) to provide an account of their circumstances & their satisfactoriness? A method of approach to the understanding of the circumstances of later life, which is essentially biographical, is outlined. It begins from an intrinsic interest in the individual life & its unique pattern. Even when used to uncover "problems," it never espouses a problem or pathological perspective. As a result, the aspects of life that are perceived as problematic are generally dealt with candidly & without reserve, giving the interviewer an authentic view of impediments to full life satisfaction & the context from which causes (& sometimes solutions) might be drawn. The method & its potential benefits are illustrated from recent & current research on MDs' careers & on older people.