This study is a multi-method, intrinsic case study of social interaction in a special care unit (SCU) for cognitively impaired older persons. It is found that residents are capable of developing a range of social bonds even though the SCU in question is found to have several organizational and physical factors that unwittingly thwart its therapeutic potential. These limitations are illuminated by consideration of the congruence between the conceptualization of the dining areas held by staff and that held by residents as revealed through the process of negotiation occurring in social interaction. The study adopts an environment-behavior perspective following the theoretical development of Lawton (1986) and merges it with the qualitative approach to place pursued by Goffman (1961) and Gubrium (1978). It is suggested that a focus on place as a unit of analysis offers potential for bridging Quality of Life with the cognitively impaired.