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Issues » 2019/1 - ERIS Journal - Winter 2019 »

Vito Flaker

Breathing the Hierarchy of Needs Away


OBJECTIVES: Needs are at basis of the long-term care response, nevertheless usually used primarily as a technical term, taken for granted. THEORETICAL BASE: Needs are a paramount, omnipresent, and key concept in social policy, social work and in health care, containing layers of historical contradictory dispositions, simultaneously establishing ‘needs’ as a lack, a right, a norm, and a desire. In long-term care the primacy of ‘basic’, bodily needs is often asserted on the account of ‘social’ needs, basing this reduction on Maslow’s notion of a hierarchy of needs. METHODS: We deconstruct the hierarchy by using the example of breathing. OUTCOMES: We demonstrate a need for terminological clarity in distinguishing between the vital functions, the activities of daily living, and the needs. The needs being not only descriptive, indicative terms, but also imperative and deontic, and therefore must always be deconstructed and based on personal goals, priorities and desires. SOCIAL WORK IMPLICATIONS: Since the life (bodily) functions and activities of living are only instrumental to the person’s priorities, ‘needs’ should be always seen as hierarchy of personal priorities – setting thus an important contribution of social work perspective to the emerging systems of long-term care.


needs, Maslow, breathing, long-term care, assessment

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