Although dramatic changes in delivery of primary care are a long way off, there are changes that could be implemented now that will improve the well-being of patients with dementia and their caregivers. First, Medicare and other providers should be required to reimburse an extensive array of caregiver support services. Caregivers routinely risk their financial, emotional, and physical well-being to provide care to their relatives or members of their community with dementia. It is time for the public to recognize their part of this social contract (12). The type of services provided by the REACH intervention should be generally available if insurers are willing to pay for them. Second, it is time for Medicare to pay for team-based case management services for elderly persons with dementia, because this approach clearly improves the quality of care. In addition, promotion of adequately reimbursed, integrated programs based on the successes of models, such as Veterans Affairs Medical Center and PACE (Program of All-Inclusive Care for the Elderly), could serve to catalyze implementation of more evidence-based approaches to the care of elderly patients with dementia and those with other frailty syndromes (13). The need for these changes is compelling, but they need advocates and champions. Patients with dementia will probably not be forming a lobby anytime soon, and their caregivers are too busy. It is time for the medical profession to advocate on their behalf.