The major purpose of this study was to identify the types and frequency of caregiving problems and associated stress and coping effectiveness. Secondary purposes were (a) to examine changes in problem frequency, stress, and coping effectiveness over time and (b) to identify relationships between problem stress and personal, illness, coping, and well-being variables. A stress and coping model guided the study. Fifty-eight caregivers participated during the first 4 months of caregiving. Caregiver and stroke survivor demographic and well-being data were collected during acute rehabilitation. Three problem-related themes emerged: interpersonal disruptions, sustaining the self and the family, and stroke survivor functioning. Although problems sustaining the self and the family were most frequent, interpersonal disruption problems were rated most stressful and lowest in coping effectiveness. A component of emotional distress, either anxiety or depression, was related significantly (p < .05) to the stress level of each problem theme. Counseling on problem-solving strategies may improve caregiver well-being.