Deborah will invite her aging mother for dinner on Sunday, Deborah's birthday. She would feel guilty if she didn't. But the truth is Deborah would rather her mother spend the day somewhere else. Deborah would like to celebrate with her young children and be spared her mothers litany of ailments and complaints.

"I love her," said Deborah, "but she feels so sorry for herself, it's hard to be around her a lot. I try to do everything I can for her. I'm constantly taking her to doctors, I have her for dinner twice a week, I take her shopping. But I have a job and a husband, and my children need me. Plus I have my own health problems. It just gets to be too much."

Deborah is among the more than 23 million American adults providing special care for aging relatives and friend--care recipients who cant perform the necessary day-to-day activities. Love, a sense of commitment, or guilt may thrust some people into a caregiving situation. Some take on the caregiving role willingly, others reluctantly. In either case, caregiving can disrupt family life, strain resources, and create emotional chaos.

Studies show that family caregivers are more likely than non-caregivers to experience strokes, heart attacks, depression and anxiety. The stress and isolation brought on by caregiving may lead to feelings of anger, resentment and grief. Caregivers also are at increased risk for unhealthy behaviors such as overeating and substance abuse; those recovering from addictions may be at greater risk for relapse.

While many caregiving situations may develop into an unmanageable burden, that need not be the case. Caregiving can be a positive experience, one that brings families together during a difficult time. Some caregivers draw on the principles of the Twelve Steps of Alcoholics Anonymous to help them cope, especially when the behavior of the ailing loved one becomes unpleasant.

"Caregivers have a right to peace of mind, but first they have to become willing to let go of the controls," said Pat Samples of Brooklyn Center, Minn., an author of self-care materials for caregivers. "Sometimes they care so much, they believe its entirely up to them to make sure everything turns out right. That's unrealistic. The Twelve Steps can help caregivers let go of that burden. They find serenity when they come to trust a power greater than themselves with the outcome."

Bob, a recovering alcoholic whose mother died recently, relied on the Serenity Prayer when his mother's health declined and she alternated between demanding his help and resisting it. "I used to worry about her falling, and sometimes I would get angry when she treated me like I was still nine," he said. "But then I figured, what's the point? I can't change her."

The Serenity Prayer helped Bob deal with his powerlessness. It says: "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."

Bob set some boundaries for himself. He learned how to say no without feeling guilty and he practiced detachment with love. Detachment means respecting the other person's right to make choices. It is remembering you cannot control anyone else's feelings, thoughts or behavior, and that you are not responsible for them.

Detachment is a delicate matter for caregivers, who must step in when the relative can't make sound decisions, yet step back when the person is capable. Detachment also means taking care of yourself. Bob saw to it that his mother got good care, but he didn't let her chronic condition trap him in a life of despair. Between visits, he found ways to relax and enjoy himself.

Caregivers seeking support and guidance may contact Children of Aging Parents, a national nonprofit resource and referral organization on caregiving for the elderly, based in Levittown, Pa., (215-945-6900 or http://www.careguide.net/). Other resources include the National Agency on Aging (800-222-2225) and local area agencies on aging.

--Published August 16, 1999