Specially designed outdoor spaces (SDOS) have been developed to improve the quality of life of people with dementia. However, few follow-up studies have been done to examine their use once implemented. The purpose of this study was to gain a better understanding of how SDOS are used and the objectives of their design fulfilled. A qualitative descriptive study was conducted of a SDOS 3 years after it was built to answer the following questions: How has the garden changed from the original design? What are the current patterns of use of the garden? What factors facilitate use of the garden? What are the barriers to use of the garden? Four main sources of data were used: landscape architectural drawings, non-participant observation, focus groups, and in-depth interviews. The results lend support to the theoretical principles of garden design in the literature. The garden was considered an important part of the service program. However, factors such as garden maintenance, organizational support, staff training, and accessibility may limit its impact.