The proportion of older adults in Western European countries, as in the United States, continues to increase rapidly. Faced with geriatric care dilemmas decades earlier, however, these countries have had more experience on which to base the development of community-based, integrated care systems for the elderly. This article provides observations from a 1993 World Health Organization Fellowship study of long-term care facilities in four European countries: Scotland, Sweden, Norway and Denmark. Several emerging trends in geriatric care documented in the literature were confirmed. These included: moratoria on institutional long-term care, emphasis on informal care and support, provision of 24-hour assistance in the home, care management to individualize care, and an expanded set of providers within integrated delivery systems.