Although the DSM-III-R states that personality disorders are less apparent among the elderly, the authors argue that such disorders are actually exacerbated by old age. The impact of personality disorders is severe among the frail elderly, because such disorders interfere with the maintenance of social support networks which become particularly crucial with advanced age and incapacity. Since frail older persons with personality disorders usually lack support systems, they are likely to come to the attention of social workers. Provision of services is impeded when social workers fail to recognize the presence of personality disorders among these clients. Based on case management experience, the authors present case examples and suggest useful intervention strategies.