This study examined the congruence between needs identified as significant by older adults in comparison with caregivers (nurses) and elders' families. The study involved 44 patients, 94 nurses and 44 families from the Shoham Geriatric Center in Pardes Hanna, Israel. The findings are based on data gathered through questionnaires distributed at the nursing home. The findings indicate a discrepancy between residents' needs as identified by the staff, the families and the elderly residents themselves. An analysis based on primary needs showed that in comparison with the residents and their families, the nurses attributed greater significance to values and personal outlook of the residents, provision of proficient physical care, skilled mental support, social life and institutional requirements. Families attributed the most significance to the provision of information and family involvement, and in contrast, according to the residents, the most important area was skilled mental/emotional support. Also discussed are the research and practical implications of these findings.