As yet the determinants of the need for nursing homes and old age homes are not clearly understood. This may be due to the fact that care facilities providing different levels of care may yield different predictors of use. Moreover, the absence of theory and ignorance of the problems with ‘use‘ as the dependent variable, may be responsible for this. In this study these issues are addressed explicitly. The study focuses on the need for living in an old age home and a theoretical model predicts under what circumstances frail elderly people will express the need for living in such a home. Findings show that, as hypothesised, loss of comfort and affection are among the main predictors of a strong orientation towards living in an old age home. Resources to counter the loss of comfort and affection – a spouse, income, home adaptations, private help, informal and formal home care – were only partly effective in their hypothesised function of deterring orientation towards living in an old age home. Pressure from others to apply for an old age home had the strongest effect. The findings are discussed and some implications for policy are considered.