When President Donald Trump announced plans to conduct widespread deportations of undocumented and temporarily protected immigrants living in the United States, people were quick to point out the impacts that this would have on key economic sectors that rely heavily on them, such as construction and agriculture.
However, Trump’s deportation plans put another key industry at risk: the long-term care field.
As the Baby Boomer and Millennial generations age and the birth rate drops, the United States is beginning to experience the impacts of an aging population. The U.S. Census Bureau reports that the median age in metro areas increased 0.6 years between April 2020 and July 2024, with 13% more individuals over 65 and fewer children under 18. People have been quick to point out the long-term implications this could have for programs like Social Security, but the aging population also poses challenges to the maintenance of nursing homes and retirement communities.
Immigrants have played a key role in filling these roles, representing 28% of the direct long-term care workforce. Along with foreign-born individuals who possess a green card or visa, this number also includes undocumented immigrants and those with Temporary Protected Status (TPS)—both groups that the Trump Administration has targeted.
As of 2024, an estimated 1.2 million people lived in nursing homes across the U.S., and as the population continues to age, that number is only likely to grow. This doesn’t account for individuals who receive other types of long-term care, such as assisted living. More than five million workers are involved in direct care, and this number is projected to rise. The long-term care sector is expected to be one of the largest growing industries in the United States, with the Paraprofessional Healthcare Institute anticipating nearly nine million job openings between 2022 and 2032.
However, the Trump Administration’s policies towards immigration, particularly regarding TPS holders, have not only prevented the direct care workforce from growing but have degraded it. Since April, the Department of Homeland Security has terminated TPS for hundreds of thousands of immigrants, with a majority of them from Venezuela and Haiti. While federal courts have temporarily blocked some of the proceedings, the Trump Administration’s actions have still threatened the stability of the direct care sector.
“In the aging services field, the stakes could not be higher. Workforce shortages contribute to the stark reality that the U.S. is currently struggling to meet the demand for long-term services and supports among the nation’s older population,” Katie Smith Sloan, president and CEO of LeadingAge—a service membership organization dedicated to supporting aging adults—wrote to Secretary of Homeland Security Kristi Noem in a publicly published letter. “Foreign-born workers with legal status, including parolees and TPS holders from Haiti and Venezuela, play a meaningful role in stabilizing this fragile workforce….Your agency’s decisions to terminate the temporary parole for all CHNV [Cuba, Haiti, Nicaragua, and Venezuela] individuals and roll back TPS designations for Haiti and Venezuela have created immediate uncertainty and concern for employers and workers alike.”
With caregivers often earning low wages—the hourly average was $16.72 in 2023—it can be challenging to find and retain individuals who are willing to work. Furthermore, restrictions on visas and a growing hostility towards immigrants in the U.S. have limited the number of migrants and refugees who are coming to the U.S., direct care professionals report.
As deportations continue and the aging population in direct care grows, this gap is only expected to increase, placing long-term care facilities in jeopardy of facing worker shortages that could ultimately threaten their vitality. Deportations and suspended migrant protections don’t just serve to endanger the safety and stability of immigrants who have already settled in the U.S.; they also hold the potential to limit essential care for a growing population of seniors across the country.