The aim of this study is to understand how the staff is working with users with cognitive impairments and how they see at the participation of its users. This can be broken down into two parts, how to reflect on the problem and also how to work actively with it. The reflective part is the opportunities and difficulties the staff will tend to see with participation. The active part is how they are working to develop ways to increase the participation of users with cognitive impairments. Our study is based on qualitative interviews with seven respondents. The theoretical framework we have used for our study is duty ethics and utilitarian ethics. The result indicates that a measure of non-participation is accepted within supportive activities for people with cognitive impairments based on their level of function. We conclude that professionals working with cognitively impaired users make a decision to limit unhealthy and destructive behaviors with the reason that it is for the best long term effect for the user’s quality of life.