Aims: This scoping review identified the interventions and outcome measures used by occupational therapists working with older adults in residential care facilities. Methods: A five-step approach was used to retrieve and screen studies from five databases. Included studies described an occupational therapy intervention with older adults living in residential care facilities, were published in English, between 1990 and 2019 in a peer-reviewed publication. Data were mapped using domains of the Canadian Model of Occupational Performance and Engagement. Results: Findings from 51 studies revealed that occupational therapists most commonly implemented occupations as the intervention with little focus on aspects of the environment. Outcomes predominantly measured person factors and less commonly occupational performance and engagement. Conclusion: The exploration of the past foci of practice and measurement of therapeutic impact enables occupational therapists to consider how their practice can enhance future occupational performance and engagement of residential care facility residents.