This study aimed to outline development of the Intimacy and Sexuality Expression Preference (ISEP) tool, which elicits preferences for the expression of intimacy and sexuality of older people, living with and without dementia, in residential settings. Using a Delphi technique involving 14 panelists, tool items were evaluated for importance, usefulness, relevancy and clarity on a 5-point Likert scale. All tool items achieved a mean score of ≥3.4 across the four areas of evaluation with an overall average tool-level content validity index of 0.89. Instructions were deemed appropriate, easy to understand and simple to follow. The ISEMP tool shows promise to improve care and support older people’s expression of intimacy and sexuality from a person-centered approach. Before implementation, more research is needed to test the tool in residential care settings and establish external validity.