Purpose: To investigate how caregivers balance engagement with detachment to cope with cumulative demands and losses.

Design: Qualitative, descriptive. Population, formal and informal caregivers in the United States. A sample of 14 was studied between 1992 and 1994.

Methods: Data were collected in open-ended interviews, then were coded and analyzed using grounded-theory methods. Credibility and fittingness were established.

Results: Caregivers who balance engagement and detachment can affect outcomes without needing to control outcomes. Such caregivers are pragmatic and make conscious choices based on their emotional needs. They set and maintain limits and boundaries and are able to monitor the balancing process while recognizing the importance of practicing self-care.

Conclusions: The longer and more intense a caregiver's involvement, the more important it is to learn to balance engagement and detachment. Caregivers may need to learn effective balancing skills.