Nearly 20 years ago, Denny Campbell was in a car accident that left him with severe head trauma. Mr. Campbell found himself in a wheelchair, and his wife, Elizabeth Campbell, found herself in the role of caregiver for her husband.

Now, at age 53, Mrs. Campbell says, "I can hardly explain my life."

After nearly two decades of therapy, her husband can stand for short periods of time and take small steps, but the recovery has been arduous. He was in a coma, and then it took him three years to speak, and for more than a decade he experienced bouts of anger, which his doctors attributed to the brain damage.

"It sounds terrible, but we've survived," she said.

Her family and her friends helped her, she learned what worked and what didn't, and gradually she adapted to her new life.

Last year, Mrs. Campbell, who works on the switchboard for UPMC's Greenville and Farrell campuses, heard about a caregiving class UPMC Health Plan was offering for its members. Even though she's been a caregiver for many years, she decided to go the class, which offers advice for caregivers about taking care of themselves while taking care of others.

Many of the lessons -- to take time for herself and decrease her stress -- were ones Mrs. Campbell had learned through trial and error over the last 20 years. But for her classmates, most of whom were new to caregiving, the class was a chance to share their anxieties and learn how to survive and thrive during the caregiving process.

More Americans may, like Mrs. Campbell, become caregivers in the coming years. The demand for at-home caregiving is expected to increase dramatically, due in large part to the aging of the baby boomer population, said Dr. Richard Schulz, an internationally known expert on caregiving from the University of Pittsburgh.

To mark the beginning of National Caregivers Month, Dr. Schulz, the director of the University Center for Social and Urban Research at the University of Pittsburgh, will speak at 10 this morning at the Herberman Conference Center at UPMC Shadyside about the caregiving experience.

The day-to-day activities of caregiving, including grocery shopping, handling finances, dealing with insurance companies, eating and dressing, can cause stress for the caregiver. Dr. Schulz has been a leader of a 10-year study on the health effects of caregiving on married couples, and he said he sees a lot of negative effects, including depression, poor self-care, increased chronic illness and increased mortality.

Last year, Kelly Sturdivant, the director of sales operations at UPMC Health Plan, started feeling overwhelmed as she and her sister juggled their personal and professional lives with caring for their elderly parents. Their father, who was 85 at the time, had just entered a nursing home, and their mother, who was 74, was still living on her own but needed help.

Assuming the role of caregiver meant a big change in both their lives, she said, and sometimes, it led to more stress and less focus on their own needs.

"Because of her [physical] state, it made sense for me to pick up [my mother's] medicine, and then I'll forget my own or forget to get my own refill," she said. "My sister experienced the same thing."

She heard about UPMC Health Plan's caregiving classes and decided to go. The classes gave practical advice and she said she used some of the techniques, including tips on how to speak to her father when he was angry and frustrated.

"It was a chance to get away from your desk and talk to people that were empathetic to what you were going through because they were going through the same thing," she said.

UPMC Health Plan started offering caregiving classes to its members in June 2008, said Kendra Winters, the manager for UPMC for Life Community Relations. The six-week class, titled "Powerful Tools for Caregivers," is conducted by trained employee volunteers.

"If [caregivers] don't take care of themselves while they are caring for others, it can be so stressful that they in turn become the ones that have illnesses and the health problems, because they didn't take a step back and look how they can take better care of themselves," Ms. Winters said.

It's a problem that Gloria Barsamian, the author of the 2009 book "Sustenance and Hope for Caregivers of Elderly Parents; The Bread of Angels," saw frequently in her 28 years working as a social worker in Massachusetts.

"I found that people were totally unprepared to caregive a loved one," she said.

Caregiving can be an emotionally and spiritually rewarding experience, she said, but planning and dialogue is necessary to ease the transition and prevent stress for all parties.

She recommends people have a conversation about caregiving with their loved ones before caregiving is necessary, and then, once the caregiving process starts, strive for a balance in their lives.

"If you don't take care of yourself, you can't do it," she said.

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