The MDE unit has filled a significant gap in the care of the psychogeriatric patient. Prior to its existence, the aggressive demented patient was generally managed by physical or chemical restraints. As community needs increase and require changes in the type of institutional care provided, the program will continue to respond with adaptive programs and expanded staff expertise. In the future the program may play a larger role. Due to gaps in the health care system, this type of program may have to admit more psychogeriatric patients. Also, this unique patient population could provide material for scientific research on dementia and its treatment. The MDE program depends not only on physicians and medications but also on a dedicated interdisciplinary team to manage this interesting and exceptional population.