Many Haitians may soon not be able to work in the US. That will make caring for the elderly much harder

Colin O’Leary recently had the toughest day of his career.

The executive director at Laurel Ridge Rehabilitation & Skilled Care Center, O’Leary had to tell 13 of his top staffers — all Haitians with Temporary Protected Status, known as TPS — they were losing their jobs. That’s because the Trump administration is terminating the protection for Haitian TPS holders after February 3 as part of its broader immigration crackdown.

Replacing the employees, who care for roughly 115 residents at the Boston center, will take time. They include hard-to-find, experienced certified nursing assistants and dietary aides who know their charges’ needs and habits – who likes their chicken mixed with mashed potatoes while being fed, who needs extra help getting out of bed and who might be breathing a little more heavily, a potential sign of a health problem.

Like O’Leary, elder care industry leaders nationwide are bracing for the loss of a key pillar of their workforce. Nearly 350,000 Haitians are set to lose their TPS this week, and a sizeable share of them care for older Americans. They work as nursing assistants, dietary aides, cooks, maintenance workers and other staffers in nursing homes, rehab centers and assisted living facilities. They also help senior citizens as aides in their homes.

The looming departures add pressure to an industry already contending with 350,000 open positions — a shortfall that’s expected to grow in coming years as the nation ages.

Overall, immigrants make up more than a quarter of workers who provide direct care in long-term care settings, according to KFF, a health policy research group. Notably, they make up nearly one-third of those who work in home care.

The curtailment of immigration is “really creating problems for a sector that is already challenged from a workforce perspective,” said Katie Smith Sloan, CEO of LeadingAge, an association of nonprofit providers of aging services.

Some of her members already have to rely on costly temporary workers from agencies, while others turn prospective clients away because of a lack of staff to provide quality care.

In Boston, the local elder care industry is suffering from a severe staffing crunch, which is only expected to get worse. The city has one of the largest Haitian communities in the US.

O’Leary’s tight budget makes it difficult to raise wages to compete for new hires or turn to a staffing agency. Meanwhile, he’ll have to lean on his remaining employees to work a lot of overtime as he rebuilds the team, which he fears could take years.

But that wasn’t his main concern.

“I felt like I was letting them down as a leader,” he said of his Haitian employees.

Haitian TPS holders are among the latest foreign-born residents whose lives are being upended by the Trump administration, which is focused on slashing the number of immigrants entering and living in the US.

The Department of Homeland Security announced the termination of TPS designation for immigrants from multiple countries, including Honduras, Nepal and South Sudan, though federal judges have stymied many of those efforts. Many Haitian TPS holders are hoping that a federal judge in the District of Columbia will grant them at least a temporary reprieve.

TPS relief applies to people who would face extreme hardship if forced to return to homelands devastated by armed conflict or natural disasters. The recipients are vetted and are not eligible if they’ve been convicted of any felony or two or more misdemeanors in the US. The DHS secretary has discretion to designate a country for TPS.

Haitian immigrants became eligible after an earthquake rocked the country in 2010. The designation has since been renewed multiple times as the country faces a host of crises, including widespread violence by armed gangs, food insecurity, displacement and a leadership vacuum after the president was assassinated in 2021.

Several Haitians have sued DHS, arguing the department didn’t conduct the necessary review of whether it’s safe to return. The suit also alleged that the protection is being terminated, in part, because of President Donald Trump’s “racial, ethnic, and national-origin animus towards Haitians.”

Asked for comment, DHS said that the Haiti’s TPS program “was never intended to be a de facto asylum program, yet that’s how previous administrations have used it for decades.”

“The assertion that the only way we can take care of our seniors is by allowing unvetted illegal aliens and foreigners with criminal records to remain in the country is grossly false and lazy,” DHS spokesperson Tricia McLaughlin said in a statement.

One TPS holder who cares for a senior citizen in New York told CNN that her heart pounds when she thinks she might have to go back to Haiti, which she fled in 2023. She’s afraid of being killed if she returns, but she also doesn’t know how she’ll be able to survive in the US if she can’t work.

“There are a lot of insecurities in Haiti, and then there’s a lot of gang violence that continues to go up,” she said in Haitian Creole through a translator.

Meanwhile, she also worries about what will happen to the elderly woman with whom she has developed a connection after caring for her for nearly two years.

“She appreciates the help I provide to her,” said the caretaker, who asked that CNN not use her name for fear of reprisal from the federal government. In turn, she is proud that the woman trusts her.

Many home care agencies are having difficult conversations with clients and their families, informing them that their caregivers will no longer be able to provide services, said Katia Guillaume, a vice president at Service Employees International Union Local 1199, which represents about 150,000 home care workers in three states.

“When you are providing care so intimate as feeding and bathing, you develop a bond with someone,” Guillaume said. “To know that that person is no longer going to be here – when this person is sometimes the only person they see – it’s really hard for the patients. It’s hard for the caregivers. It’s hard for the employers.”

Goodwin Living, which provides senior living and health care services to 4,000 older adults in the Washington, DC area, lost four workers from Haiti last summer when the Trump administration terminated their humanitarian parole.

It took about six months to replace one of the cooks, said Rob Liebreich, CEO of the faith-based nonprofit organization.

Soon, Liebreich expects to part with four more workers – including another cook – from El Salvador, whose TPS will expire in coming months. He fears those staffers will be even more difficult to replace since finding the right people is becoming ever more challenging.

Already, Goodwin Living can’t meet the demand for home hospice and home health services because it can’t find enough workers. Now it’s considering whether to build more independent living rather than assisted living units that require clinical staff.

“It’s making us think about what kind of services should we offer, what limitations are going to be in front of us in terms of staffing that may limit our ability to provide services,” he said. “And that’s not what we should be thinking about.”