Persistent changes in long term care policy reform in Ontario prompted one home care program to undertake a multifaceted study to evaluate the effects of those changes. This article describes the qualitative component of the study examining perceptions of clients (persons with disabilities; adults over 80 and under 80 years of age) and of informal caregivers concerning their satisfaction with services and the impact of service delivery on their quality of life. Responses and descriptions of relevant perceptions and experiences varied with category of participant. Study findings revealed that satisfaction with services and concomitant quality of life depended upon the quality of communication with service providers.