Understanding the economic challenges of dementia care means dealing with the complex interplay of direct and indirect costs. Current treatment regiments are very fragmented and much responsibility falls to the patient and family, who may not be able to navigate finances, insurance and options to build a coherent system of care. The author provides current and projected costs for individuals, families, insurers, providers, and tax payers to argue that Alzheimer’s and other dementias should be revisited in light of new models of care for chronically ill people