Table 1 Eligibility criteria for Dutch EASYcare Study

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, behavioural 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

Fulfil 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 proven 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 with in our study

Life expectancy < 6 months because of terminal illness