Immigration: Who Will Care for Our Elderly?

A recent New York Times article describes a disturbing scenario that is likely touching many families nationwide. In the article, a 93-year-old woman, “Joan”, lives in Texas and has depended on “Anna”, for more than a decade. Anna comes to her home four days a week to help with shopping, laundry, housecleaning and driving Joan to appointments. “Anna is a wonderful person whom I trust completely.”

Anna is also an undocumented immigrant from Mexico

Both women fear that Anna will be detained and deported. Joan’s daughter lives in Oakland and is concerned about what would happen if Anna gets pulled over; her mother can neither drive nor care for herself. She knows that finding another caretaker like Anna will be nearly impossible, and she’s now researching alternative solutions for her mother.

The Trump administration’s immigration policies are taking a toll

In Brooklyn, an HR director asked local employment agencies to find 20-25 new nursing assistants and practical nurses. It’s a typical request, and usually, “I’m flooded with applications the next day.” Not anymore; she received five applications in a 30-day period.

She thinks the Trump administration’s immigration policies and rhetoric have discouraged potential workers. The organization typically drew from immigrant communities. Contributing to her employment problems:

• A loss of 25 Haitian-American nursing assistants and practical nurses whose temporary protected status (TPS; temporary status given to eligible nationals of designated countries who are present in the U.S.) was terminated in November, and they must leave by July 2019.
• Those healthcare workers with DACA status remain in limbo.
• One in four of the direct-care workers in the nation’s nursing homes,
•  and homecare agencies are foreign-born, according to an analysis of census data by Paraprofessional Healthcare Institute (PHI), a New York research organization.
• In the gray market, where consumers hire home-care workers directly and pay them under the table, the proportion is likely far higher.

A growing workforce shortage in direct care

There is a growing work force shortage in direct care that affects the entire industry; it may be most visible as it impacts older and disabled people and their families.

• Long-term demographic changes drive labor shortages. The good news is that people are living longer, but they’re developing chronic diseases and disabilities along the way.
• The sheer size of the baby-boom generation ratchets up demand.
• The population of working-age women, who typically provide care both paid and unpaid, has shrunk, and has more career options.

Caring for old people dependent on a large number of immigrants

Caring for old people is a job that native-born Americans prefer not to take for a variety of reasons, including poor pay and benefits and the physical demands. As a result, nursing homes are frequently staffed by immigrant caretakers. With fewer immigrants available to fill these jobs, expect more system chaos. There are reports of nursing homes shutting down or stopping admissions altogether. The majority of aides and nursing assistants are American citizens, but nearly 35,000 come from Haiti, El Salvador, Nicaragua and Honduras, whose immigrants have had TPS status in the U.S.—now terminated under the Trump administration.

11,000 care workers from Muslim countries won’t be available

Immigrants from Sudan, whose TPS status was also terminated, will have to leave the United States as early as this fall. Nearly 11,000 care workers come from Muslim countries but will no longer be able to immigrate because of the Supreme Court’s new ruling on Trump’s travel ban.

Sociological side effects of this immigrant deportation

• Even when workers are legal residents, they may consider moving when relatives and friends are deported.
• Whole neighborhoods begin to feel targeted. When friends, colleagues and family are deported, it shatters communities, leaving families feeling vulnerable.
• Short-staffed nursing and care facilities mean that those already working there are putting in longer shifts, increasing pressure on the workforce.

Many families and healthcare workers fear that the Trump administration’s massive deportations will further undermine a system that is already poorly managed and regulated. Many believe it will get much worse over the coming months as we begin to feel the effects of these deportations.

The other side of the matter: The immigrants

There is, of course, the other side of this matter–that of the immigrants who have come to this country seeking better lives and a safe place to raise their families—just as our own ancestors did. Many have fled persecution, death threats, violence and gang wars. We’ve always found ways to integrate these immigrants into our communities, enriching our culture along the way.

Sadly, the current leadership is turning its back on them, holding them in detention, putting their children in cages and splitting up families that may never be reunited. These hardworking immigrants took the jobs that no one else wanted, and many of those jobs may now go unfilled. The consequences will be felt in nursing homes and homecare, agriculture and myriad other industries. We will all pay the price on many levels.

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