In one of his earlier books, Living and Dying at Murray Manor, the author availed himself of ethnographic techniques to explore the experience of life in a nursing home. This volume extends that exploration to an assessment of the quality of long-term care provided to residents of nursing homes, and of the resulting quality of lives. Taking a bottom-up rather than a top-down view, Gubrium presents these qualities in the voices of -the residents themselves, in collaboration with the interviewer. Because many residents have been -long stayers- in nursing facilities, they are confronted with matters of home, family, life history, dependence, isolation, self-worth, even destiny in ways that would be irrelevant in shorter hospital stays. Such matters present significant narrative contexts for conveying the subjective meaning of the quality assurance that has become a leading goal of health care delivery. Two key concepts are employed to organize and interpret the narratives: narrative linkages and horizons of meaning. Narrative linkages refer to the experiences, inside or outside the nursing home, that are drawn upon to communicate subjective meaning. A horizon is the pattern of narrative linkages a resident conveys in speaking of life. The approach and narrative material provide conceptual, methodological, and personal lessons. The issues raised by Gubrium's book are informed by a view of residents as biographically active and by the expectation of narrative diversity. He relates thereby a personal encounter with storytellers who offer the listener the broad range of orientations and special circumstances that continue to make meaning even at the very end of life.