In this study, the system of care for 4907 irreversible dementia (ID) sufferers in Metropolitan Toronto and the Region of Peel was investigated. Mail survey data were compiled from senior administrative personnel (data include observation ratings by clinical and direct service staff) within 41 long-term care facilities, 15 acute care hospitals, and 30 community services. Consistent with the results of other descriptive studies, the findings reveal that: 1) long-term care facilities had the highest average proportion of ID sufferers; 2) the majority of ID sufferers were 75 years and older and predominantly female; and 3) ID sufferers on community service caseloads were less impaired than those in long-term care facilities. The study findings also indicate that the following factors may be important in assessing the care and management of ID sufferers within long-term care facilities and acute care hospitals: type of facility, admission criteria, arrangements for accommodation, number and nature of special programs, extent of inservice training, levels of staffing, and number and nature of family support services. In addition to these variables, the location and size of the catchment area and eligibility criteria may be important factors in similar community service assessments. The findings pertaining to the frequently used inpatient and community resources, additional resources required, and unmet needs of ID sufferers and family are discussed with respect to health care and senior support service planning and implementation within the outlined regions.