This story originally appeared in the California Health Report.
For the past five years, Mida has provided in-home care for a Los Angeles woman, who’s now 89.
Mida, whose last name is being withheld because of her concerns about her safety, grew up in Mexico and has lived in Los Angeles for 27 years. Now 56, she is a naturalized citizen, which legally means she has the same rights and protections as someone born in the United States.
But the recent changes in immigration policy and accompanying U.S. Immigration and Customs Enforcement raids in Los Angeles and across the country have made her worry about her safety.
“I fear I will be a target,” Mida said, speaking in Spanish and adding that she’s “scared about the ICE raids, because of my appearance alone. People are singled out and aren’t separated (by legal status).”
“I am very happy with my work, but with what is happening with immigration, it is very difficult.”
The ICE actions threaten the stability of the current and future caregiver workforce, affecting those who are undocumented, as well as nearly 500,000 workers with legal status. On Feb. 26, 109 organizations sent a letter to Congress calling for reining in ICE actions due to the harm to older adults, people with disabilities and their caregivers.
“We are losing our most valuable asset in California: our workforce,” said Luz Gallegos, founder and executive director of TODEC, or Training Occupational Development Educating Communities, a nonprofit organization that supports immigrants in California’s Inland Empire and Imperial County. “If we don’t have a strong, healthy and present immigrant workforce, we don’t have a strong and healthy economy.”
An already-strained caregiver workforce
Nationwide, about 820,000, or nearly 28 percent, of long-term caregivers for older adults are immigrants, according to a 2023 report from the Kaiser Family Foundation. This includes workers who provide care in nursing homes, assisted living facilities and people’s homes, helping with medications, housekeeping and personal hygiene. These support services allow older adults to remain in their homes and are generally more economical than institutional care. Researchers have found that in communities with more immigrants, U.S.-born seniors are more likely to stay in their homes, due to help from immigrants who work as home aides and other service jobs, often for low wages.
The current workforce does not meet the demand for caregivers in California. In 2025, more than 100,000 older adults lived in nursing homes and about the same number resided in assisted living facilities — and there were thousands of job openings.
Meanwhile, the gap between the number of caregivers and the rising aging population is expected to widen. By 2030, a quarter of Californians or more than 10 million people will be 60 and older, and a third of the older adults are expected to need assistance with in-home health or personal care.
Susan Eisenberg, communications officer for the California Department of Aging, said the agency has not received reports of nursing home staffing issues related to immigration. The agency is addressing the unmet and future demand for caregivers, as outlined in the state’s Master Plan for Aging.
But, Mida, the U.S. citizen caregiver, said she and other immigrant caregivers she knows are concerned and are being cautious when going outside for their clients’ errands and doctor appointments.
Caring for the elderly can be stressful due to the intense responsibility and the emotional and physical demands. Many positions offer low wages, often without benefits, and have a high burnout rate, all of which contribute to the workforce insufficiency.
In addition, in December 2025 President Donald Trump repealed the 2024 minimum staffing requirements for nursing homes, which had required about 3 and a half hours of care per resident and 24-hour coverage by a registered nurse. This was supposed to help in cases of short staffing, but resident advocates feared it could jeopardize resident safety due to greater staff burdens
Senator Ron Wyden (D- OR), member of the Senate Finance Committee, criticized the repeal. In a February committee hearing, he said, “It’s time to guarantee residents in nursing homes receive the quality of care they deserve and to lift the strain off long-term care workers reaching the breaking point.”
Impact of immigration raids
In California, ICE activities are tracked by community-based rapid response networks, such as the California Collaborative for Immigrant Justice. ICE patrols are also tracked by immigrant rights groups, other community-based organizations and local news outlets, such as L.A. Taco and GV Wire, who often alerting their communities via social media.
At least 8,250 people in California were detained by ICE in the first nine months of 2025, and more than 70,700 people nationwide were detained in the year ending January 25, 2026, according to Trac Immigration, an independent research center based at Syracuse University.
Despite the U.S. Department of Homeland Security’s claim that they are going after the “worst of the worst of criminal illegal aliens,” nearly 75 percent of Latino ICE detainees last year had no criminal record, according to a report from the UCLA Luskin School of Public Affairs. Many people were apprehended by ICE at job sites, such as manufacturing plants, meat processing facilities, farms and constructions zones.
Health care sites, including long-term care facilities were removed the list of “protected areas” from ICE raids in January 2025. ICE detentions have occurred at health care facilities in California. CalMatters reported that the presence of ICE agents causes distress for health care workers because of the conflict between complying with law enforcement and the desire to protect their patients, as well as their own safety.
“Everybody’s fearing for their safety,” Gallegos said. “In our region, we’re used to Border Patrol, but not so intentional to just stop anybody because they’re brown.”
ICE activity increased by nearly 1,500 percent in San Diego and Imperial Counties from May to October 2025, compared to the previous year, according to an analysis by CalMatters.
Gallegos said that for the immigrant community, the ICE raids are as devastating and fear-inducing as the COVID-19 pandemic, wildfires and other natural disasters.
“(Workers) are kidnapped and deported or leaving on their own because they don’t want to live with this trauma, in fear, being caged up in their homes, (worrying) if they’ll see their kids again,” she said.
TODEC provides free Know Your Rights cards, called “Red Cards,” developed by the Immigrant Legal Resource Center, which lists an individual’s Constitutional rights.
Another threat to caregivers — Medicaid cuts
Additional threats to the caregiver workforce, and the clients that care for, include the nearly $30 billion annual funding cuts to Medi-Cal, California’s version of Medicaid, included in H.R. 1 or the “One Big Beautiful Bill Act”. Medi-Cal pays for 6 of 10 nursing home residents, and for services, such as in-home care, that are not covered by Medicare.
Previously, as a result of Medicaid cuts in 2017, some nursing homes closed, and others reduced staffing. Understaffing increases the likelihood that patients will experience falls, medication errors or neglect. Overburdened staff spend less time with each patient, leading to less companionship and resident familiarity. Loneliness is a major contributor to poor health, including cognitive decline, for the elderly.
But Mida and Gallegos from TODEC are holding on to hope.
Gallegos said Her organization is pushing for immigration reform and a path to citizenship for immigrants, not unlike the amnesty given with the Immigration Reform and Control Act in 1986, during President Ronald Reagan’s administration.
“In a world (where) there’s hate, there is more love than hate,” Gallegos said, “It brings hope that some many people from different paths are stepping up to help our community.”
The California Health Report reports on communities across the state about health equity issues.
