Recent funding programmes supporting research and development in telecare h
ave argued for a shift in perspective from a technology-driven approach to
one that is needs-led. While this is in the interests of both users and tec
hnologists, achieving this goal is not straightforward. This paper outlines
some of the conceptual, methodological and practical problems that potenti
ally constrain a needs-led approach and illustrates the emergent issues wit
h a case study of the development of an intelligent home monitoring system
to support the independent living of older people. The research indicates c
lear differences between users and technologists in the way problems, needs
and requirements are understood and defined. This in turn has consequences
for the way assistive technologies are developed and implemented.