This study examined patterns of nursing home admission for males and females with Alzheimer's disease. It also examined reasons why women may be less likely to remain in home and family-based care. A 2-year, four-wave follow-up study was conducted among 573 patients and their family caregivers. Results from logistic regression analyses showed that females and males were institutionalized for different reasons. Men were institutionalized primarily for medical and caregiving need factors. Women showed less physical and less cognitive impairment, and their model of placement showed more importance of family caregiving patterns.