While caregivers of individuals with Alzheimer's disease or a related dementia experience a range of caregiving burdens or strains, it has been found that they also experience positive outcomes or gains. This study examined both the caregiver strains and gains in a diverse urban sample of 85 caregivers (spouses and adult children). Eighty-one percent of the caregivers reported both strains and gains, while 19% of the caregivers reported only experiencing strains. The caregiver strains originated from worries and uncertainties, balancing multiple demands, and feeling overwhelmed with care, while spiritual growth, personal growth, and feelings of mastery produced feelings of gain. Implications for clinical social work practice will be presented.