Among a sample of old elderly, frail seniors, this article examines congruence in spouse-spouse caregiving relationships. Congruence is examined through qualitative interviews with both caregivers and care receivers. Overall, most spousespouse caregiving couples demonstrate positive affect congruency, with both husband and wife expressing predominantly positive affective tones. However, there is more likely to be positive affect congruency where the husband is caregiver than where the wife is caregiver. Further, few husbands as caregivers express negative sentiment, whereas a third of wife caregivers express negative affect, possibly due to men's perceived choice but women's obligation to take on caregiving. While a majority of couples also reveal congruence of meaning, it is considerably less than for affect congruence. When congruence is related to quantitative data collected from structured interviews with both the caregiver and care recipient, it is satisfaction with the partner and with life that is related to congruence. While the sample is small, the data point to the caregiver's rather than the care receiver's salience in defining congruency within the caregiving relationship.