Various psychological approaches to the treatment of elderly patients (including activity and stimulation programmes, reality orientation, environmental approaches and behaviour modification) are discuseed with regard to their efficacy and those features that approaches claiming success have in common. The importance of the attitudes of the care staff is discussed, especially in relation to the consistency and intensity of application of treatment programmes. It is argued that the behavioural model is a useful starting point for future progress, and that much of the present literature is comprehensible in this framework.