Their kids are grown and they're back at work, but many middle-aged women find they are still juggling, trying hard to strike a balance between advancing in their careers and caring for their aging parents. This daunting new challenge can be made easier if both sides - care givers and takers - are prepared for it.

Gina Petruccelli is the primary caregiver for her 84-year old mother. "People have asked me, 'Why do you do it?' and I think, 'How could I not?'," she says.

The 49-year-old flight attendant told ABC Morning News how she takes care of her mother, who had suffered two major strokes. Her mother, Millie, says she appreciates what her daughter is doing for her. "She has been very, very helpful and it has been rather strenuous because she has her job and she worries about me," she says.

Being committed to taking care of her mother, Petruccelli admits, has negatively affected her career. "There are opportunities that I haven't explored because it would necessitate a move," she says. "I've got a lot of responsibilities with her."

Gina Petruccelli is one of a growing number of American women who juggle careers and caring for their elderly parents. According to the Family Caregiver Alliance, the typical caregiver is a 46-year-old woman who is employed outside the home and spends more than 20 hours a week caring for a mother who lives nearby.

Business executive, May Lou Quinlan

Business executive Mary Lou Quinlan says because many adult daughters are dedicated to their parents' caregiving, they are not advancing in their careers as much as they would like. Some even consider quitting their jobs to be a full-time caregiver. Quinlan - who's written magazine columns and books about working women - does not recommend that.

"You need your salary," she point out. "You need your benefits, maybe your benefits could even help your parent. Women find that their job is their haven. It's the escape and the normalcy that they are going to crave as things get tough."

To help balance their family and work responsibilities, she recommends women discuss their situation openly with their supervisor. "The good news is that your boss may be in the same seat because all of us will be facing this," she says. "But when you go to your boss, think of it as a business plan. I mean, how can I do a 'win-win plan' so that I ask perhaps for part-time, leave, or maybe you can take on a job that nobody wants to do that you can do on your days off. But try to hold on to part of that job because you're going to need it."

Juggling work and family is just one of many challengers caregivers face, according to psychologist Barry Jacobs. "The burden of care often falls on either the oldest or youngest daughter," he says. "Sometimes that causes friction among the siblings as to who is providing care and who isn't stepping up and providing care." He points to psychological challenges, as well. "Sometimes the relationship with their parents is good and they want to give back to their parent by taking care of them. But in some families, the relationship with their parents has not been good and adult children feel very burdened by taking care of a parent who they have resentment towards and they don't really want to provide that care. Sons and daughters can, over time, be prone to having marital problems with their own marriages because of providing care to a parent."

To help adult children deal with those stresses, Jacobs wrote The Emotional Survival Guide For Caregivers: Looking After Yourself and Your Family While Helping an Aging Parent. In it, he notes that when there is no hope of a full recovery or when a disease changes the parent's personality, many caregivers struggle with depression and anxiety.

He recalls one of his clients - a woman in her 80s who had had a stroke and had a certain amount of dementia as a result. "I remember talking to her 3 daughters, who were in their 50s and early 60s. And the daughters said to me that they feel that the mother that they knew was dead, and the woman that was still alive was a stranger." Jacobs says he hears that sentiment frequently. "When you have an older parent who has Alzheimer, dementia or any other disease which affects their cognition and personality in many ways, the family is being asked to provide care for someone who is very different than the person they have always known and loved. They have to hold on their memories of the person as they knew that person, but also see the person's personality now as a manifestation of the disease. It's not that the person is willfully trying to be difficult or paranoid."

The psychologist recommends that caregivers seek social support and explore community services and programs that would help ease the burden. "In the United States," he observes, "many churches, synagogues and mosques have support services available for people caring for aging parents. It could be respite services or transportation services or even financial help. In terms of government programs, through what are called the Area Agencies on Aging, which exist in every county of the United States, there is funding available to help family caregivers provide care for elderly citizens and the funding can be used for buying equipment, hiring home health aides, getting some sort of respite care."

In addition, Jacobs says, children of aging parents should learn about the health consequences of getting older so they will know what to expect. And, he says, parents can help their children by starting early on to plan for their later years. They can explore various support options, discuss the best arrangements with their family and make important decisions themselves while they can, instead of leaving the entire burden to their children.