This survey demonstrates the value of pilot studies of the kind described. They should be followed by other thorough investigations. Until recently the state hospitals were considered "end of the road" institutions. They are now going through a new development. We observe how slowly but firmly custodial psychiatry in state hospitals is changing to an active, continuous, treatment psychiatry. The really "end of the road" institutions, with far fewer facilities than state hospitals, are the county homes. This lost sector of psychotic, semipsychotic, and nonpsychotic persons should be included in the sphere of interest of contemporary psychiatry. Our belief is strong that, in spite of many handicaps, psychiatry can help to relieve the unnecessary suffering of a considerable number of the elderly residents and can stimulate the community to solve this problem in a more satisfactory way than it is doing at present.