Care home placement is a defining event in the lives of dementia patients and their carers. Whilst a care home placement may be the appropriate decision, care and support for the person with dementia and their carer has potential to delay institutionalisation. In certain circumstances, placement following an acute hospital admission may be indicative of failures in the care process [1]. Understanding how inappropriate or premature placements can be avoided has important implications for patients, carers, commissioners and policymakers.