Abstract
Drawing on interviewsummaries from 52 in-depth interviews with SocialHMOmembers, coded for quality-of-life themes, we explore how home-and community-based services affect quality of life, autonomy, and control. We identify areas where services positively influence quality of life, including promoting functional independence and preventing further functional decline, and we raise questions about important quality-of-life related care that has been outside the Social HMOs'priorities or which they have been unable to adequately address. Elders might benefit if the Social HMOs and other similar programs could be expanded to include services such as training in falls prevention, increased attention to social needs, and better assessment and follow-up of mental health problems.