Immigration Enforcement Threatens Home Health Aides, Stranding Vulnerable Seniors

Solange French, 91, faces an uncertain future as her live-in home health aide from Haiti confronts potential deportation following a Supreme Court decision that cleared the way for the Trump administration to terminate temporary protected status for hundreds of thousands of immigrants. Martha Nelson, who has provided essential daily care for French—from preparing meals to assisting with showers and medical appointments—may be forced to leave the country within days, leaving the elderly woman apprehensive about managing alone.

The Supreme Court ruling last month upheld the administration’s authority to end TPS for approximately 350,000 Haitians and 6,000 Syrians, with legal experts cautioning that the decision could eventually affect 1.3 million people from 17 countries. The outcome has created significant disruption across the caregiving sector, as facilities and home health agencies brace for the loss of workers while grappling with an already depleted workforce.

Care facilities nationwide are preparing contingency plans as TPS expirations take effect. The Arc Rockland, a group home for disabled individuals in Nanuet, New York, stands to lose 19 caregivers with TPS status on top of 20 workers lost to previous immigration policy shifts. Cabrini of Westchester, a nursing home in Dobbs Ferry, New York, employs eight Haitians whose status remains uncertain, while the facility’s overall workforce comprises approximately 75 percent immigrant workers.

Immigrants comprise roughly one in five workers across the U.S. labor force and are disproportionately represented in caregiving roles, with one-third of home health aides being foreign-born, according to PHI, a nonprofit focused on the caregiving workforce. The potential departure of these workers could significantly strain an already understaffed industry and force remaining employees to absorb additional shifts.

Jewish Community Services of South Florida terminated 18 caregivers when their TPS lapsed, prompting Anna Fischbein, an 87-year-old Holocaust survivor who had relied on the same Haitian aide for a decade, to describe the loss as deeply personal. “I lost not only a lady working for me,” she said, “I lost a friend.”

Haitian immigrants facing TPS expiration confront an untenable situation: remaining in the country illegally and working underground while fearing detection and removal, or returning to Haiti amid widespread gang violence and economic hardship. One Brooklyn nursing home employee, speaking anonymously out of safety concerns, expressed the emotional toll of the uncertainty while emphasizing his commitment to lawful employment and tax obligations.

Nelson and French’s relationship exemplifies the deep bonds forged between caregivers and clients. Both emigrated from Port-au-Prince to New York decades apart—French in 1970 to pursue business opportunities and Nelson in 2010 following the devastating earthquake. Nelson began caring for French nearly three years ago after the elderly woman suffered a hip fracture, becoming not merely an employee but an integral part of her daily routine and emotional support system.

French expressed concern about how American attitudes toward immigrants have shifted over her five decades in the country. Nelson, now 69, carries her work authorization document in a black cloth pouch at all times and prays weekly at church for resolution. She worries intensely about both her own fate and the well-being of the woman who has become like family to her, acknowledging that French’s independence would be severely compromised without her presence.