Health care staff are obliged to help patients participate in their care. Previous research has shown that information and relationships with staff are important factors for patients to feel involved. The aim of the study was to describe patients' experiences of participation during hospitalization for hip fracture. Eleven patients being treated for hip fracture were included and data were collected using interviews. Analysis of the data was carried out through qualitative content analysis. The results illustrate that the experiences of participation are governed by the patient's personal circumstances, needs and wishes and are affected by how responsive the staff are to these. Patients' experience of participation is also affected by having to adapt to the health care organization and structure. To pursue individualized care, staff need to start from patient preferences and it is a challenge to adapt care to both the individual and the organization. By paying attention to patient preferences, the staff have a greater opportunity to implement changes in health care that will benefit a large patient population. This can lead to patients gaining better functional capacity and quality of life. © 2013 Elsevier Ltd.