South Carolina Community Long-Term Care (CLTC) data were used to ident
ify factors increasing the risk of institutionalization in people with
dementia. Clients diagnosed with dementia and observed at least twice
between lune 1993 and December 1994 (N = 786) were studied. Logistic
regression determined that clients with a decline in ADL function who
were white, had a nonrelative or child as a caregiver, and were diagno
sed with Alzheimer's disease were at increased risk of institutionaliz
ation. Identifying CLTC clients at increased risk of institutionalizat
ion could be useful in designing additional interventions to prevent i
nstitutionalization or in planning the transition to institutional car
e.