[Troubled times in care of the elderly. Increasing number of the "oldest old" and demented, shortage of general practitioners and lack of clarity with regards to locating resources].

The media image of general breakdown in care of the elderly, replete with portrayals of malpractice and maltreatment, is analyzed in the light of changes in demographics, care resources and care delivery systems during the past decades. A substantial increase in the number of people aged 80 years or more, increasing numbers of elderly persons with dementia, deinstitutionalization of health care, together with the present economic crisis, place a considerable burden on the care system, as illustrated by an increased nursing load, a decrease in the number of elderly persons receiving home services, and a concentration of support to the most impaired. The author calls attention to the need for refined methods for describing care delivery systems, longitudinal population based studies, and a national hospital plan. Primary health care, already pushed to the limit by dwindling resources and job vacancies, is hard put to shoulder the burden of responsibility for the elderly.