Immigrant Caregivers Are Losing Jobs Amid U.S. Elderly Care Crisis

Key Takeaways

• 41% of home health aides in the US are foreign-born, vital for elder care.
• Trump administration policies revoked work permits and stopped refugee admissions since June 2025.
• Nursing homes face staff shortages, closing wings and reducing admissions, risking care quality.

The United States 🇺🇸 is facing a deepening crisis in its long-term care sector, as nursing homes and home health agencies struggle to keep their doors open and provide quality care to the nation’s elderly. The root of this problem, as of June 2025, is a sharp decline in the number of immigrant workers—especially those serving as caregivers—caused by the Trump administration’s strict immigration policies. These changes have left facilities across the country unable to fill critical vacancies, putting millions of seniors and disabled Americans at risk.

Who Is Affected and What’s Happening?

Immigrants make up a large share of the workforce in nursing homes and home care. They are the backbone of daily care for many elderly Americans. But now, due to new government actions, many of these workers are losing their jobs or being forced to leave the country. The Trump administration has:

• Suspended refugee programs, stopping new arrivals who often fill caregiving roles.
• Revoked or refused to renew work permits for hundreds of thousands of foreign-born workers, including those with Temporary Protected Status (TPS) and Deferred Action for Childhood Arrivals (DACA).
• Increased deportations and made it harder for new immigrants to come or stay.
• Refused to create new visa categories for caregivers, leaving existing pathways crowded and slow.

As a result, nursing homes and home health agencies are losing staff faster than they can hire replacements. According to LeadingAge Wisconsin, some facilities have entire wings sitting empty—not because there aren’t enough residents, but because there aren’t enough workers to care for them.

Why Is This Happening Now?

The Trump administration’s immigration crackdown is at the heart of the current crisis. By suspending refugee admissions and stripping work authorizations, the administration has cut off two of the main sources of new caregivers. Deportation efforts have also increased, targeting both undocumented immigrants and some who are in the country legally.

This has led to a sudden and severe shortage of workers in a sector that was already struggling. The number of immigrants working as home health aides had grown by 24% between 2018 and 2023, but that trend is now reversing. As work permits are revoked and new arrivals are blocked, the workforce is shrinking at a time when demand is rising.

How Big Is the Problem?

The numbers show just how dependent the United States 🇺🇸 is on immigrants for elder care:

• 41% of home health aides are foreign-born.
• 30% of nursing home housekeeping and maintenance staff are immigrants (compared to 19% of the overall U.S. workforce).
• 28% of all direct care workers in long-term care are immigrants.
• In some states, like Hawaii, over 70% of certified nursing assistants (CNAs) in nursing homes are foreign-born.
• The share of foreign-born CNAs in nursing homes rose from 13.6% in 2000 to 19.1% during the pandemic.

At the same time, the need for care is growing fast. The U.S. population aged 65 and older is expected to increase by 8 million by 2030, reaching 71 million, and could surpass 100 million by 2075. Demand for home health aides, nursing assistants, and personal care aides is projected to rise by 35–41% between 2022 and 2037.

What Are the Immediate Effects?

Staff Shortages and Facility Closures

Nursing homes and home health agencies are being forced to:

• Reduce admissions or turn away new residents.
• Close entire wings or, in some cases, shut down completely.
• Cut services, leaving fewer options for families who need help caring for loved ones.

Robin Wolzenburg of LeadingAge Wisconsin reports that the problem is not a lack of people needing care, but a lack of staff to provide it. Resettlement agencies, which used to help place refugees in caregiving jobs, have paused their work because the refugee program is suspended.

Declining Quality of Care

With fewer workers, the quality of care drops. There are:

• Longer wait times for basic services like bathing, feeding, and medication.
• Lower staff-to-resident ratios, meaning each worker has to care for more people.
• Worse health outcomes for residents, including more falls, infections, and hospitalizations.

Research from Harvard and Brookings shows that nursing homes with more immigrant CNAs provide better care, more direct care hours, and higher quality overall. When these workers are lost, everyone suffers.

Impact on Families

When facilities can’t provide care, the burden falls on families. Adult children may have to quit their jobs or cut back on work to care for aging parents. This not only strains families emotionally and financially, but also hurts the broader economy as more people leave the workforce.

Shortages also mean higher costs for private care, putting quality services out of reach for many middle- and low-income families.

Loss of Cultural Competency

Many older immigrants rely on caregivers who speak their language and understand their culture. When immigrant caregivers are forced out, these seniors lose the personalized care they need to feel comfortable and safe.

Why Can’t Native-Born Workers Fill the Gap?

Caregiving jobs in nursing homes and home health are physically demanding, emotionally tough, and often pay low wages—typically between $34,000 and $38,000 per year. Turnover is high, and many native-born workers are not interested in these roles.

Cassandra Zimmer-Wong of the Niskanen Center points out that the sector already struggles with retention and unattractive pay, making the loss of immigrant workers especially dangerous. The Migration Policy Institute adds that the impact will be felt most in states and cities with high immigrant caregiver populations.

