This chapter addresses the important issue of how the concept of therapeutic landscapes is useful in the analysis of residential care environments for older people. It provides a critical examination of how such seemingly therapeutic landscapes also are problematic. The chapter also provides an understanding of how places created as therapeutic for older adults in the United States become inherently unhealthy in a number of ways that diminish the intended, and often real, therapeutic benefit. It describes the conundrum of a type of therapeutic landscape that is being replicated for millions of older adults across the world. The chapter discusses the assessment of implications for residential care/assisted living, as well as how the concept of therapeutic landscapes is enhanced by the inclusion of such critical analysis of places of care. 'Residential care settings' is a generic phrase that may be used to describe a range of senior housing and long-term care options in the United States.