The US desperately needs more direct care workers to provide personal assistance to frail older adults and younger people with disabilities. Many native-born Americans were unwilling to do this work even before the Covid-19 pandemic. Now, shortages are far worse. Yet, the US continues to bar entry to those who are willing and able to care for frail older adults and people with disabilities—immigrants.
This week, I participated in a fascinating Brookings Institution panel discussion on immigrants and caregiving. Some panelists were immigration experts, two of us came from the long-term care world. Yet our conclusion was unanimous: Without a substantial increase in immigrant care workers, the shortage of people available to provide personal assistance will not abate anytime soon.
Yet, even as President Biden slowly unwinds some of the Trump Administration’s highly restrictive immigration rules, many curbs remain in place. Democrats are battling among themselves over how, and whether, to lesson some of these curbs. And Republicans are nearly unanimous in opposing more immigration.
Who will pay?
While largely unnoticed, the price of this political gridlock is being paid by older adults and their families. It drives up the cost of care, leaves many with no paid support at all, forces more adult children to quit their jobs or reduce their own hours of paid work, and puts even more pressure on already-struggling long-term care facilities.
The shortage of care workers in the US is simply unsustainable. It is forcing nursing homes and assisted living to turn away residents because they don’t have staff to care for them. It is driving some out of business.
Roughly 400,000 care workers left their jobs during the pandemic. And a 2021 study by the Advocacy Group PHI and the University of California San Francisco found that, as of a year ago, almost none had returned to the direct care workforce. Workers occupations were beginning to rejoin the labor force, but care workers were not returning to their old jobs.