Step-by-Step Impact on Stakeholders

Here’s how the crisis unfolds for different groups:

1. Immigrant caregivers lose their jobs or face deportation.
2. Care facilities lose staff and can’t fill open positions.
3. Facilities reduce admissions, close wings, or cut services.
4. Elderly and disabled Americans have less access to care, longer wait times, and lower quality of life.
5. Families must step in to provide care or pay more for private services.
6. The economy suffers as more family members leave the workforce to care for loved ones.

What Do Experts and Industry Leaders Say?

Leslie Frane of the Service Employees International Union (SEIU) calls the situation a “perfect storm,” with anti-immigration policies making staffing shortages even worse and threatening the quality of care.

Clif Porter of the American Health Care Association says the country needs streamlined legal pathways for immigrant caregivers to meet growing demand. Industry groups like LeadingAge, SEIU, and the American Health Care Association are all calling for expanded visa options, protection of work authorizations, and comprehensive immigration reform.

Academic studies back up these calls, showing that immigration crackdowns lead to more elderly people being placed in institutions and worse health outcomes.

Historical Background: How Did We Get Here?

The United States 🇺🇸 has long relied on immigrants to fill direct care roles in nursing homes, assisted living, and home health. These jobs are hard to fill with native-born workers because they are tough, pay little, and have high turnover.

Past immigration enforcement programs, like Secure Communities (2008–2014), have shown that strict policies reduce the supply of caregivers, increase the number of elderly people in institutions, and worsen care outcomes.

The COVID-19 pandemic made things worse by causing even more staff shortages, and the sector has not recovered since.

What Could Happen Next?

If current policies continue, the crisis will only get worse. More facilities will close, costs will rise, and the quality of care for millions of elderly and disabled Americans will drop.

Advocacy groups are pushing for several solutions:

• Special visa categories for frontline care workers to make it easier for immigrants to work in caregiving jobs.
• Pathways to permanent residency for direct care workers, so they can stay and build stable lives.
• Expanded refugee and humanitarian admissions to bring in more workers.
• Reforms to help foreign-trained professionals get U.S. licenses more easily.

So far, Congress has not passed any major changes, but the issue is becoming more urgent as the population ages and the crisis deepens.

Real Stories: The Human Side of the Crisis

Immigrant caregivers often form close bonds with the people they care for. They provide not just physical help, but also emotional support and companionship. Many families say their loved ones would not be able to stay at home or in their communities without these workers.

When these caregivers lose their jobs or are forced to leave, it’s not just a loss for them—it’s a loss for the people they care for and for the entire community.

What Can Facilities and Families Do?

Right now, options are limited. Facilities are trying to recruit more workers, but the pool of eligible candidates is shrinking. Some are offering higher pay or better benefits, but this raises costs for residents and families.

Families may need to:

• Check with local agencies for available services.
• Consider home care options, though these may be limited or expensive.
• Advocate for policy changes by contacting lawmakers and supporting organizations working on immigration and elder care issues.

Where to Find More Information

For those affected or interested in learning more, the following resources provide up-to-date and official information:

• U.S. Citizenship and Immigration Services (USCIS): For details on work authorizations, visa status, and immigration forms.
• Bureau of Labor Statistics (BLS): For workforce data and job outlook in the care sector.
• LeadingAge: Advocacy and resources for aging services providers.
• Service Employees International Union (SEIU): Represents nursing facility workers and home health aides.
• American Health Care Association (AHCA): Represents long-term care facilities.

If you need to check your work authorization status or apply for renewal, you can find the official forms and instructions on the USCIS website.

The Bottom Line

The United States 🇺🇸 is facing a serious shortage of caregivers in nursing homes and home health due to the Trump administration’s tough immigration policies. Immigrants, who make up a large part of the caregiving workforce, are losing their jobs and legal status. This leaves facilities unable to care for a growing elderly population, putting millions at risk.

Without quick action—such as creating new visa pathways, protecting work authorizations, and reforming immigration laws—the quality and availability of care will continue to decline. As reported by VisaVerge.com, the future of elder care in the United States 🇺🇸 depends on recognizing the vital role immigrants play and making it possible for them to continue their important work.

Key Takeaways:

• Immigrants are essential to elder care in the United States 🇺🇸.
• Strict immigration policies are causing severe staff shortages in nursing homes and home health.
• Quality of care, facility operations, and family well-being are all at risk.
• Policy changes are urgently needed to protect both caregivers and the people who depend on them.

For those seeking more information or needing to take action, start by visiting the USCIS official website for the latest updates on work authorization and immigration status. Stay informed, speak up, and support efforts to keep quality care available for all who need it.

Learn Today

Temporary Protected Status (TPS) → A temporary immigration status protecting eligible foreign nationals from deportation during crises.
Deferred Action for Childhood Arrivals (DACA) → A US immigration policy allowing certain undocumented youth temporary legal status and work permits.
Certified Nursing Assistant (CNA) → A caregiver certified to provide direct patient care in nursing homes and health facilities.
Work Authorization → Official permission allowing non-citizens to legally work in the United States.
Refugee Program → A government initiative to admit displaced individuals seeking protection in the US.

This Article in a Nutshell

The US elder care crisis worsens as immigration policies cut immigrant caregivers, forcing nursing homes to close wings and reduce services, endangering millions of seniors dependent on quality long-term care.
— By VisaVerge.com