Caregiver stress goes beyond managing the myriad of the emotional and physical symptoms experienced by caregivers. Unfortunately, few approaches to caregiver stress address the root cause that produces the emotional and physical reactions experienced by caregivers. Symptom management is important, yet is vital to address the underlying cause of caregiver stress, unmet and unrealistic expectations. The mismatches of expectations surface for a variety of reasons, and often go unrecognized as the catalyst for emotional and physical symptom manifestation. Caregivers can explore ways to reduce stress by setting and managing more realistic expectations.