Objective: Research shows that active support provision is associated with greater well-being for spouses of individuals with chronic conditions. However, not all instances of support may be equally beneficial for spouses’ well-being. The theory of communal responsiveness suggests that because spouses’ well-being is interdependent, spouses benefit most from providing support when they believe their support increases their partner’s happiness and is appreciated. Two studies tested this hypothesis. Method: Study 1 was a 7-day ecological momentary assessment (EMA) study of 73 spouses of persons with dementia (74%) and other conditions. In Study 1, spouses self-reported active help, perceptions of how happy the help made the partner and how much the help improved the partner’s well-being, and spouses’ positive and negative affect at EMA time points. Study 2 was a 7-day daily assessment study of 43 spouses of persons with chronic pain in which spouses reported their emotional support provision, perceived partner appreciation, and their own physical symptoms. Results: Study 1 showed that active help was associated with more positive affect for spouses when they perceived the help increased their partner’s happiness and improved their partner’s well-being. Study 2 showed that emotional support provision was associated with fewer spouse reported physical symptoms when perceptions of partner appreciation were high. Conclusion: Results suggest that interventions for spouses of individuals with chronic conditions take into account spouses’ perceptions of their partners’ positive emotional responses. Highlighting the positive consequences of helping may increase spouses’ well-being.