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This study used the Stress Process Model to determine whether nursing home placement had an adverse effect on the bereavement outcomes of adjustment to loss, continued perceived presence, longing, preoccupation and guilt among caregivers to elderly family members with dementia. Variables included background characteristics, pre-bereavement stressors, resources and post-bereavement outcomes. The sample, N=291, consisted of caregivers to family members with dementia, with approximately half, N=158, providing continuous care in the home until the death of the family member, while the remaining respondents, N=133, placed the care recipient in a nursing home. The findings suggest a reconsideration of our understanding of the multiple losses and grief experienced by caregivers to family members with dementia.