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In Samuel Shem's classic novel The House of God,1 elderly demented patients were scornfully called gomers—short for "Get out of my emergency room." With apparent disdain for the debilitated elderly, it is not suprising that American society has failed to make elder care a priority in policy as well as in practice. While modern medicine has prolonged life expectancy, it has not made comparable progress in addressing the psychosocial consequences of aging. Unfortunately, the incidence of dementia and other cognitive impairments are predicted to increase as the population ages. By a recent estimate, 4 million Americans will have Alzheimer disease (AD) by the year 2000.2 The impact of AD and other forms of dementia on patients' families and caregivers is substantial and their needs must also be addressed.
Perel VD. Psychosocial Impact of Alzheimer Disease. JAMA. 1998;279(13):1038–1039. doi:10.1001/jama.279.13.1038-JMS0401-5-1
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