The elderly living with neurodegenerative diseases will increase as the population age. The acute hospital beds will mostly be occupied by the elderly, as they live with multiple comorbidities. Cognitively impaired elderly are even more likely to be admitted and hospital environment is harmful for them. Providing a comprehensive care package for the elderly with cognitive issues aim to reduce hospital associated complications, especially falls and delirium and ensuring no additional geriatric syndromes are added to the patients’ lists of problems. Timely recognition and diagnosis of cognitive issues is still a challenge in most acute hospitals. Once the elderly patients with cognitive issues are identified, safety measures and personalized care plans can be initiated to reduce delirium, fall, restraint and nutrition risks. Hospital wide education initiatives on delirium and dementia related topics are vital to providing the best care for this group of vulnerable elderly.