Investigated were changes over time for caregivers of dementia patients, with a focus on factors associated with nursing home placement. Caregivers were all spouses, and at the time of the initial interview were caring for the patient at home. Subsequent nursing home placement was more strongly associated with subjective factors, particularly caregivers' perceived burden, than with objective indicators of the severity of dementia. Although wives initially reported more burden than husbands, no differences were found at the follow-up.