This book is all about improving the health care of elderly people, which is facing unprecedented challenges in the 1990s. Energies need to be concentrated in three main areas: • the development of high quality care in community settings • the future role of specialized hospital services • the way that long-term care is delivered. All of these are interconnected and success with any of them depends on successful relationships. For example, success in community care requires working interfaces with primary care, the private sector and hospital care. These interfaces are not static but comprise dynamic interactions between people - people in different teams, with different back grounds, training, perspectives and interests. What people do is influenced strongly by the organizations they work for. These inescapable facts lead us to the structure of this book. By concentrating on sectors, people and organizations, we hope to deal with all the important relationships in a coherent way. Yet this book is not intended to be from a service providers' perspective. We have arranged the book in this way so that providers are best equipped to meet the needs of their customers - whether they are patients, resi dents or clients. We know that elderly people may experience dislocation in their care because of frictions and gaps be tween different sectors, disciplines, teams and organizations. To achieve seamless care, there is a need for greater under standing and harmony of purpose and action across the care spectrum.