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Intellectual impairment alone can make institutionalization necessary. Even supportive families may find disruptive behavior, such as nocturnal wandering or paranoia, intolerable. If 24-h care is required, nursing home placement may be appropriate. But mildly to moderately demented patients can often function quite well in their own familiar environment, especially if families have been taught coping [...]

Consideration must be given to whether potential caregivers are willing and able to perform the tasks necessary to keep the older person at home. Strongly motivated families usually can perform elaborate and detailed care, but they may be indifferent or become resentful or worn out from assuming such responsibility. Home care often involves a long-term [...]