Family caregivers are a quickly growing population in American society and are potentially vulnerable to a number of risks to well-being. High stress and little support can combine to cause difficulties in personal and professional relationships, physical health, and emotional health. Siblings are, however, a possible source of protection for the at-risk caregiver. This study examines the relational and health outcomes of gratitude exchange between caregivers and their siblings as they attend to the issue of caring for aging parents. Dyadic data was collected through an online survey and was analyzed using a series of Actor-Partner Interdependence Models. Intimacy and care conflict both closely relate to gratitude exchange, but the most significant variable influencing gratitude was role. Specifically, caregivers are neither experiencing nor expressing gratitude on the same level as their siblings. Expressed gratitude did not relate strongly or consistently to well-being variables, though it did relate to diminished negative affect. Implications for theory, the caregiver, the sibling, the elder, the practitioner, and the researcher are addressed in the discussion.