[The demented patient: his family, social and therapeutic environment]

The patient's environment determines to a large extent the evolution of his illness. His family, which is almost always thrown into a state of confusion by the patient's illness, has the crucial role of providing support and protection even if they are overwhelmed by his needs. The support of the community is indispensable in order to assure the continuity of the parental role; therefore the need to create specialized services such as geriatric hospitals, hospices, special residences, out-patient therapeutic units, and social and medical services for care at home. The Geneva geriatric and gerontological experience is presented to better illustrate these needs.