The study used a qualitative design to describe the decision making involved when an older adult relocated to a nursing home. Tape recorded semistructured interviews were conducted with 18 nursing home residents. Findings indicate that the decision to relocate the older adults to the nursing home was commonly made by their physician in response to acute and chronic health problems. Subjects described their residential preferences, discussed problems encountered after nursing home placement, and gave advice to other older adults contemplating relocation to a nursing home. Nursing interventions could be directed toward community residential alternatives and advocacy to ensure the older adult's involvement in the decision making as much as is possible.