The Unseen Backbone: How Immigrants Power Senior Care
The future of senior care hangs in the balance, heavily reliant on the dedicated work of immigrant caregivers. In Framingham, Massachusetts, Bethany Health Care Center, a facility caring for nearly 150 elderly women, vividly showcases this critical reality.
More than 40% of Bethany’s staff hail from over 26 countries, enriching the facility’s work environment with diverse cultures and experiences. “They are workers whom Bethany ‘can’t afford to lose,'” asserts Terry hodge, the center’s administrator, echoing the sentiment of countless other care facilities across the nation.
These immigrant employees provide the bedrock of daily care, assisting residents with personal needs like dressing, bathing, and feeding, while offering crucial companionship and emotional support. As Hodge poignantly states, “Our residents rely heavily on the care and companionship of the nursing staff and the housekeeping staff.The immigrant workers are very crucial to the functioning of this facility and to the physical and mental health of the people they serve.”
Though, looming immigration policies cast a shadow on this crucial workforce. The potential for wide-scale deportations and restrictions on new arrivals, especially targeting asylum seekers and beneficiaries of programs like deferred Action for Childhood Arrivals (DACA) and Temporary Protected Status , incite fear and uncertainty among those who contribute so much to the well-being of the most vulnerable.
Elder Care’s Workforce Crisis: Trump’s Immigration Policies Add to the Strain
The specter of President Trump’s promised immigration crackdown looms large over the already strained elder care industry. With an aging population demanding more care services, facilities are facing a critical shortage of workers, and the potential tightening of immigration policies adds another layer of anxiety to an already precarious situation.
“They are extremely anxious about what the future holds for them,” saeid a source familiar with the situation. “We, as a facility, are anxious about losing any staff.”
Experts warn that even Trump’s rhetoric on immigration could deter potential workers from coming to the US, further hindering efforts to fill the gaps in the health care sector. The United States desperately needs more caregivers to meet the growing needs of its senior citizens.
Nicole howell, director of workforce policy at LeadingAge, an institution representing over 5,400 nonprofit aging services organizations, emphasizes the critical role immigration plays in the field. “We have a group of older adults that are going to live longer than we have ever seen, and they will need and require access to care and services,” she said. “Disrupting the workforce is harmful to those individuals and their families.”
While the specifics of Trump’s immigration plans remain unclear, the elder care industry is taking a proactive approach. They are working to highlight the importance of immigration to the sector and urging the new administration and Congress to explore legal pathways for foreign workers to fill the critical caregiving roles.
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The world of long-term care heavily relies on the dedication of caregivers, and a significant portion of these individuals are immigrants. Nearly a quarter of all nursing assistants in the healthcare sector are foreign-born, encompassing citizens, permanent residents, and unauthorized migrants.
Steven Hubbard, a senior data scientist at the American Immigration Council, highlights that while immigrants make up 17.7% of the US workforce,they represent a staggering 42.4% of home health care aides according to 2023 Census Bureau data. Of these, 6.4% are undocumented,illustrating the critical role undocumented immigrants play within this sector.
further emphasizing the immigrant presence in long-term care is David Grabowski, professor of health care policy at Harvard Medical School. He notes that over 30% of non-direct care workers in these facilities, such as housekeepers and dietary staff, are foreign-born. “Caregivers are the backbone of long-term care, and foreign-born workers are a big part of that backbone,” he emphasizes. “Without them, we’d face enormous staffing shortages, and the quality of care and quality of life for individuals would inevitably suffer.”
Adding another layer to this complex picture is the “gray market,” where individuals or families hire aides directly. According to experts, these caregivers are more likely to be undocumented, revealing the hidden and often vulnerable nature of this workforce segment.
The coming decades will see a dramatic shift in the landscape of elder care as the Baby Boomer generation ages. The number of Americans aged 65 and older is projected to surge by 47%, climbing from 58 million in 2022 to a staggering 82 million by 2050, according to the Population Reference Bureau. This demographic shift will mean that seniors will comprise 23% of the US population by mid-century, a significant jump from their current 17% share.
This impending surge in the senior population will undoubtedly place immense strain on the long-term care industry, which already faces chronic staffing shortages and high turnover rates.Recognizing the growing urgency, the 2024 National Center for Health Workforce Analysis predicts a 39% increase in demand for direct care workers between 2022 and 2037. This includes essential roles like home health aides, personal care aides, nursing assistants, and psychiatric aides. Even though employment for home health aides and personal care aides is expected to grow, the pace will be slower compared to other direct care positions.
