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The first edition of this book was suggested by Tom Arie, Professor of Health Care of the Elderly at the University of Nottingham. The seven years since the first edition of this book have seen a revolution in the way that Health Services in the United Kingdom are organized. One of the original co-authors, Mike Church, has moved on through several NHS posts to independent practice in the area of management consultancy. He has been replaced by Carol Martin, a lecturer in the Psychology of Old Age in our department. In addition to the changes in the NHS there has been an explosion in the knowledge base of old age psychiatry, with several journals now devoted to the subject. A new diagnostic classificatory system (ICD10) has also been launched. In preparing this second edition, we have tried to remain true to the spirit of the first edition, whilst incorporating new knowledge and the changing context of our practice. Throughout the text we have used the terms 'patient' and 'client' interchangeably. The people we serve are the same whatever we call them! We have also, generally, but not always referred to patients in the female gender, since this reflects the fact that more women than men survive into old age. We have ordered the book so that the basic background information and skills in approaching the problems of old age are dealt with first.