This study explores the significance of addressing intimacy and sexuality needs among older adults, including those living with dementia, in residential care settings. The study introduces the Intimacy and Sexuality Expression Preference (ISEP) tool designed to foster meaningful discussions between healthcare providers and residents about their preferences. A user-centric case study, conducted with 14 residents in a Queensland residential care facility, illustrates the tool’s potential to enhance care practices. However, the study’s limited scope underscores the necessity for further research to ascertain the tool’s broader effectiveness across various care settings.