A little prevention can help avoid serious falls.

You may be over 65 and still doing it. Uh, yeah. You’ve always done it, so why not keep doing it now? It’s like cleaning out the gutters of a tall ladder. What’s so important?

A couple of years ago I had a patient who was standing on a ladder cutting branches, which he had been doing for many years. A branch came off, knocked him down the stairs and sent him to the hospital for several weeks. He was never the same.

Here’s a shocking statistic: 46,653 people died from falls in 2022, more than twice as many as 21,156 died from homicide. And here we are, so many people are worried about violence and killings when the real death toll is due to falls around the house.

A study published in the British Medical Journal compared falls in the US to gun deaths. One in five injury-related hospitalizations are the result of falls, and they are the second leading cause of injury-related deaths worldwide among people 65 years of age and older. Firearm deaths are higher among young people, and falls are more common among older people.

So what can you do to prevent falls? I have some advice for my older friends.

Throwing mats: If you have rugs in your home, get rid of them or reattach them. You’re not as nimble as you used to be and your legs may not lift as well as they used to – these mats can be dangerous.

Lighting: Make sure there is night lighting throughout the house, especially from the bed to the bathroom. I can’t tell you how many people fall when nature calls in the middle of the night. Even if they don’t fall, they can get their toe stuck in something that will be incredibly painful.

Handrails: While we’re on the subject of toilet breaks, install grab bars in bathrooms, showers and near toilets. Too many people fall while in this divine space.

When you sit on the toilet and defecate (yes, I’m talking about poop—sorry, Mom), you’re doing something called Valsalva (a maneuver named after the Italian physician who first identified it in the 1700s). This allows you to push it all out of your rectum.

You also relax the sphincter. (By the way, this anal muscle gets too little attention; that little bastard can tell the difference between a solid and a liquid and a gas, unless you’re sick, for 100 years. Hip hip hooray for the anus.)

Either way, when your body performs these functions, your blood pressure may drop. When you’re done, which means when you get up, you might fall too. Having a grate around your toilet can help you enjoy those golden years you’re looking forward to.

Medicines: Next, let’s talk about drugs. Ask your pharmacist if any of your medications may make you dizzy.

There are what are called the Beers Criteria (named after Dr. Mark Beers), which list medications that may be dangerous for people age 65 and older. This includes things like over-the-counter sleeping pills, which can make people unsteady.

Check the Beers criteria to see if you are taking one of these drugs; your pharmacist can help with this.

Winter safety: When you go outside this winter, walk with a de-icing cane and wear ice crampons like Yaktrax on your shoes or boots. Or use a velcro bottom – the kind that ice fishermen use when they do this crazy winter sport in Wisconsin (at least my cousin from California says it’s crazy, although ice fishing can be quite enjoyable on a sunny January day) .

Vision and hearing: Make sure your glasses are up to date. If you can’t see well, you may fall. If you need hearing aids, get them. Hearing is part of how we navigate the world. Believe it or not, when you hear your steps, you walk better.

Vitamins: Last but not least, consider taking vitamin D – 2000 IU every day. In the winter in the Greater Upper Midwest, we don’t get enough sunshine.

To get the sunlight you need to make enough vitamin D in January, you’ll have to go outside, take off your shirt, and sit in the sun for 30 minutes every day around noon. Try it on January 15th and let me know what it’s like.

My spin: When it comes to preventing falls, a little thought can save your life. Stay healthy.