The relationships between marital communication of later-life couples coping with chronic, physical illness, caregiver depression and marital satisfaction were examined in this study of 25 patients and their spouse caregivers. Guided by Bowen Theory, lag sequential analyses and sequence repetition analyses were conducted on observational data to determine the effects of open communication, closed communication, and pursuer-distancer communication on caregiver depression and marital satisfaction. The findings indicate that reciprocal closed communication between caregivers and spouses was positively related to caregiver depression, reciprocal open communication between caregivers and spouses was negatively related to marital satisfaction, and reciprocal pursuer-distancer communication was negatively related to marital satisfaction. Further, sustained pursuer-distancer communication was related to higher caregiver depression. Communication patterns were found to be related to family of origin relationships. Possible explanations for these findings and implications for family therapy and future research are discussed.