What happens when the people caring for our most vulnerable are forced to look over their shoulders every day?
That is the reality for many immigrant caregivers in nursing homes today. Across the United States, long-term care facilities are facing a growing crisis, not just from staffing shortages or funding cuts, but from rising fear and uncertainty caused by changes in immigration policy.
Nearly one in three direct care workers are foreign-born. They bathe, feed, and comfort our most vulnerable. Now, many are being pushed out of the workforce, either through legal barriers or fear, leaving residents at risk and facilities struggling to cope.
Disrupted Care and Emotional Loss
When caregivers leave suddenly due to immigration-related issues, residents lose more than a staff member. They lose a trusted companion. Consistency and continuity of care are vital for elderly individuals, particularly those with dementia or limited mobility. A disrupted care team can lead to emotional distress, safety concerns, and a decline in health outcomes, as shown in a study from the National Institutes of Health.
In some communities, residents have already felt the effects. Caregivers avoid speaking about their backgrounds. Some have quietly left the country. Others remain, but with increasing fear and uncertainty.
The Link Between Immigration and Elder Care
Immigrants are essential to the elder care infrastructure in the United States. They are more likely to remain in their roles longer, are committed to building trust with residents, and often bring language skills and cultural awareness that enrich the caregiving environment, as described by the Center for American Progress.
At the same time, the industry is facing increasing pressure from proposals to reduce Medicaid funding. Medicaid covers more than half of all long-term care spending in the U.S., making it a critical source of support for nursing home care.These combined challenges place enormous strain on a sector that is already struggling to recover from the effects of the COVID-19 pandemic. More details are available in this issue brief from KFF.
A Call for Policy Alignment
Immigration and healthcare policies can no longer exist in silos. The long-term care sector depends on immigrant workers, many of whom are now facing fear and uncertainty.
Policies that disrupt their ability to work do not just affect jobs. They affect the quality of care for older adults.
We need immigration reform that reflects the reality of our healthcare system, and care policies that support fair pay, job security, and staffing stability. Immigrant caregivers are not optional. They are essential.
As Brookings notes, immigration reform is key to fixing care workforce shortages. It is time we treated it as a healthcare issue.
