During a day of errands, Gladys Wintner was walking into the Waterworks Giant Eagle near her Fox Chapel home when an SUV came barreling toward her. To avoid the speeding vehicle, the octogenarian stumbled backward and fell to the ground.

That moment began what her daughter, Nancy, calls "a long, difficult, emotional haul."

After the fall, the injuries Gladys suffered rendered her in need of frequent care -- a need that Nancy was instrumental in filling.

Gladys also suffered from Addison's disease, a condition affecting her adrenal glands, so frequent doctors visits and medication were required on top of help with every day errands. Nancy, 50, who runs her own public relations business GWN Consultants, admits she's had to "put some things on hold" to fulfill her new caregiver role.

"Most of it fell on to me," she says. "Your parents are obviously the most important people in one's life. There comes a point in time when you have to make some decisions."

Gladys died in February 2006 at age 84, and now Nancy has shifted her attention to helping out her father, Harold, 87. The first practicing CPA in McKeesport, Harold is nearing retirement. While the independent senior does not require round-the-clock care, Nancy stays involved by helping him run errands and accompanying him to doctors visits.

Nancy is not alone in her role as a caregiver. In 2004, the National Alliance for Caregiving and AARP report more than 44 million Americans age 18 or older, or an estimated 21 percent of the adult population, provide care for an adult family member or friend age 18 or older. Their responsibilities range from making runs to the grocery store to physically bathing, dressing and changing their loved one.

Dr. Susanne Hartmann, medical director of geriatric medicine at UPMC St. Margaret in Aspinwall, points to preventative care as the reason why these numbers are so high.

"People live longer because the medical system has gotten better at treating and diagnosing sooner," she says.

"People are living longer with chronic illnesses, causing them to be frail and have memory problems and require that extra care and support they didn't need."

The U.S. Census Bureau reports that there were 36.8 million people age 65 and older in July 2005. Between 2004 and 2005, this age group increased by 457,000 people.

By 2050, that figure is expected to jump to 86.7 million, or 21 percent of the total population.

Pennsylvania has the second oldest population after Florida. Allegheny County has 1.2 million people, 18 percent of which are 65 or older; 18 percent of the population in Westmoreland County also is 65 or older.

"Every time I turn around, they're opening a new nursing home," says Paula Tchirkow, president of Allegheny Geriatric Consultants in Carnegie. "There will be an increase in the number of people needing care as the baby boomers get older."

Export resident Janice Walter, whose father, Stuart, is a resident of Arden Court in Monroeville, calls her generation the "sandwich generation," because its members are caring for both aging parents and growing children.

"It can be very stressful," she says. "Even if they are adult children."

Nancy says she learned a lot from Tchirkow, a client of hers, while caregiving for her mother, about what to expect from her new role. The experience wasn't without challenges though.

The most important task she says she faced was serving as an advocate for her parents when they were hospitalized.

"I made it a point to be there as early as 6:30 a.m., because that's when doctors make their rounds," she says. "Adult children should know what's being ordered for their parents.

"Be really cognizant and clear of what the parent's situation is. Make sure they're safe in their home and make sure they're being honest with the doctor."

Nancy found respite through an organization called Home Instead, which sends qualified caregivers to provide help with a range of needs. The process, she says, made her think about her own future.

"It's very difficult at times and it can be quite emotional," Nancy says. "It makes you think as a baby boomer, 'What can I do that I won't be in a similar situation?'"