During the initial year of an outpatient geriatric clinic for impaired elderly and their families, ratings were made on the presence and severity of problems in 10 areas by the patients, the family members who accompanied them, and the clinic staff. In 9 of the 10 problem areas, the patients had the lowest rate of identifying a problem as moderate or severe. Problems noted by the families of impaired elderly are generally confirmed by a comprehensive clinical evaluation, and the problems are more likely to be identified by the family than the patient, especially when the impairment involves a dementing illness.