Quo vadis geropsychiatry? Perspectives for a new "state of the art"

The number of older geropsychiatric patients is increasing dramatically. "The Big Three - Dementia, Depression, Delusion" are challenging our care system. Today 80 % of those affected live at home, with 5-8 % receiving care in facilities. There is very little between. What is lacking: cross-facility co-ordination, co-operation, systems of reference with overall responsibility, ease of access, particularly of clarification and consulting services, mobility of psychical support, massive support for relatives, and specialised, graduated services for various areas of life and needs. A vision of an integrated supply of services is delineated, the intertwining of private, mobile and inpatient modules adumbrated. Simultaneously the problems with transitions, education and case conferences, specialists, conference of the supporters and quantity structure of services are addressed. Solutions are suggested and the solvability of this important socio-political problem of the next decades demonstrated.