Intimacy and its contribution to life satisfaction have not been explored among institutionalized elders. We studied residents of a Veterans Affairs nursing home and assessed cognitive and physical function, life satisfaction, and importance of intimacy. The Folstein Mini-Mental State, Barthel Index, Life Satisfaction Index-Z, and a series of vignettes were used to assess each domain. Vignettes depicted various scenarios (e.g., recent admission to a nursing home, notification of diagnosis of a terminal disease), and asked the subject to rate the importance of intimate social, intellectual, emotional, or physical interactions. Social intimacy was rated as most important, followed by nonsexual physical, intellectual, emotional, and finally, sexual-physical intimacy (social vs. sexual-physical, p = 0.0013). In addition, social (r(s) = .299, p = 0.023), nonsexual physical (r(s) = .312, p = 0.019), and intellectual (r(s) = .382, p = 0.005) intimacy were associated with life satisfaction. Nursing home care providers can enhance resident quality of life through social, intellectual, and nonsexual physical interactions even when the underlying medical, physical, or cognitive deficit cannot be ameliorated.