The psychological treatment of incontinence in elderly patients is reviewed. It is concluded that the use of psychological methods in functional cases with non-dementing elderly patients leads to optimistic results. However, those studies which have used patients with dementia have been few and have so far led to poor results. Some of the factors associated with toiletting behaviour in the elderly and other approaches which stress the behaviour of the nurse rather than that of the patient are considered. A study is described which illustrates these principles in the case of geriatric patients with dementia who are highly dependent for their physical care.