This chapter describes quality of care and financial issues associated with poor care transitions, and includes the American Geriatrics Society recommendation to improve transitional care. It presents some conditions identified as having quality gaps in caring for older adults when transitioning in both directions between nursing facilities and the emergency department. The chapter explores the relationship between delirium and dementia and the importance of early screening in health care settings and during care transitions. It discusses conflicts related to emotional reality of moving an older adult from a familiar environment to any long-term care (LTC) setting. The chapter defines relocation stress syndrome (RSS) and its effects. It also describes strategies to identify and minimize the risks associated with older adult relocation; addresses problems from a clinical standpoint; creates interventions and care plans that facilitate positive outcomes; and increases staff awareness, sensitivity, tolerance, and creativity on the topic of care transitions.