The consequences of dementia, for both patients and primary caregivers, are formidable. Primary caregivers are often overburdened or are signifcantly at risk for becoming overburdened How do we meet this substantial and complex social challenge, which is as yet insuffciently recognized? We must start looking for new forms of care and support, for more goal-oriented care while maintaining humane values. The problem of dementia demands that we follow more leads: new treatments and interventional care, greater use of technology, new divisions of labour among professionals and more empowerment of primary care. At issue is the organization of physical and social environments for patients with dementia that closely meet their needs. The road toward this goal is long and complicated, but a start has been made in the Netherlands.