Abstract
In the Netherlands a tight network of mainly intramural psychogeriatric nursing facilities exists. A discussion is going on whether these beds may substitute beds for elderly infirm inpatients of psychiatric hospitals, which are more expensive. The move towards community psychiatry may lead to insufficient planning of services for patients with combined chronic mental and somatic conditions. Elderly patients in psychiatric hospitals and nursing homes show significant differences in psychopathology as well as ADL deficits. It is argued that in both types of facilities at present different categories of patient are taken care of. Planning of services should take into account different patterns of needs among elderly infirm mental patients. Dementia is in itself not a decisive factor in the allocation of patients to primary nursing homes or psychiatric facilities.
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