Dutch EASYcare Study

Inclusion Criteria: * 70 years of age and over * The patient lives independently or in a home for the aged * The patient has a health problem that was recently presented to the GP by the patient or informal caregiver * The request for help is related to the following problem fields: cognitive disorders, behavioral and psychological symptoms of dementia, mood disorders, mobility disorders and falling, or malnutrition * The patient/informal caregiver and GP have determined a goal they want to achieve * Fulfill one or more of these criteria: MMSE (Mini Mental State Examination) equal to or less than 26, GARS (Groningen Activity Restriction Scale) equal to or greater than 25 or MOS-20/subscale mental health equal to or less than 75 Exclusion Criteria: * The problem or request for help has an acute nature, urging for action (medical or otherwise) within less than one week * The problem or request for help is merely a medical diagnostic issue, urging for action only physicians (GP or specialist) can offer * MMSE \< 20 or proved moderate to severe dementia (Clinical Dementia Rating scale \[CDR\] \> 1, 0) and no informal caregiver (no informal caregiver is defined as: no informal caregiver who meets the patient for at least once a week on average) * The patient receives other forms of intermediate care or health care from a social worker or community-based geriatrician * The patient is already on the waiting list for a nursing home because of the problem the patient is presented w…