The coronavirus pandemic and the fast-tracked federal response is inverting long-standing rules and practices for caring for frail older Americans, reports Forbes . For one thing, a temporary ban on nursing home visits and group activities and communal dining effectively puts residents in quarantine, which will likely exacerbate their tedium and loneliness and make worse some of those seniors dealing with anxiety and depression. The U.S. Centers for Disease Control and Prevention's temporary waiver of Medicare's three-day rule for coverage at skilled nursing facilities for people infected by COVID-19 has made advocates hopeful that momentum for a permanent reversal of the regulation will build. Meanwhile, temporary closure of senior community centers and adult day programs in response to the pandemic is a serious blow to frail older men and women, increasing their vulnerability to social isolation and prevention of needed exercise or meals. This, in turn, raises pressures on family caregivers. On the positive side, the House-passed Families First Coronavirus Response Act allocates $250 million in extra funding for home-delivered meals through Senior Nutrition programs, benefiting low-income, home-bound, and disabled seniors and their caregivers. However, a shortfall of personal care aides is likely to worsen.

Oklahoma Gov. Kevin Stitt (R) has released a draft plan to block grant a portion of Medicaid, confirms Politico Pro . This marks the first formal proposal issued by a state since the Trump administration encouraged them earlier this year to "pursue the new conservative twist" on the safety net program. The draft waiver would only apply to the poor adults in that demographic, with the proposal including a phased-in requirement that most adults either work, volunteer, or attend school. The draft waiver is now out for a month-long comment period in the state — the first step in a lengthy process. The state requires approval from CMS, and Medicaid advocates are expected to challenge the block grants in court, which could entangle the policy in a protracted legal battle.

The Dollar General store chain announced plans to dedicate the first hour of each shopping day to seniors and change operating hours starting Tuesday to help avoid the spread of COVID-19, reports KKTV . All stores intend to close an hour earlier than current close times to let workers clean and re-stock store shelves, as well as for their health and wellbeing. Stores will continue to maintain the current opening schedule. Other shoppers are urged to plan their shopping trips around this window so the most susceptible customers can shop during the first hour of operation and be less worried about getting infected. "We appreciate our customers' understanding of our decision and request they visit our stores later in the morning to allow at-risk populations the ability to purchase the items they need at affordable prices," said Dollar General CEO Todd Vasos.

University of Virginia professor and geriatrician Laurie Archbald-Pannone suggests four tips in The Conversation to help seniors remain connected during the coronavirus epidemic when advisories for social distancing are in effect. She first recommends that seniors take advantage of online communications technology like FaceTime, Zoom, Skype, or Snapchat. A second suggestion is remote participation in community activities, like volunteering to make phone calls for political parties, faith-based groups, and other organizations. Seniors also should stay current on the pandemic and other important news, but Archbald-Pannone thinks they should not do so to excess in order to avoid needless anxiety. "Watch a news update in the morning, then check in again at night," she advises. "Don't stay with it all evening — 30 minutes or an hour is plenty." Archbald-Pannone's fourth suggestion is for seniors to stay in touch with close friends and family, especially those who also are practicing social distancing. "Social distancing does not mean social isolation, and even a potentially deadly virus should not force us to be alone," she writes.

U.S. Vice President Mike Pence announced over the weekend that the Trump administration will prioritize Americans older than 65 to be tested for the coronavirus if they exhibit symptoms, reports CBS News . "It's important that the tests are available for the people most in need," he declared. The United States has not been testing at nearly the rate of, say, South Korea, which can more effectively spot cases and trace community proliferation due to testing. The Trump administration has received criticism for lacking sufficient tests in recent weeks, and U.S. healthcare providers are complaining that they do not have access to enough tests to check people who require them. Pence added that he and President Trump will on Monday brief governors on public-private partnerships for needs related to the pandemic. The administration also is collaborating with the private sector to expand testing capabilities, including drive-thru testing.

