Dementia patients in primary care. Care managers offer a solution to providing ongoing care.

The structure of our healthcare system does not take into consideration the many psychological and social needs of older patients. For a patient like Mr. G, who has mild-to-moderate dementia, a critical aspect of primary medical care is determining the patient's non-medical needs. These needs often bear directly on medical care. Cost is one reason primary care offices do not have more care managers. Yet, in the seven intervention sites participating in the Council for Jewish Elderly study, six have arranged to continue with the social worker or have made substantial efforts to come up with the funding to do so. As we continue to look at our changing demographics and the needs of our increasingly older population, public policy planners must look at care management in primary care settings as an important clinical provision of care. To find a care manager in your area, log on to www.caremanager.org, which is the web site of the National Association of Professional Geriatric Care Managers. Click on the "Find a Care Manager" link and fill out the search form.