Photo by Graham Cullen Ada Brooks, 96, plays the piano and sings a tune as her daughter and caregiver, Jane Lieberman, looks on in Lieberman's Jefferson home.

But one year later, she found herself taking care of a 94-year-old mother with Alzheimer's disease.

Now 96, Ada Brooks has no trouble remembering old hymns, her first job at a canning factory where she worked for 10 cents an hour, or the people she worked with as a nursing home volunteer in Prince George's County more than 10 years ago. She remembers her parents, and sometimes acts as though they're still alive. And she doesn't hesitate to break into song or a story, regardless of what's happening around her.

But though her mind isn't clear, Ada is physically healthy for her age, Jane said.

"She has nine lives, but has only used five so far," she said.

Following surgery to remove a brain tumor in 2005, Ada spent time in a nursing home, where she developed a urinary tract infection and went into septic shock. Miraculously, three days later, doctors told her she could go home. Ada has survived colon and breast cancer and a dangerous fall on the front steps of her daughter's house.

Ada depends on Jane for everything. After her fall, she wouldn't go with paramedics to the hospital or let them put a neck brace on her, even though she had a head injury and a broken wrist; Jane had to drive her to the hospital herself. And that's just one example of how Jane's daily routine is so incredibly intertwined with her mother's.

"The role of a caregiver is very demanding, lonely, challenging, frustrating and physically exhausting," said Lieberman, who's an only child. "You're thrown into a situation and even if you're not prepared for it, you're it."

More than 44 million Americans provide care to a family member or friend, and that number continues to grow, according to the Frederick County Department of Aging. Being responsible for someone's full-time care can lead to physical and emotional stress, which can in turn cause health problems and depression for the caregiver, and possible abuse, neglect or premature placement in an institution for the sick or disabled person.

To help prevent these situations, the Department of Aging offers a small stipend to caregivers every year. The money can be used to pay professionals or even family members to stay with the sick or disabled person so the caregiver can run errands or simply get out of the house for a while.

For the most part, Jane takes her mother everywhere she goes, since Ada can't stay at home by herself, and Jane fears being reported to authorities if she leaves her mother in the car while she shops, she said. So while the department's respite funds are limited to $250 per person per year, Lieberman says this money can go a long way in helping a caregiver get a much-deserved break.

"If the caregiver has no relief, this person has to go somewhere else," she said.

The department has no financial criteria for the respite care stipend, but there is often a waiting list for available money, said coordinator Mary Collins. The program usually serves about 45 people every year, but the department is always looking for additional funding sources to complement the state money. Funds are also available to cover special medical needs, like wheelchairs and equipment not covered by insurance, she said.

"We want to give people options," Collins said. "When they're limited by finances, they don't have a lot of options. This can restore balance and give them a break."

The department also facilitates a monthly support group for caregivers, and Lieberman said she's been fortunate to find others in situations like hers to talk with.

Though Lieberman's retirement years may not be what she expected, she said taking care of an ailing loved one has its rewards.

"You know they're well cared-for and that they'll have a happy life," she said.

And though she may not be fully aware of how her life affects her daughter's, Ada appreciates Jane's efforts.

"Jane loves me," she says with a smile.

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As part of National Caregivers Month in November, the Frederick County Department of Aging will host several speakers at the Frederick Senior Center, 1440 Taney Ave., Frederick . Events are as follow:

-- Nov. 6, 2 to 3 p.m., Ruth Chipley on possible tax assistance for caregivers.

-- Nov. 13, 2 to 3 p.m., Deb Bauer-Lawton on managing caregiver stress.

-- Nov. 20, 2 to 3 p.m., Robert Sharps and George Kauffman on Maryland's commitment to veterans.

For more information on listed events, the department's respite program, or the caregiver support group held the last Wednesday of each month, call 301-600-6001.