This study aims to contribute to a better understanding of the main family caregivers of highly dependent elderly. Performed in a geriatric outpatient unit, the study used a content analysis methodology, and data were collected with interviews and 14 group sessions with 24 subjects. The following categories emerged: denial versus acceptance of the disease before and after diagnosis; how and why the main caregiver assumes this role; caregiver's characteristics; caregiver's experiences; meanings ascribed to care-giving; history of the caregiver's relationship to the elder before the disease; caregiver/elder relationship since onset of the disease; changes in the caregiver's life; changes in the family; and causes for the appearance of the disease. In conclusion, there are three dimensions in the target issue: (1) implications of the legacies, multi-generational transmission, repetition of the patterns, and myths and beliefs in each family system; (2) seniors as active participants in the care-giving decision; and (3) the support group as a key resource for the family.