Healthcare agencies and researchers identify several areas in which healthcare disparity affects elder, African-American diabetics including higher rates of diagnosis, higher limb amputation, increased kidney failure, and stroke. While the disparities have been documented, elder, African-American diabetics rarely have been invited into discussions concerning these disparities, research questions, project or program design, and results. They are not asked to be stakeholders in health care or health policy discussions. This study used grounded theory as a participatory action research method to invite elder, African-American, diabetics into the discussion using focus groups. The patient participants then suggested providers they believed to be "successful" in their care who were then interviewed. The analysis suggests that where patient/ provider communication has been peripheral that care and perception of care and patient suffer. Where successful communication was central to the patient/provider relationship, provider preconceptions lessened and patient compliance levels rose. This dissertation offers several downstream, midstream, and upstream recommendations using a patient-focused lens.