A University of Southern California (USC) study in PLOS One for the first time suggests that combined blood pressure and cholesterol medications could benefit people with dementia, reports USC News . "We know that managing hyperlipidemia and hypertension is important, and this study tells us there might be certain combinations of drugs that have additional benefits for Alzheimer's and other dementias beyond the management of those targeted conditions," said University of Washington, Seattle Professor Douglas Barthold. Researchers examined the medical and pharmacy claims of a random 20 percent sample of Medicare beneficiaries 67 and higher, enrolled in traditional Medicare from 2007 to 2014. The investigators associated Medicare Parts A (inpatient care), B (outpatient care), and D (prescription drugs) claims with enrollment files that included characteristics like race and sex. Use of cholesterol-controlling drugs pravastatin and rosuvastatin, in combination with angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers (ARBs) for high blood pressure, was linked to lower risk for dementia compared to other drug combinations. People using pravastatin and rosuvastatin plus ARBs were at a particularly lower risk — especially men. Using ARBs with pravastatin correlated with 21 percent lower odds of a dementia diagnosis, versus subjects using other combinations of drugs. "Even small delays in onset can dramatically reduce the burden on patients, caregivers, and the health system as a whole," concluded USC's Julie Zissimopoulos.

Nearly 53 percent of U.S. workers expressed a high intent to remain with their current employer in the fourth quarter of 2019 — higher than the global average of 39 percent, according to a quarterly Gartner Inc. survey of over 40,000 employees in 40 countries and regions cited by WebWire . For the first time, the U.S. workforce ranked No. 1 with the highest level of intent to remain with their current employers. In addition to more workers staying put, only 13.5 percent of U.S. workers actively sought new employment during the fourth quarter of 2019, well below the global average of 20.8 percent. Brian Kropp, chief of research for the Gartner human resource practice, adds a note of caution: "The disruption organizations are currently facing due to COVID-19 is likely to affect the labor market, including intent to stay, job seeking, and business confidence."

The state government of Wisconsin on Friday issued guidelines recommending that family visits to long-term care and assisted-living communities should be mainly limited to "end of life situations or when a visitor is essential for the resident's emotional well-being and care" so that residents are protected from coronavirus, reports the Milwaukee Journal Sentinel . "Older and medically vulnerable adults have significantly increased risk of severe illness and death from COVID-19, necessitating that we take all reasonable efforts to prevent introduction of this infectious disease into residential care (communities)," wrote Division of Public Health Administrator Jeanne Ayers. She further urged communities to screen all visitors for coronavirus, including healthcare workers, consultants, and family members; ban visitors who show symptoms of coronavirus; have hygiene supplies such as masks, tissues, and hand sanitizers on hand; and not allow employees who show "signs and symptoms of a respiratory infection" to work. Ayers also urged that senior communities have a designated employee entrance.

A study from the University of Cambridge in Brain suggests inflammation in the brain may contribute more to certain dementias than previously assumed, reports Medical Xpress . The authors enlisted 31 participants with three different varieties of frontotemporal dementia (FTD), who received brain scans to detect inflammation and abnormal "junk" proteins. The researchers determined that across the brain, and in all three FTD types, greater inflammation in each brain region correlates with more harmful accumulation of junk proteins. "We predicted the link between inflammation in the brain and the build-up of damaging proteins, but even we were surprised by how tightly these two problems mapped on to each other," said Cambridge's Thomas Cope. Cambridge's Richard Bevan Jones suggested that "there may be a vicious circle where cell damage triggers inflammation, which in turn leads to further cell damage." According to Cambridge Professor James Rowe, the findings also imply "that inflammation is part of many other neurodegenerative diseases, including Parkinson's disease and Huntington's disease. This offers hope that immune-based treatments might help slow or prevent these conditions."

California Gov. Gavin Newsom on Sunday advised 5.3 million seniors and those with chronic conditions at risk to stay home to slow the spread of the coronavirus in the state, reports the Los Angeles Times . "We recognize that social isolation for millions of Californians is anxiety-inducing but we recognize what all the science bears out and . . . we need to meet this moment head-on and lean in," Newsom said. He added that senior Californians' safety is a priority and urged family members to take care around seniors and frail individuals. Persons at higher risk for infection include those over 70 years old and with underlying medical conditions like diabetes, obesity, asthma, and heart, lung, or kidney disease and those with compromised immune systems. If someone in one of these categories becomes ill, early diagnosis allows more time to treat the virus, which may require putting them on oxygen or a ventilator. The U.S. Centers for Disease Control has urged seniors in areas where there is community spread of coronavirus to "stay home as much as possible and consider ways of getting food brought to your house through family, social, or commercial networks."