Aging in America News

Japan and New Zealand Show How It’s Done

Allison Cook

What if we woke up tomorrow and one-quarter of the direct care workforce, including home care workers and nursing home workers, had left their jobs?

Family caregivers would have to leave or cut back their own work in to care for loved ones. The remaining workers would have even more unmanageable workloads—causing many more to leave the workforce. And older adults and people with disabilities would be left in homes or facilities without the care they need—increasing acute care costs and decreasing quality of life.

This is a potential reality with many of the immigration changes proposed by the Trump administration. According to PHI, an organization recognized for its expertise on the direct care workforce, more than 1 in 4 of the over 5 million direct care workers are foreign-born. Furthermore, as emphasized in a New York Times article, “Countless others take part in the vast gray market, potentially worth billions of dollars, employed by families who hire in-home aides, many of them undocumented, by word of mouth or online.”

Meanwhile, we already struggle to fill these jobs. Despite the workforce shortage, home care workers are already the largest occupation in the U.S. And there will be nearly a million new job openings to fill in the next decade. As our population ages, we have a lower percentage of the population available to do this work just as the demand is increasing. The only way to meet these needs is to look outside of our current labor pool.

Other countries have come to the same conclusion. For example, Japan—which has nearly 30% of its population over the age of 65—has a visa process specifically for nurses and care workers. New Zealand has a visa that allows for indefinite residency for those who are working in the care sector, including the direct care workforce.

The Bipartisan Policy Center and PHI have recommended that the U.S. develop its own care visa process. Instead, the Trump administration has sought to cut the number of immigrants, with proposed changes ranging from “the largest domestic deportation in history” to barring new immigrants to eliminating birthright citizenship. “There are hundreds of thousands of people in the U.S. with work authorization—individuals with TPS [Temporary Protected Status], DACA [Deferred Action for Childhood Arrivals; aka Dreamers], parole, or pending asylum cases. They’re following the rules, working, and contributing. But the current administration’s priorities are clear, that these workers are no longer welcome here,” shared Leslie Ditrani in a Q&A with Aging in America News. These immigration changes would weaken an already struggling sector.

In short, the data, experts, advocates, and the international community all agree—we should be expanding rather than cutting the number of immigrants coming to the U.S. to work in the care sector. If we don’t, we’ll all feel the disastrous impacts.

Allison Cook is the founder of Better Aging and Policy Consulting.