Self-talk versus Needs-talk: an exploration of the priorities of housebound older people

This article argues that the material and social circumstances of older people living with disabilities mean that their priorities and subjective evaluations of quality of life are likely to be categorically different from those used by service provider organisations. Based on a qualitative study of a purposive sample of older people, who are over 75 and have recently become housebound as a result of disability, the paper describes two modes of understanding: ‘Self-talk’ and ‘Needs-talk’. It is suggested that these two modes are to an extent irreconcilable and limit the degree to which care assessments and care-management can satisfy users.