This qualitative analysis focuses on the discussion of care, division of labor, and perceptions of gratitude and ingratitude between an adult primary caregiver of an elderly parent and his or her sibling(s). Interviews with 20 caregivers addressed the following questions: When do caregivers feel appreciated or unappreciated by siblings? How do siblings communicate that appreciation? How does gratitude influence the experience of caregiving and family relationships during caregiving? Findings revealed that gratitude was manifested through verbal and behavioral expressions, with antithetical communication that left the caregiver feeling unappreciated. Verbal expressions of gratitude included a simple “thank you,” thanks for what the caregiver does, and for who the caregiver is. The inverse of these expressions included neglecting to say “thank you,” failing to identify the extent of the caregiver's work, and communicating criticism. Behavioral expressions took the form of following through on promises, and failing to do so presented as ingratitude.