This study examined, the role that home care staff played in the process of adaptation to home care for elderly disabled patients and their families following hospital discharge using qualitative analysis. The sample consisted of three home care cases involving elderly disabled patients in a city in Aichi Prefecture, Japan. The cases were particularly challenging ones for home care staff because of patients' clinical symptoms and need for special support. Data consisted of home visiting records and interviews with home care staff. Data were collected from the beginning of each case to the end of August 1998. Data analysis focused on patient and family adaptation to home care and the support given by home care staff to follow process; (1) an initial period of confusion, for patients and families during the introduction of home care services, (2) a stable period of home care and (3) a period of deterioration. During the early stages of home care support, patients and families showed signs of stress. They, were anxious about having home-care support and had unclear expectations regarding home care staff. During periods (1) and (2), home care staff had work on building supportive relationships with patients and families and provide reassurance. The home care staff who concerned then was not, specific profession, but the specific person. Next, home care staff waited to see how patients and families would utilize various support systems. The approach they used during this time was non-confrontational. Staff mainly observed and quietly supported patients and families according to their responses. Patient and family adaptation to home care is dependent upon a process in which patients, families and home, care staff recognize that a gap exists in mutual understanding. Unless all parties can agree on certain points, moving to the next goal is impossible, such as changing a lifestyle or learning to live with a handicap. Home care staff must always first consider the level of patient and family adaptation to a life requiring home care support in order to progress to the next steps of care.