Just when they would normally be entering the most productive years of their working lives, more and more women in their 40's and beyond are struggling to cope with the growing burden of caring for elderly parents.
With more people living into their 80's and 90's, these women are finding that the responsibility of caring for a frail parent or parent-in-law can last more than a decade.
While some men provide the primary care to their parents, the usual pattern is that sons offer financial help while daughters or daughters-in-law do the hands-on care.
''And it's going to be primarily women for a long time,'' said Elaine M. Brody, a leading researcher on the issue, who is affiliated with the Philadelphia Geriatric Center, a nursing home. ''Women can go to work as much as they want, but they still see nurturing as their job. There is a powerful, almost primordial feeling that they have to provide all the care, no matter at what cost to themselves.
''With many more very old people, and fewer children per family, almost every woman is going to have to take care of an aging parent or parent-in-law,'' she said.
To do that, many switch to part-time jobs, pass up promotions or quit their jobs altogether, finding themselves unable to carry the double burden of career and caring for parents - or the triple burden, for those who must care for children and parents at the same time. And the shift is coming at a time when many more families have come to depend on two incomes.
''You feel like you're drowning in tasks at the same time as you're trying to deal with this terrible emotional wrench of your parent being completely dependent,'' said a woman who quit her job as a preschool director shortly after her mother's mental health began to deteriorate. ''I felt, although I know it isn't true, that I was literally in the most horrible situation in the world. And she wasn't even living with me.''
A 1985 survey by the Travelers Corporation found that about one in five employees over the age of 30 was providing some care to an elderly parent, most often a widowed mother. Most of the employees caring for those relatives were women, even where it was the husband's parent who needed the care.
Another study, in Philadelphia, surveyed 150 families in which married women, about half of them employed, provided most of the care for their widowed mothers. More than a quarter of those who were not working had quit their jobs to care for their mothers; a quarter of the employed women had considered stopping work.
The American Association of Retired Persons estimates that in 1987, seven million American households included people caring for the elderly, and 55 percent of those care givers also had jobs. The association's 1989 survey of working people who cared for the elderly found that 14 percent of the part-time workers had left their full-time jobs because of care-giving responsibilities.
Almost a third of the part-time workers spent more than 20 hours a week helping older relatives with chores like transportation, feeding, dressing, grocery shopping and managing finances.
Of those not employed who once had jobs, 27 percent had taken early retirement or simply resigned to meet their responsibilities. 'My Baby's Taking Care of Me'
''One reason older women are so much poorer than older men is that the average women spends 11 1/2 years out of her working life on all forms of care giving, compared to six months for the average man,'' said Joan Kuriansky, executive director of the Older Women's League, a nonprofit advocacy group in Washington. ''When you quit your job to take care of your mother, you don't get Social Security credits or pension credits.''
For some women, providing loving care to an aged relative, even with all its financial and emotional costs, is an affirmation of strong family ties and a source of great pride.
''My mother will say, 'Lord, isn't it something: my baby's taking care of me just like I took care of her,' and we'll all laugh,'' said Juanita Eubanks of Hillsborough, N.C. ''I feel good knowing she's getting as good care as a person can get.''
The 48-year-old Mrs. Eubanks and her 52-year old sister, Dorothy Shanklin, both work full-time, but after hours they share another job: caring for their 81-year-old mother, who is disabled by a stroke.
''We take turns sleeping in the room with her, putting her on the pot if she needs to and making sure she doesn't get out of bed, wander around, fall down and fracture something,'' said Mrs. Eubanks, who has moved her husband and 12-year-old daughter into her mother's home. ''I do one week, and then my sister does one week. We chip in to pay the girl who's here in the day.'''' A Nightmarish Surprise
But for many others, the responsibility comes as a nightmarish surprise that throws their lives out of kilter and makes them feel guilty, inadequate and fiercely resentful of brothers and sisters who are not taking part. One such woman quit her job as a New York social worker last year after her mother developed Alzheimer's disease.
''I felt like I was going under, and I couldn't do my job because I was pretty much in pieces,'' she said. ''I was furious at my brother, who didn't help at all. My 15-year-old daughter is mad at me because I am so engaged with my mother. My son has stopped visiting me. And the friends who had been wonderful and supportive through the babies and the divorce just faded away now that I need them most.
''I am alternately so sad about my mother's decline that I can't stop crying and so enraged that my life is being messed up that I want to dump her. I used to think I was good at crises, but this just goes on and on, and I'm falling apart.''
Most women find that the combined demands of family, work and caring for an elderly person leave no time for theselves.
''We have not been away or on vacation for almost five years,'' said a 55-year-old legal secretary in Cleveland, whose widowed mother, 79, has lived with her since 1977. ''My mother can't walk more than a few feet by herself, and I worry about her, so I call home three times a day. I don't go places with my son or my husband because there's a guilt trip about leaving her alone too long. I don't get any help. It's become an unmentionable with my sister. If I bring it up, she just says I'll go to heaven for what I'm doing. My main enjoyment in life is getting to work at 7 A.M. and having an hour of quiet.'' A Demographic Revolution
The number of middle-aged women with elderly parents to care for has increased dramatically in the last few decades. In the early 1970's, only 25 percent of people in their late 50's had a surviving parent, but by 1980, 40 percent did. So did 20 percent of those in their early 60's and 3 percent of those in their 70's.
The need for care becomes particularly acute for the oldest old people, those over 85 - a group that has grown from fewer than 300,000 in 1930 to about three million now.
''Caring for an elderly parent has become a normal experience in the life of a family,'' said Ms. Brody, of the Philadelphia Geriatric Center. ''But unlike other life stages, you don't know when it will occur, and you don't expect it to happen. It may be when you still have young children at home or when you are old yourself. There has been a demographic revolution, but it's only beginning to come out of the closet as an enormous social problem.''
In a typical day, she said, the following people called the center for help: an exhausted 70-year-old woman who could no longer go on caring for her disabled 93-year-old mother; a recently widowed 50-year-old who had just finished her education to return to work, but found that her mother had Alzheimer's disease and could not be left alone; a couple in their late 60's with three frail parents between them; a divorced woman of 57 who was caring for two disabled sons, a 6-year-old grandchild and an 87-year-old wheelchair-bound mother; and a young couple in their early 30's, about to have a first child, who had taken two older people into their home - the wife's terminally ill mother and her confused, incontinent grandmother.
Another demographic trend promises even heavier burdens for the children of aged parents. Because family sizes have been shrinking, there are fewer and fewer potential care givers, making it ever more likely that a woman will end up caring for more than one elderly relative.
In the Philadelphia study, almost half the women caring for their mothers had helped an elderly father before his death and one-third had helped other elderly relatives. Twenty-two percent were providing help to more than one elderly relative. And two-thirds also had children living at home.
Claire Angel, 57, said she and her mother cared for her father together 10 years ago, when he was dying of lung cancer. After her father's death, her mother began losing her memory and Ms. Angel took her in. Five years ago, she placed her mother in a nursing home, and that same year her husband developed Parkinson's disease.
''By the time it came to putting my husband into a nursing home last year, it wasn't so scary, because I knew what they looked like,'' said Ms. Angel, a musician who is starting a cookie business now that caring for others no longer takes up all her time. ''It's almost like an invisible world that no one knows about. Most of our friends fell away. I was very hurt at first, very angry that they turned away, but now I know that it's tough to look at. When you have someone in your house who needs constant care, there is no day, no night.''