Before the pandemic and when she had the extra money, Lucy Jackson would sometimes go out to buy the adult incontinence products she needed to get through the day and night. But now, worried about catching the coronavirus, she rarely leaves her Newark, New Jersey, boarding house.
To get supplies, she relies more on friends, family and the Modestly Cover Diaper Bank of Essex County, New Jersey.
"During this pandemic, it's been very, very difficult," Jackson, 72, said.
From child hunger to racial disparities, the pandemic has revealed and worsened many long-standing societal issues. And for people like Jackson, that includes access to absorbent briefs, diapers, pads and other incontinence products that are essential for daily living. Nonprofits that distribute these items report a surging demand and have scrambled to find new ways to distribute them as other agencies that serve older adults shut down or reduced their operations because of Covid-19.
Compared to 2019, the Diaper Bank of North Carolina distributed 977 percent more adult products in 2020. In San Antonio, the Texas Diaper Bank doled out 610 percent more items. And from October to January alone, the Essex County bank has distributed twice as many adult diapers as usual.
Cheryl Gartley, president and founder of The Simon Foundation for Continence, which draws awareness to the issue, said the number of emails that her nonprofit is receiving from people seeking help and sharing details about tight budgets and job losses has grown tremendously.
"Some of the stories that people write just feel like a fist has come out from your computer screen and punched you," she said. "They are so sad."
About half of adults ages 65 and older who live at home instead of a nursing home or similar setting suffer from urinary or bowel leakage, according to a Centers for Disease Control and Prevention report. Incontinence is especially common in women. The National Poll on Healthy Aging found that nearly half of women ages 50 and older report urine leakage but often don't tell their doctor.
While Medicaid pays for incontinence supplies, the coverage varies by state and can be difficult to qualify for. That leaves some spending as much as $50 to $100 weekly for products, Texas Diaper Bank CEO Jorge Medina said.
"Depending on the severity of the issue, it can really add up very fast," he said.
For those on fixed incomes, that can be more than they can afford under usual circumstances. But as millions face financial hardship because of Covid-19, these aren't usual times. The reasons for the soaring need are many, but they often boil down to money.
"The problem right now is that Americans don't have enough money, and so all of these materials, basic necessities are things that people are struggling to access," said Joanne Samuel Goldblum, CEO and founder of the National Diaper Bank Network. It partners with nonprofits that distribute children's diapers, period products and adult incontinence supplies, which have all seen an uptick in need, she said.
Without the items, older adults can end up isolated and embarrassed, worried about how they smell or what might happen if a restroom isn't nearby. An inadequate supply or inferior product can lead to urinary tract infections, rashes and other complications that can trigger more serious problems, said Steven G. Gregg, executive director for the National Association for Continence.
According to a survey of people who received adult supplies from the North Carolina diaper bank during the pandemic, having what they need made a big difference. Some 61 percent said access to the products reduced stress, 35 percent felt less frustrated, 37 percent were able to pay a bill and 33 percent could buy more food.
"It's a silent need," said Michelle Old, executive director of the North Carolina diaper bank. "It's huge and overwhelming. And really, in the end, it's going to take our lawmakers to value dignity and hygiene items for their community members."
Help could be on the way. On Feb. 8, Sens. Tammy Duckworth, D-Ill, Kevin Cramer, R-N.D., and Bob Casey, D-Pa., introduced the End Diaper Need Act of 2021, which sets aside funding for diapers for kids with serious health issues and babies, along with incontinence supplies for low-income adults or adults with a disability.
But it's also going to take work to remove the stigma of incontinence so that people seek treatment and family members aren't too embarrassed to speak up when they notice a telltale odor, said Leslie Pike, program manager at the Diaper Bank of Southern Arizona, which distributed 14 percent more adult products in 2020.
"People who need these supplies often struggle with almost crippling shame where they won't ask for help," she said. "That's another one of our missions is to be able to deshame this topic. To be able to say, this is a normal thing. … And we need to be OK with speaking about what happens to us. It's not something to be ashamed of."