Immigrants make up a significant share of the long-term care workforce. Areas with higher immigration flow have had more adequate staffing and care outcomes in nursing homes, according to a new study.
In U.S. nursing facilities, naturalized citizens and noncitizen immigrants account for over one in five workers and nearly one-in-three home care workers, a KFF Health News analysis found. Those rates increased from 2018-2023.
Delia Furtado is a University of Connecticut professor of economics, and co-authored the study, which appeared this January in the “Journal of Human Resources.”
Furtado and her co-author Francesc Ortega used U.S. Census and American Community Survey data, along with nursing home outcome information from LTCFocus from 2000 to 2010.
The study compared labor markets with large inflows of immigrants to those with fewer immigrants in that same period, and analyzed the quality of care in the nursing homes in those areas.
Furtado said they examined several measures of well-being, such as fewer falls. Researchers found areas with more immigrant workers saw residents falling 5% less frequently. She said residents needing bathroom help can get hurt if there aren’t enough workers, “then they'll wait, and they'll wait, and they have to go, so they might get up, and that's often when falls happen,” Furtado said.
The study also found a 16% decrease in the number of residents with pressure ulcers. Furtado said residents who are laying down could develop bedsores if their positioning is not changed enough.
There were also 34% fewer residents that had to be physically restrained to keep them safe, in cases such as residents who developed agitation.
“So one way to address this, if you have enough workers, is to have someone sit there with the person who is agitated and calm them down with words with company,” Furtado said.
While the data is not recent, Furtado said it’s important to consider when thinking about future staffing in care settings.
“The U.S. population is aging,” she said. “It is not a choice, it is an issue that we are going to have to deal with.”
She said one solution to labor shortages in nursing homes is to create more work visa opportunities for immigrant workers that include caregiving roles.
“There are special visas for agricultural work. There are special visas for seasonal work,” Furtado said. “We don't have special visas for work in the elder care sector or in general sectors with staffing shortages, and so maybe these types of pieces would be something to think about.”
