The purpose of this descriptive correlational study was threefold: (a) to assess the relationships between boundary ambiguity, spirituality, marital relationship quality, and caregiver strain and depression among older African American spousal caregivers of persons with Alzheimer’s Disease (AD); (b) to identify which variables are the best predictors of caregiver strain; and (c) to identify which variables are the best predictors of depression. The sample consisted of 25 female and 15 male spouses, who were ages 60 to 87. The data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression. Marital relationship quality was correlated with the two dependent variables, caregiver strain and depression. In hierarchical multiple regression, a model containing gender, years since spouse’s diagnosis with AD and marital relationship quality predicted 40% of the variance in caregiver strain. Marital relationship quality was the only significant predictor for depression. The model containing marital relationship quality predicted 22% of the variance in depression. Additional findings were that participants scored high on the spirituality measure, that years since diagnosis of AD was negatively correlated with boundary ambiguity, spirituality, and caregiver strain, that there was a significant decrease in the quality of the marital relationship since the spouse became a caregiver, and that almost half had no help with caregiving. There was limited support for the proposed conceptual model, therefore, a revised model was proposed. Based on the study results, in dealing with spouses who are providing caregiving to AD patients, nurses need to assess the quality of the marital relationship, and to recognize that the longer the spouse is a caregiver the greater the strain and depression, and that community resources need to be mobilized to assist the spouse with caregiving. A depression screen and marital assessment may provide cues regarding psychosocial needs of spousal caregivers.