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Regardless of age, every American must face a frightening statistic. After a person reaches 85 years old, there is a 50 percent chance he or she will be physically or mentally dependent.

The causes of dependency vary, from strokes and joint disease to muscle weakness or memory loss. However, dependency in any form is typically a serious family problem.

Dependency forces children to become their parent's parent - no easy task. Every day, I am confronted by frantic children and irate parents.

"My mom will not listen to anything I say," says one daughter.

"Why won't she just mind her own business?" responds the parent.

While physical dependency is an enormous challenge, memory loss is of far greater concern. Parents and loved ones with cognitive impairment have absolutely no insight into their condition. In many instances, they refuse to allow help in the home, or they continue to drive despite being a risk to others.

Memory loss is often accompanied by personality changes. A patient of mine is convinced that his family is "stealing him blind" and has, on occasion, shown anger that verges on violence to those around him.

And, despite being totally unreliable, he refuses help taking medications, thus developing numerous complications from his treatment.

Unfortunately, this is not an uncommon situation.

While dependency can be extremely difficult for patient and family, there are ways to cope:

By working in concert with a team of health care professionals, a geriatrician can comprehensively evaluate the patient who has physical disabilities and optimize his medical management. An individual rehabilitation program can be developed and may include nutritional counseling, plus physical and occupational therapy to improve strength, gait and balance, decrease risk of falling and significantly improve mobility.

For patients with memory loss and personality changes, physicians must make an accurate diagnosis of the cause of the memory problems, avoid drugs that can make symptoms worse, and, when necessary, treat with medications that help slow the rate of memory loss.

There are also medications available to treat depression, hallucinations, paranoia and aggressive behavior. On occasion, assistance from a psychiatrist who specializes in geriatrics is required.

Most importantly, children or loved ones of dependent individuals must better understand the issues of dependency.

For most elderly people, their greatest wish is to remain independent, in their own home and in control. Although children tend to focus on issues of safety, it is not typically a parent's most pressing concern.

Virtually every older person I know would happily accept increased risk if it meant remaining independent.

We should respect our older loved one's wishes as much as possible. As long as an individual is not a danger to others, risk is acceptable.

However, problems arise if an individual's physical or mental impairments can prove harmful to the wider community - such as forgetting to turn off a stove or continuing to drive despite clear indications to stop. Here, a geriatric team can help a great deal. Become truly educated about the issues affecting your parent or loved one, insist on a driving evaluation and create a safer house to minimize risk.

As we approach old age, we must all face issues of dependency. Remember, quality of life is the key. By taking steps today to be healthy tomorrow, we can all prevent the serious conditions that lead to dependency.

Gerontologist David Lipschitz holds both a medical degree and a Ph.D. and is the author of "Breaking the Rules of Aging." Write to him at His Web site is