The problem of managing elders with cogntive impairment can be complex as co-morbid medical and psychiatric symptoms complicate the clinical picture. Family and caregivers are often confused, angry, frustrated or overwhelmed and need to be evaluated for their competence as caregviers. Outside help and the potential need for placement and advanced directives also need to be addresed. After the work up for depression and/or cogntive impairment is complete and appropriate meds are prescribed, the focus of managment shifts to coping strategies for the identified patient and caregivers. Those with accumulated experience working with elders accrue the necessary skills and knowledge to meet these needs but the presenters argue that manual-based approaches can be taught efficiently to sytematically train a new cohort of healthcare personnel to help meet the needs of managing these patients in an aging society.