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Purpose: The goal of this study was to explore and describe the process of nursing home placement decision making and adaptation among adult children caregivers of demented parents in Korea and to generate a substantive theory grounded in their experiences. Methods: The participants were 16 adult children caregivers who had placed their demented elders into nursing homes. Data were collected by in-depth unstructured interviews with individual participants. Data were analyzed by Strauss and Corbin’s Grounded Theory methodology. Results: Analysis revealed that the core category of the process of nursing home placement decision making and adaptation among adult children caregivers was accepting the inevitable and reorienting to changes. It consisted of four phases: realizing a dead end, seeking a way out, accepting the inevitable decision, and reorienting to changes. Participants were driven to the corner of making the inevitable decision by the overwhelming care situation and confronted by various challenges in dealing with the decision. But they managed to accept the inevitableness of the decision and further learned to reorient themselves to the changed care situation utilizing various action/interaction strategies. Conclusion: The findings of the study provide the basic information for developing proactive strategies to support family caregivers better in the difficult period of nursing home placement.