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May is Older Americans Month. This year’s theme is Blaze a Trail. The National Council on Aging’s Administration for Community Living is collecting stories of older trailblazers. Which reminds me: On Wednesday, May 11 the Berkeley Library Board of Trustees is scheduled to meet at 6:15 PM, location unknown at this time (check www.savethebplbooks.org on May 10.) 

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Bernie, Hillary, Ted, and The Donald … Who is the oldest? The youngest? 

Rafael Edward “Ted” Cruz 46 years 

Hillary Rodham Clinton 68 years 

Donald John Trump 69 years 

Bernard “Bernie” Sanders 74 years 

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Is your doctor board certified? Do you care? You should. As one ages chronologically, so does one’s primary care physician. At some point, you will both part company. Mine retired about a year ago, and I have yet to identify a “replacement,” i.e. someone with her credentials – maturity, board certifications in both internal and geriatric medicine – who is accepting new patients, Medicare and Medi-Cal. 

Wikipedia describes board certification as the process by which a physician or other professional in the United States demonstrates mastery of basic knowledge and skills through written, practical, or simulator-based testing. 

There are approximately 24 boards that certify physician specialists. There is no legal requirement to attain board certification, but some hospitals demand that physicians are board certified in order to get privileges. Board certification is so desirable that doctors who are not (yet) certified, but presumably could be, sometimes describe (advertise) themselves as “board eligible” to practice medicine in a particular field.  

Physicians seeking board certification in a given area of specialty must successfully complete and pass an examination process designed to test their mastery of the minimum knowledge and skills contained in the core competency document. Prior to taking the examination, a physician must graduate with an MD or DO (doctor of osteopathy) degree and meet all other prerequisites to certification as set out by the certifying agency or "board." 

Renewal every ten years or so of a doctor’s board certification is believed to help keep knowledge and skills up to date. Many boards of certification now require that physicians demonstrate, by examination, continuing mastery of the core knowledge and skills for their chosen specialty. Recertification varies by specialty. 

The United States Medical Licensing Examination (USMLE) is a professional exam sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners(NBME). Physicians with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States. 

Doctors are licensed by their states to practice medicine, but they are also expected to be “board-certified” in their particular field — surgery, obstetrics, pediatrics, etc. This certification comes from the professional organization of each field. Geriatric medicine is a sub-specialization, usually of internal medicine.  

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1. The state of _______ posted the United States’ highest rate of Medicare being overbilled for services in 2015. Providers charged an estimated $1.25 billion more than they should have. The state’s Medicare bills were too high an estimated 19.4% of the time, according to the report from the U.S. Department of Health and Human Services. As of February, health care providers had filed appeals on more than 800,000 claim denials, a number it will take roughly 10 years to work through. Congress placed a moratorium on the audits.
2. The debate over divesting coal and oil from the pension portfolio of the state of ______ appears to have smoked out an uncomfortable truth: Nearly 20 years after the state proclaimed its pension funds tobacco-free, they continue to contain tobacco investments.
3. Americans won't be able to travel to _______ in order to die. Its new assisted suicide law will apply only to that nation’s permanent residents. A senior government official told the Associated Press that visitors will be excluded under the new law, precluding the prospect of suicide tourism.
4. In the United States, assisted suicide for mentally competent, terminally ill patients is legal in five states-- Oregon, Montana, Vermont, and Washington. ________ recently became the fifth state to legalize aid in dying. The law will take effect later this year.
5. The nursing home industry has steadfastly opposed granny cams, installed to monitor nursing homes and assisted living facilities (they’re different.) Under a bill proposed by lawmakers in the state of _________, families seeking to protect their loved ones from maltreatment in nursing homes would have the right to monitor their care with electronic recording devices without fear of retaliation. The volume of maltreatment complaints in the state’s nursing homes more than doubled since 2012. The proposal would make it the sixth state explicitly to permit residents of long-term care facilities to install surveillance equipment in their private rooms. (Ask: How many nursing homes provide private rooms?) Modeled after a bill signed last year in Illinois, this legislation would require a nursing home resident to consent to the use of a camera before it can be installed and to notify the facility of intent to use electronic monitoring. In addition, signs must be clearly posted notifying visitors of the devices. Allegations of abuse in senior homes are notoriously difficult to prove, and hidden cameras are considered one of the few ways that families can corroborate claims by elderly relatives. (Ask: How many nursing home patients have families?)
6. According to a report from the government of _______ , the elderly (age 60+) population in that nation of 1.252 billion (2013) has increased substantially. 71% of the elderly reside in villages, 29% in cities. Prevalence of heart diseases among the elderly is much higher in urban areas than in rural. Urinary problems are more common among aged men; aged women suffer joints problems. The literacy rates among elderly females (28%) is less than half of the literacy rate among elderly males (59%).
7. The gender pay gap in ___________ is at a record-high 18.8%. But perhaps an even more insidious disparity is the superannuation gender gap in this nation, wherein women retire with just over half the amount of super as men, and one in three women retire with no pension at all. (Superannuation refers to the arrangements people make to accrue funds to replace their income in retirement. It is government-supported and encouraged, and minimum provisions are compulsory for employees.)

Recommended reading: “Hearing aid use is associated with improved cognitive function in hearing-impaired elderly; A study suggests hearing loss contributes to sensory-specific cognitive decline.” Public Release: 25 April, 2016. Online via eurekalert. Source: Columbia University Medical Center. This study was published online in the American Journal of Geriatric Psychiatry. A shorter version, in English and in Spanish, is available at HealthDay News for Healthier Living. 

A hearing aid may do more than help you hear better. New research suggests that the devices might also help prevent mental decline in elderly people with hearing loss. Cognition is the mental process of knowing, including aspects such as awareness, perception, reasoning and judgment.  

While Medicare does not fund hearing aids, Medi-Cal (California’s Medicaid) pays for "medically necessary" health care such as hearing aids for persons with Medicare. In Alameda County, contact one of several hearing aids facilities for information about this. As a nonveteran, I tried numerous other sources of alleged assistance, all unsuccessful. I understand that any honorably discharged veteran is eligible for free hearing aids from the VA. Contact your VA hospital or clinic for an appointment. Be sure to have your DD 214 when you apply.