There are many opinions about what is now called elderly care, and most of them are negative. There are also many laws aimed at improving the quality of what is referred to as elderly care today, yet opinions remain unfavorable. Care today does not have an image problem, because without a different approach to care, there will be no better image. The texts on reform care address the political and social conditions for elderly care today, critically examine the underlying reasons for "poor" care, and reflect on the possibilities for a new and needs-based care – especially for people with dementia. The ideas contained in the texts are based on more than 25 years of practical experience, which the author has gained as the managing director of an independent care facility and an associated home care service.