Denmark, Norway and Sweden are entering the graying society. The demographic situation creates new demands on buildings, infrastructure and services. The number of residential homes is increasing, especially for older persons with a dementia diagnosis. This is a type of public building that is regulated by programming documents that eventually will define the residential environment. This article is based on a survey of 78 architectural competitions from the period of 2000 to 2012. The competition documentation of nine Nordic competitions has been analyzed by use of close reading and drawing analysis. This study suggests that there is a gap between reality and visions. Despite research-based guidelines, the architecture of contemporary residential care homes relies on universal qualities that are associated with the home environment rather than with the particular conditions of this housing that integrates home in a care environment. A multidisciplinary approach, however, is desirable inorder to create appropriate and sustainable environments for frail older people.