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The purpose of this study is to explore the grounded theory literature surrounding the health care decisions of dementia caregivers and to evaluate the rigor of these studies according to methodological guidelines. This scoping review was guided by Arksey and O’Malley’s scoping review framework. Articles were then evaluated against key principals of grounded theory. Results from five included articles show that while researchers label their study as grounded theory, some aspects of the methodological principles do not get adhered to. We draw lessons from these shortcomings to make recommendations for future research. Exploration of the shortcomings of grounded theory research could offer suggestions for improving the overall methodological rigor in dementia caregiving research, which may enhance the credibility of the findings. Grounded theory methodologies in dementia caregiving research could move findings from qualitative descriptions to explanations of processes, such as substitute decision-making for dementia caregivers.