The European Dementia Consensus Network (EDCON) is a special project of the Madariaga Foundation located in Brussels. The Madariaga Foundation seeks to facilitate collaboration between European countries and between the public and private sector. This paper will review the differences in the definitions of Severe Dementia and summarise the EDCON consensus on their implications for management. EDCON recommends that: - The attributes of the person suffering from dementia should be given as much attention (and are as important for care) as the severity of cognitive decline in dementia; - The dementia syndrome (particularly in it's severe form) is inadequately defined by criteria which only includes the domain of cognition; - Physical, legal, social and cultural factors defining the environment of patients and their families should be carefully examined and that the results of this examination should be used in conjunction with the results of the somatic and psychiatric assessment in planning care and placement of the patient; - patients with severe dementia should have access to palliative care; - family members should be included in the care plans for those with severe dementia who are in institutional care.