Direct payments have been available to older people receiving community care services in the UK since February 2000. However, scepticism remains about older people's desire and ability to use direct payments and take-up so far has been low. Drawing on interviews with older people, local authority care managers and direct payments support service workers, this topical report looks at how older people use direct payments and how they make them work. It considers the role of direct payments support services and local authority care managers in making direct payments a real option for older people. The report is particularly valuable in reflecting the views and experiences of older people themselves.