The paper examines the conversational and discursive processes that occur within domiciliary visits between community psychiatric nurses (CPNs) and relatives of chronically confused people. Three conversation formats are identified, through which talk between CPNs and carers is organised. In addition, various discursive practices are also identified within domiciliary meetings. The contribution of these conversational and discursive features to the work of CPNs is fully discussed in relation to what they accomplish within the visit. The data comprised 48 paired tape recordings. Of these recordings, 24 were unstructured interviews between CPNs and informal carers to people who had been diagnosed as having dementia by a medical practitioner. In addition, 24 domiciliary meetings between primary informal carers and their CPNs were tape recorded and fully transcribed. The transcripts were analysed using techniques drawn from conversation analysis and discourse analysis. The implications of the findings upon CPN practice are examined.