Immigration and the Elderly: Foreign-Born Workers in Long-Term Care

Aging populations and the growing need to provide long-term care to the elderly are among the leading demographic, political, and social challenges facing industrialized countries, including the United States. As of 2004, 34.7 million people in this country had lived to their 65th birthday or beyond, accounting for about 12 percent of the U.S. population. Nearly 90 percent of the elderly population is native-born. By 2030, the number of older people in the United States is likely to double, reaching 72 million—or nearly one out of every five people. The aging of larger numbers of Americans will require significant increases in financial and human resources for healthcare support and other social services. As a result, immigrants will continue to play a significant role in the growth of the U.S. labor force in general and of the direct-care workforce in particular. It is in the best interests of long-term care clients, providers, and workers if governments and private donors foster high-quality training and placement programs rather than leaving the future of the direct-care industry to chance.

Among the findings of this report:

• The 65+ share of the population grew from 4.1 percent in 1900 to 8.1 percent in 1950 to 12.4 percent in 2000, and is projected to reach 19.6 percent by 2030. In absolute terms, the 65+ population is projected to increase from 35.0 million in 2000 to 71.5 million in 2030.
• In 2000, 4.6 million elders, or 4.5 percent of the 65+ population, resided in nursing homes. The group that is most likely to require formal care—those age 85 and over—is projected to increase from 4.7 million in 2003 to 9.6 million in 2030 to 20.9 million in 2050.
• The Bureau of Labor Statistics projects that the long-term care workforce will grow from 2.8 million to 3.7 million workers between 2004 and 2014—an increase of 34.7 percent. This is nearly three times higher than the projected growth rate of the U.S. labor force as a whole. After large numbers of baby boomers start to turn 85 around 2030, employment of direct-care workers will grow to about 6 million in 2050.
• In 2005, there were 2.5 million direct-care workers age 18 and above in the U.S. labor force, accounting for almost 2 percent of all employed persons. Three quarters worked in nursing, psychiatric, and home-health jobs. One in five was born abroad. Nearly nine in ten were women.
• U.S. immigration law provides virtually no opportunities for foreign paraprofessionals to work in the United States on a temporary basis or to come here as permanent immigrants. There are no temporary visas designed for direct-care workers and the number of immigrant visas available for all less-skilled workers is capped at only 5,000 per year.