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Ninety-six per cent of the residents occupying the 11 Local Authority Homes within the catchment area of one Scottish district psychiatric hospital were surveyed to estimate current levels of organic cerebral impairment and behavioural problems in the Homes. Clear evidence of dementia was shown by 27.1% of the residents but the actual prevalence of organic cerebral impairment could be as high as 66.4%. An excessively high level of socially disruptive behaviour was discovered. This study suggests that Local Authority Homes, with their present staffing levels, are having to cope with large numbers of dependent and behaviourally disturbed old people. Four possible solutions are outlined. Irrespective of what is adopted, it is essential that Health and Social Service developments are fully co-ordinated.