This article discusses some key issues to consider in the development and delivery of arts-based elderly care. The purpose of this paper was to deepen the understanding of the elements affecting quality and their interplay. This is essential when developing policies and procedures for the successful use of arts and arts-based methods in elderly care. Professionals of different fields and backgrounds are using arts activities or arts-based methods with diverse aims and means in various settings in elderly care. This highlights the need for shared concepts, terminology and definitions of quality as well as a better understanding of the education and training needs of associated staff. This article suggests some tentative definitions and concepts as a basis for further discussion. It is pointed out in this paper that the quality of arts-based methods in elderly care is greatly dependent on the construction of the professional identities and competencies of those working in the field. This paper describes the different settings of arts-based work with the elderly and maps the essential competencies needed in these settings, thus providing a framework for developing quality management.