This article aimed to describe characteristics of and design elements in gardens/patios at 87 residential living homes for older people and to describe and compare residents’ and staff members’ perceptions of these spaces. The result showed that many gardens/patios had several recommended design elements and at the same time obvious deficiencies. The residents (n=415) valued various aspects of the garden/patio more highly than the staff did (n=667). One conclusion is that managers responsible for residential living homes for older people should pay attention to and takes measures to ameliorate shortcomings and deficient elements in design and accessibility so that the garden/patio can be used as an important health promotion resource in the care of older people. Residents and staff can be seen as very important actors in such development work.