My 75-year-old mother lives alone in her own apartment. She has been showing some signs of aging, but she continues to take care of herself and refuses to let me bring in a caregiver. She fell down a few weeks ago, but it was on a wall-to-wall carpet and nothing happened. Do you have any tips for preventing falls around the house? - A.F., Tel Aviv Judy Siegel-Itzkovich comments: The American Occupational Therapy Association recently issued guidelines for reducing the risk of falls at home. Falls are the leading cause of injury and accidental death in adults over the age of 65, says Prof. Fengyi Kuo, an expert in occupational therapy at the University of Indianapolis, on behalf of the association. The remedy to this problem at home is safety awareness and implementation of prevention practices. There are four main safety hazards that can lead to falls and injuries in the home - poor lighting, loose carpets and throw rugs, baths without handles and poorly arranged furniture. To minimize risks, increase lighting in the home, particularly along pathways to the bathroom and on stairs. Use night lights, especially in bedrooms, hallways and bathrooms. Remove throw rugs and loose carpet or secure them firmly to the floor. Be cautious when walking on thick carpet. In addition, install handles or railings in bathtubs and showers to prevent slipping. Use non-slip or rubber mats or install non-slip strips on tub and shower floors. Elderly people should take their time when getting into or out of bathtubs and showers. Arrange furniture so there is plenty of room to walk freely. Remove electrical cords from walkways by placing them under rugs or furniture or stapling them along walls and baseboards. And always keep phones in every room of the house and by the bed and keep emergency numbers by each phone, or use an emergency beeper worn on the wrist. I am 74 and live in Guadalajara, Mexico. Seven years ago, I had a spine operation in which a disc was removed. The surgeon wanted to enlarge the nerve canal. When he did this, he cut a nerve - the one that controls the intestine, bladder and vagina. After a few years, the pain became unbearable. I saw all kinds of pain experts, a neurosurgeon and so on, but no one was able to help me. Finally an endocrinologist prescribed me a drug called Lyrica, which was a miracle. The pain decreased by 80 percent, but there are side effects that really bother me, such as vertigo, loss of control of my sphincter and bladder, sleepiness and lack of energy. Is there another painkiller with less side effects? - G.D., Mexico Dr. Nathan Cherny, leading expert on palliative medicine at Jerusalem's Shaare Zedek Medical Center, replies: This is a difficult problem, and there are no easy solutions. But there is another drug called gabapentin (Neurontin is the commercial name) that is widely available around the world. It is related to Lyrica, but a bit different, and it is often better tolerated by patients. Since you did benefit from Lyrica, ask your doctor for Neurontin and try it. I am 68 , and I recently received a postcard from my health fund suggesting that I get a vaccination against pneumococcal pneumonia in addition to flu vaccine. What is this? Is it important to get the shot? - M.E., Herzliya Judy Siegel-Itzkovich comments: All four health funds encourage people over the age of 65, especially if they suffer from chronic illness such as heart disease, diabetes, lung or kidney disease, to get this shot. Resistance to pneumococcal pneumonia infection is reduced to certain cancers, cancer treatment, long-term use of immunosuppressant medications such as steroids, kidney failure, a damaged or removed spleen, or HIV/AIDS. In the US alone, 500,000 people develop pneumococcal pneumonia, a common bacterial pneumonia that can lead to serious and possibly fatal illness; about 40,000 of them die of it each year. It is fortunate that there is an effective vaccine against it. It is believed to be effective for at least 10 years, is considered safe and rarely causes serious side effects. Most need only one injection, and they can get it anytime. Ask your doctor about the vaccine, which is given routinely by the health funds. The Treasury has recognized the danger of pneumonia and gave the health funds permission to give it free to high-risk people. Rx For Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx For Readers, the Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to [email protected], giving your initials, age and residence.