Elderly stroke patients and their families were studied to determine the health effects of providing home care on family caregivers, whether or not caregivers actually providing care in the home experience different effects than caregivers whose family members live in nursing homes, and factors associated with any observed deleterious effects of caregiving. One hundred forty-seven stroke patients were eligible for study. Of these, 101 were available for follow-up; 89 family caregivers were interviewed (88%). Caregivers reported both positive and negative effects of providing home care. When actual home caregivers were compared with potential caregivers (those with family members in institutions), no differences in effects were seen. The relationship between each of three health effects (general, social, and emotional) and patient and caregiver attributes was explored. No factors were found to be related to poorer perceived general health. Dependent patient functional status and additional life stress were both associated with diminished social activity and emotional ill-health. In the latter instance, insufficient social activity and help from family were additional risk factors. If policy is going to advocate home care, its consequences for family caregivers must be known.