In a cross-sectional survey, the authors assessed the attitudes of older patients and their carers towards receiving copies of letters about them and the effects upon outcomes of sharing letters. They also studied the opinions of consultants on letter-sharing. The results were few old age psychiatrists shared letters with patients or carers, and many had concerns about this practice. In contrast, letters were considered 'very welcome' by 87% of patients and carers who received them, and 81% of those who did not would be 'very pleased' to receive them.