Jason Lee, CEO of the Home Care Association of America, a leading trade group representing agencies providing personal care aides to seniors and individuals with disabilities, emphasizes the critical need for more workers. “we have a long way to go in terms of making sure that we have coverage,” he says. To alleviate the ongoing staffing crisis, the association is actively advocating for the creation of a dedicated home care visa.
Research conducted by Dr. Grabowski reveals the significant impact immigrants have on nursing home staffing levels. According to his findings,an increase in immigrant arrivals within a community directly correlates with a surge in full-time nursing home staff,leading to improved patient care. Immigrants often fill crucial roles as Certified Nursing Assistants (CNAs), providing essential services such as feeding, bathing, and dressing patients. These services are vital in reducing patient stress and promoting overall well-being.
“This is very basic care, but it’s really essential,” Dr. Grabowski emphasizes, highlighting the profound impact these seemingly simple tasks have on patient lives.
The Immigration Dilemma in Senior Care: Talent Gaps and Innovative Solutions
The elderly care industry is facing a critical challenge: a shortage of qualified workers. “If you don’t have enough workers, bad things happen,” Adrian A. Blanco, ph.D. warned.
To combat this crisis, some organizations are exploring innovative ways to attract immigrants to the field. Robin Wolzenburg, LeadingAge Wisconsin’s senior vice president, witnessed firsthand the potential of this approach when an influx of Afghan refugees arrived several years ago. Recognizing their need for employment, Wolzenburg collaborated with state resettlement agencies to prepare the newcomers for essential elder care roles like housekeeping, laundry, and support work. The goal? to eventually train them for nursing positions. This initiative successfully placed at least two dozen refugees into meaningful employment.
Wolzenburg has faced new anxieties since the presidential election, with LeadingAge members asking about the potential impact of the Trump administration’s policies on immigration efforts. When asked directly about the uncertainty, Wolzenburg’s response was candid: “My answer is, ‘I don’t know yet.’” she admitted.
How does Bethany Health Care Center’s immigration policy support their immigrant staff?
Archyde: In Conversation with Terry Hodge, Administrator at Bethany Health Care Center
Archyde sits down with Terry Hodge, the dedicated administrator of Bethany Health Care Center in framingham, Massachusetts, to discuss her experience working alongside immigrant caregivers and the challenges the long-term care industry faces.
Archyde (A): terry, thanks for joining us today. Your facility, Bethany Health Care Center, is a testament to the vital role immigrants play in elder care.Can you share some insights into the immigrant workforce at Bethany?
Terry Hodge (TH): Thank you for having me. At Bethany, we’re incredibly fortunate to have a diverse staff hailing from over 26 countries. They enrich our work environment with their unique cultures and experiences. Without them, we’d struggle to provide the level of care our residents deserve.
A: According to our research, over 40% of your staff are immigrants. Can you tell us about their roles and the impact they make?
TH: Absolutely. Our immigrant employees are the backbone of daily care at Bethany. They assist residents with personal needs like dressing, bathing, and feeding, and provide invaluable companionship and emotional support.Our residents rely heavily on their care and companionship. They’re absolutely crucial to the functioning of our facility and the physical and mental health of the people they serve.
A: That’s inspiring to hear. However, we understand that there’s concern surrounding potential changes in immigration policies. How do these developments affect your workforce and the care you provide?
TH: the looming threat of deportations and restrictions on new arrivals has created a lot of anxiety among our immigrant staff. They’re integral to our operations,and any loss of staff due to immigration policies could cause a major disruption in care. Our residents’ well-being is at risk, and that’s a serious cause for concern.
A: How do you navigate this uncertainty and ensure the best care for your residents?
TH: We’re committed to advocacy and supporting our staff. we actively seek updates on immigration policies, engage in dialog with local officials, and examine legal options to protect our employees. Ultimately, though, it’s crucial for policymakers to understand the critical role immigrants play in our care system and enact policies that reflect this reality.
A: Terry, with the baby boomer generation aging, the demand for elder care will only increase. How do you see immigration playing a role in stemming the workforce crisis?
TH: Immigration will be vital in addressing the workforce shortage. We need more caregivers, and attracting and retaining foreign-born workers is part of the solution. We urge policymakers to explore legal pathways for foreign workers to fill these critical roles. Without a robust and supportive immigration policy, we’ll face dire staffing shortages and a deterioration in the quality of care for our seniors.
A: Thank you, Terry, for your candid insights and commitment to elder care. Your viewpoint is invaluable in shaping the conversation around immigration and it’s impact on our most vulnerable populations.
TH: Thank you for bringing this crucial issue to light. Our immigrant caregivers deserve recognition, and our seniors deserve the best care possible.
