Elderly patients with established brain failure present the family doctor with problems of longterm management for which there are, at best, limited pharmacologic solutions. An organized plan of management developed jointly with the significant other(s) will help achieve treatment objectives. By assessing the patient's physical and mental function, it is possible to work out appropriate changes in the living environment and behavioral interventions which will help retard deterioration, maintain and conserve function and reduce the confusion and distress felt by all parties. Though initially it may be more time consuming for the doctor to take on this leadership and coordination, the recurrent and frustrating crises over the long haul may well be reduced. Certainly patient care will be improved.
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