[Elderly people in dirty dwellings: an underestimated and complex problem].

Two women aged 60 and 81 years were reported by their GPs to the department of Outpatient Geriatric Psychiatry because they seriously neglected themselves and their dwellings and their cognitive functioning was markedly reduced. A management involving regular contacts, home care, assistance in money matters, structuration, diagnostics and checking for risks was instituted, coordinated by a social-psychiatric nurse, to enable timely intervention when necessary. The first patient deteriorated greatly and was committed to a psychiatric hospital, the second is living at home with home care. The difficulties and characteristics in providing adequate help to this group involve psychiatric, somatic and social factors. The number of patients concerned is probably underreported because they do not ask for help by themselves. Close co-operation between social and medical help services and early signalling of the problems are necessary to prevent eviction from their homes and subsequent homelessness and further deterioration.