By Marie C. Gualtieri
While many Americans are entering the first phase of loosened stay-at-home orders, there are homebound older adults for whom stay-at-home orders are always in effect, every day, 24/7. As our nation’s population at large has discovered, staying in presents challenges, especially with procuring food—and for some older adults, such challenges can be overwhelming.
According to AARP, more than 10 million older adults daily are at risk of hunger. As a longtime food insecurity researcher, I have had many conversations with homebound older adults, and now, with the impacts of COVID-19, these older adults are facing an additional frightening scarcity of nutritious and nourishing food.
While programs such as Meals on Wheels are dedicated to serving older adults, a recent GAO report found that prior to the pandemic, some communities had at least 12,000 names on their meal delivery waiting lists due to funding constraints—but the situation now is even worse.
In early May, Meals on Wheels America released staggering figures that compared their current operations to the week before March 1. Eighty-nine percent of programs have seen an increase in meal requests; of those, 79 percent report the number of new requests for meals has at least doubled. Extant waiting lists for home-delivered meals have grown by 26 percent.
Older adults of color were more likely to experience food insecurity prior to COVID-19, and have been disproportionately impacted by the pandemic. Before COVID-19, food insecurity among older adults of color was more than double the rate of their white counterparts. And during COVID-19, people of color are dying at higher rates than their white counterparts. While co-morbidities are a factor, this death rate is also a result of long withstanding systemic inequalities that date back centuries.
What Are the Barriers to Food Access?
There are three specific ways in which Americans experience food access barriers during the pandemic that older adults face every day. Yet, during the pandemic, these challenges for older adults are amplified.
First, grocery stores are more difficult to access, having long lines and waiting periods. Second, ordering groceries online often takes days for supplies to be delivered. And finally, due to sold-out items, people are buying items that are not their first choice or that they wouldn’t consider under normal circumstances.
Homebound older adults have always had problems accessing grocery stores and food banks: for example, Anna, an older woman in her mid-80s, used to take local public transportation every week to buy groceries, but after a knee replacement surgery she struggles with daily hygiene and cooking, let alone tasks that take her out of the house.
While many older adults are easily able to shop for groceries for other more frail individuals, standing in long lines exposes them to weather and to the coronavirus—both factors can take a toll on their physical strength and health. According to The National Council on Aging, 80 percent of older adults have at least one chronic disease; and every 11 seconds, an older adult ends up in the emergency room with a fall-related injury. Thus, grocery shopping, pandemic or no, is not always physically feasible for vulnerable older adults.
Older adults may not know how to order groceries online. While Internet use has steadily increased among older adults, and 91 percent of those with devices use technology to connect with family members and friends, many older adults remain unfamiliar with using online ordering platforms for food and other needed items.
Regardless of the problems with technology, many older adults who are able to order groceries online may wait days for them to be delivered—and may have no other option but to use online ordering, as they have few family members, friends or acquaintances who could shop for and deliver food to their door. Barbara, age 91, relies upon her neighbor to drive her to the grocery store. “My neighbor is reliable, but has commitments himself,” she explained. “He has appointments, and he and his wife visit their son for a couple a weeks at a time.”
For older adults who worry whether a family member, friend or neighbor (like Barbara’s) could help them with groceries prior to COVID-19, those fears are now amplified if family members or others cannot get to the store or cannot then come inside the home to help put away groceries or assist with meal preparation.
Shopping for SNAP Staples—It Isn’t a Snap
For people using the SNAP (formerly food stamps) benefit, SNAP-eligible products now are cleaned out from store shelves, leaving low-income older adults with fewer options. Fifty-six percent of households with adults ages 60 and older receive the minimum SNAP benefit of $16 per month, making their ability to stock up for two weeks at a time and to plan meal virtually impossible.
While Robert, age 64, receives SNAP benefits, he faces a choice between medication and food. “Most of my medications are expensive, and I have to choose between [buying] food and getting my medications. And I find I choose medication over food. And I need to take food with my medication. I try to balance, but I’m in between a hammer and a hard place.”
Robert, embarrassed, told me that he eats cat food because it’s less expensive than canned tuna fish. And he is not alone; countless older adults typically buy food they would not normally want or accept due to the lack of physical mobility or cost—items, such as microwaveable meals, that may exacerbate existing health conditions. Adeline, age 93, said, “I don’t eat the foods I want, but I eat the food I get to live.” Many older adults who live off of their Social Security or who have low-wage jobs find themselves in a hazardous catch-22 situation—one that forces them to make difficult tradeoffs in how they spend their limited income.
Collective Efforts Can Shift the Crisis
Hopefully, the effects of the pandemic upon older people can engender a collective empathy, which can be channeled into meaningful action.
The following are six ways we can all assist older adults in need:
- Call local senior services centers to learn what is needed. Many organizations providing these services heavily rely upon older adult volunteers, but due to COVID-19, these centers are seeing a decrease in volunteers when they are now most needed. Several community organizations have combined efforts to create new ways to serve older adults during the pandemic, but lack volunteers to meet capacity. Younger Americans who are seeking a way to help during the pandemic can do so by volunteering.
- Donate money to local senior nutrition programs. Recent legislation in COVID-19 emergency bills focused on senior nutrition programs. This legislation is monumental in providing direct support to ensure that homebound older adults are fed. But prior the advent of COVID and to the resultant emergency funding bills, organizations already had a dire need for more money (and large client waiting lists) to keep up with the demand for meals. Now and after COVID-19 passes, these organizations will need continued funding support to feed every older adult in need.
- Donate personal protection equipment. Aside from funding, 63 percent of senior nutrition programs report that acquiring safety supplies (gloves, masks, etc.) is their biggest challenge.
- Offer support to an older adult neighbor. Many people may not be geographically available to assist their older family members. Checking in with a phone call or a social distancing visit to ask about a neighbor’s food needs can help and also serve to reduce feelings of loneliness.
- Develop community skills-building classes. Partner with local aging agencies to host community-based classes on how to use ordering apps or online platforms to teach these skills to older adults.
- Be a voice for older adults. Encourage congressional representatives to address the barriers that older adults face. A good start would be to urge the USDA to increase the SNAP benefit minimum as a permanent change. While older adults need an increase in the minimum benefit now, they will also need it after the pandemic. Having $16 to spend over an entire month was never enough for older adults receiving SNAP, and ultimately forced them to choose between food or filling their prescriptions or paying their bills.
Marie C. Gualtieri, Ph.D., is a 2019–20 Health and Aging Policy Fellow.