Contrary to the societal view that only the frail elderly reside in long-term care facilities, many young adults who require residential care to maintain optimal health, or who are in a rehabilitation program, also live in these facilities. The relationships between residents and caregivers in long-term care facilities may develop into relationships that are more typically familial than professional. With these emerging family-like relationships, the interpersonal pattern interactions may be healthy or unhealthy and may create opportunities for growth or pathology-producing patterns. This article illustrates how applying Peplau's concept of need-pattern integrations in the long-term care setting has the potential to enhance understanding, and subsequently guide interactions, between younger residents and caregivers. The potential is greatest when interactions are guided.