If you swap caps for left control, do you swap return for right control? I've been taught not to type modifier + key with one hand.

Dvorak + Emacs user here, by the way. In my opinion mouse use is okay, but I think a drawing tablet is better than a mouse.

Do you even use two hands for shortcuts like copy and paste?

I use ctrl-c and ctrl-v for those. Right hand presses right control with palm of hand (just below pinky). Left hand types the letter like normal.

I just kind of roll my hand to the ctrl key, I don't use a finger to press it.

Same thing with right-ctrl.