Quality of life (QOL) in dementing illness comprises the same areas as in people in general. Domains of QOL in patients with Alzheimer disease (AD) include competent cognitive functioning, the ability to perform activities of daily living and to engage in meaningful time use and social behavior, and a favorable balance between positive emotion and absence of negative emotion. Dementing illness can strip the person of normal indicators of personhood. Formal assessment of such QOL indicators can counteract the tendency to view QOL as irrelevant to dementing illness. A preliminary report of ongoing research to evaluate a special care unit for patients with AD includes findings on measuring positive behaviors and both positive and negative emotion. Emotions judged from direct observation showed promising reliability and validity. Thus, it may be possible to assess the preferences, aversions, and response to interventions of dementia patients even when the patients cannot report their evaluations.