This study sought to determine the factors that influence the attitudes of family caregivers of dementia patients toward nursing home placement. A telephone survey of primary caregivers was conducted in two metropolitan areas of Taiwan. Caregivers of dementia patients were recruited from the neurology and psychiatry outpatient departments of two medical centers in Taipei (a highly urbanized area, n=144) and two medical centers in Kaohsiung (an area of mixed farm and nonfarm sectors, n=134). Family caregivers were asked if they would place patients in a nursing home if their dementia progressed. The mental status of dementia patients was the most significant variable affecting caregivers attitudes toward nursing home placement. Family manpower available for caregiving at home was especially emphasized as a determining factor affecting the decision to use nursing home care by primary caregivers in highly urbanized areas.