This chapter analyzes the concept of safety in the context of geriatric care, particularly for older adults with dementia. It explores how different conceptions of safety—such as error reduction, liability reduction, limiting choices, and physical harm reduction—can lead to unintended consequences and impact an individual’s quality of life. The chapter argues that care environments are “safety-generating social systems” with inherent risks, emphasizing the need for a nuanced understanding of these risks when making critical care decisions.