Undocumented caregivers

Dr. Louise Aronson, geriatrician and author of Elderhood, says, “Caregiving is hard work. More often than not, it’s tedious, awkwardly intimate, physically exhausting and emotionally challenging. Sometimes it is also dangerous or disgusting. It is women’s work and immigrants' work.” Most old people get care from their children, spouses, other relatives, or non-relatives. The remaining caregivers are paid, but not much. The median hourly wage for all care workers was $16.72 in 2023—lower than the wage for all other jobs with similar or low entry-level requirements.

The New England Journal of Medicine notes that “immigrants are a vital part of the U.S. health care system: at least one in five U.S. health care workers is foreign-born, including 29% of physicians, 17% of nurses, and 24% of direct care workers.” Of the 37% of foreign-born direct care workers who are non-citizens, nearly half may be undocumented. The Journal also reports a shortage of direct care workers, estimating that the shortage will grow to 860,000 by 2032, and that 8.9 million positions will need to be filled over the next decade to meet the demand.

Raids by ICE have made matters worse. As the Journal noted, “Just four days after the inauguration, 25 undocumented Filipino direct care workers were arrested in an ICE raid at a senior care facility in Chicago; at least eight have been deported.” In one case, a cancer patient, living alone at home, had fallen but wasn’t found for days because “his home health aide had stopped coming to work for fear of deportation.”

Non-immigrants are unlikely to fill the void. Direct care workers “are often subject to exploitative work practices, including wage theft. The physically demanding nature of direct care work, combined with low pay and high susceptibility to exploitation, makes these roles unattractive to U.S.-born and highly skilled foreign-born workers.”

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