Caring for patients with dementia is complex and demanding. Since family physicians (FPs) provide much of this care, we examined their practices, learning needs, and barriers to care concerning Alzheimer's disease and other dementias. We surveyed 392 (approximately 50%) Nova Scotia FPs and conducted focus groups and interviews with: FPs; staff of long-term care facilities; health professionals in home care; patients and their caregivers; FPs with advanced geriatric training; geriatricians; and psychiatrists. Results suggest that many FPs do not perform assessment and management practices as frequently as they ideally should. However, systemic factors, not only inadequate knowledge, affect care.