Surgical intervention in older people with dementia is becoming increasingly common as the population ages and the number of people with dementia continues to rise. People with dementia have unique needs that require sensitive management at all stages of hospitalisation for surgery. This learning module sets out a suggested pathway for the care of these patients, in the form of a flow chart. It discusses recognition and assessment of dementia and delirium, issues of capacity and consent, interventions required for optimum care of older people with dementia and peri-operative management. It explores the role of family and friends in achieving integrated care.