‘A Demographic Ticking Time Bomb’: Trump’s Immigration Crackdown Comes for Seniors’ Caretakers

About a third of the staff at one Miami nursing home lost their jobs after the Trump administration ended the programs letting them work legally, a certified nursing assistant who has worked there for more than two decades told NOTUS.

Anne-Mercie Blot, a naturalized U.S. citizen from Haiti, isn’t at risk of deportation, but she’s scared of what could happen when even more of her nursing home co-workers lose their employment authorization early next year.

“Sincerely, I’m expecting the worst,” Blot said.

The nursing home is staffed mostly by immigrants from Haiti, she said. Some of them are citizens or green card holders, but others hold work permits through the temporary protected status program, which allows people from countries facing disasters or strife to stay and work legally.

On Feb. 3, they and more than 330,000 other Haitians are set to lose those protections, and the nursing home will lose health care providers, kitchen staff and housekeepers who take care of its aging residents.

“We don’t know after that how many patients they’re gonna add to the load that we have to take care of,” Blot said.

In the first year of his second term, President Donald Trump has expanded his deportation efforts beyond the “worst of the worst” and increased the number of people without legal status by terminating several programs that allowed immigrants to enter the country and work legally. His administration has also paused immigration processes for people from countries included in its travel ban and detained people in the process of obtaining permanent residency.

While business leaders say they understand Trump’s goal of securing the southern border, going after people who have already been granted work authorization doesn’t make sense, especially when they’re caring for the country’s aging population.

In July, Rob Liebreich, the CEO of Goodwin Living, a Northern Virginia and Washington, D.C., home-health and assisted-living nonprofit, had to let go of 14 employees who lost their work permits after the Trump administration ended a humanitarian parole program. Liebreich said it was incredibly difficult losing those employees and that 60 of the remaining staffers don’t have permanent legal status.

“It’s been very challenging to stay current with all the changes that our team members are having to face, and obviously they’re wanting to focus on their work and service to older adults,” he said. “And at the same time, there’s a lot of confusion and a lot of shifts and changes and, unfortunately, ultimately a lot of fear.”

From a demographic perspective, cracking down on immigration means restricting the labor pool in the elder-care industry, a sector where a shrinking workforce will have compounding consequences.

The U.S. population ages 65 and older is projected to grow more quickly than younger groups over the next 30 years because of the country’s slowing fertility rate, according to the Congressional Budget Office.

Immigrants make up 22% of nursing assistants and 41% of home-health aides, according to an analysis of November U.S. Census Bureau and Bureau of Labor Statistics data by Madeline Zavodny, an economics professor at the University of North Florida.

The economist, whose work focuses on immigration, said it’s astonishing and troubling how dependent the U.S. is on immigrants to take care of the elderly.

“It’s a demographic ticking time bomb,” she said. “Unless policies change, we’re not going to have as big of a labor supply of this group of immigrants who are providing really needed work.”

The largest share of immigrants looking after the elderly — 32% — work in people’s homes, according to an analysis of a 2023 Census survey from KFF, a health policy research organization. Noncitizen immigrants comprise 13% of immigrants providing long-term care in people’s homes.

By 2034, the U.S. will need an additional 820,000 home-health and personal-care aides, according to a BLS estimate.

In response to NOTUS’ question about what the Trump administration would do to help replace employees in the elder-care industry losing work authorization, a White House spokesperson said there wasn’t a shortage of Americans to grow the labor force.

“President Trump’s agenda to create jobs for American workers represents this Administration’s commitment to capitalizing on that untapped potential while delivering on our mandate to enforce our immigration laws,” White House deputy press secretary Abigail Jackson said in a statement. “President Trump will continue growing our economy, creating opportunity for American workers, and ensuring all sectors have the legal workforce they need to be successful.”

Adam Lampert, the CEO of two Texas-based senior-care companies, employs 350 people across his two companies: Manchester Care Homes, which operates four assisted-living facilities in the Dallas region, and Cambridge Caregivers, which provides home-health aides across Dallas, Austin, Houston and Fort Worth. Immigrants who have work authorization but aren’t permanent residents or citizens make up about 20% of his caretakers, Lampert said.

If he had to let go of that 20% of the staff, Lampert said he’d have to raise his prices and the quality of service would be lower.

“These are people that are handling your grandmother, your grandfather, your aunt, your uncle; these people have to go through background checks,” he said. “We know where they come from. They have to have their papers.”

Since 2019, the base pay at Goodwin Living has increased its base pay from $11.75 to $20 an hour, Liebreich said. But increasing pay doesn’t necessarily make it easy to recruit people for the physically demanding job of caring for seniors, Liebreich said.

“The argument is that people will come to these jobs, and the reality is that it’s not happening at the pace by which we need,” he said.

Rep. María Elvira Salazar, a Republican from Florida, echoed that sentiment and said she’s been telling fellow Republicans to pay attention to her proposed bipartisan legislation that would allow vetted workers to remain in the U.S.

The Dignity Act, which hasn’t seen movement in Congress beyond its introduction, would provide legal status for eligible unauthorized immigrants who have lived in the country for years without a path to citizenship.

“Why hasn’t it happened yet?” Salazar said. “Why haven’t people who were born here filled those jobs? It’s the same story as always.”