Immigration crackdown threatens Haitian caregivers and the seniors who rely on them

NEW YORK — Who will be there each morning with Solange French’s eggs at breakfast, and who will be ready with soup or fish at lunch? When the 91-year-old needs help in the shower, who will rush to her side, and when it’s time for a doctor’s appointment, who will take her? Who will do the laundry or buy the groceries or clean the house?

Until now, the answer has been a doting home health aide from Haiti named Martha Nelson. But with the Supreme Court sanctioning a White House immigration crackdown, Nelson’s permission to stay in the country appears likely to be yanked within days, leaving French worried.

“She’s with me all the time,” says French. “Life would be impossible.”

As the Trump administration unwinds years of protections for hundreds of thousands of people from Haiti, twin populations of vulnerable people find themselves in the crosshairs: caregivers in jobs to which those immigrants have flocked, and the older adults and disabled people who rely on them.

Around the U.S., care homes and home health agencies are bracing for the loss of workers with TPS, which stands for temporary protected status, even as they continue to reel from other immigration policy changes that have squeezed an already short-staffed industry.

For businesses, it is a predicament that could hurt bottom lines and tax remaining workers. For their clients, it threatens to upend every aspect of their lives.

“They have become like family,” says Katy Sanchez, who lives in a group home for disabled people in Nanuet, New York, run by The Arc Rockland, which stands to lose 19 caregivers with TPS, on top of 20 others it lost in immigration changes last year. “If they are forced to leave, it would be devastating.”

The Supreme Court sided with the Trump administration last month, saying it could end temporary protected status. The ruling specifically pertained to 350,000 Haitians and 6,000 Syrians, but immigration advocates and legal observers say it could be applied to a broader group of 1.3 million people from 17 countries.

The justices’ move has been met with weeks of confusion. Immigration officials subsequently granted several extensions to TPS holders that carried through Monday. U.S. Citizenship and Immigration Services issued guidance Wednesday affirming TPS was over, though some attorneys and labor unions have argued work authorization remains intact until lower courts lift an injunction.

The Department of Homeland Security made light of the TPS expiration, referencing lyrics from a 1998 hit song: “It’s closing time, which means you don’t have to go home, but you can’t stay here.”

Fearful they might be in breach of the law, some employers have begun terminating TPS holders, to the dismay of their clients.

Anna Fischbein grew accustomed to visits to her home in Sunny Isles, Florida, from the same kindly Haitian health aide every week for the past 10 years. But Jewish Community Services of South Florida terminated the aide along with 17 others when their TPS lapsed.

“I lost not only a lady working for me,” the 87-year-old Holocaust survivor says, her voice broken by sobs. “I lost a friend.”

Around 1 in 5 workers in the U.S. is foreign born, according to the Bureau of Labor Statistics, but immigrants are overrepresented in caregiving roles. Among home health aides, for example, one-third are immigrants, according to PHI, a nonprofit focused on the caregiving workforce.

In lives upended by age or disability, a cherished caregiver is a lifeline. For someone living in their own home, they may be the last line of defense before institutionalization. For those in a care facility, they may be their strongest advocate, who notices subtle changes before anyone else, ensures small comforts like dollar-store word search books, and brings a sense of humanity to the humiliation of being incontinent.

“They are the first people they see when they wake up in the morning and they’re the last ones that they see before they go to bed,” says Simone Smith, vice president of human resources at Cabrini of Westchester, a nursing home in Dobbs Ferry, New York, where eight Haitians with TPS await word of their fate.

Like similar facilities around the country, Cabrini is prepared to scramble to secure replacement staffers from nursing agencies and plead with remaining workers to take overtime shifts. Cabrini’s workforce is about 75% immigrant. Among those with TPS, Smith senses “almost a hopelessness.”

A Haitian who loses TPS faces an unbearable choice: Attempt to stay in the U.S. and find underground work, tiptoeing through life with fear that authorities will eventually find and remove them. Or return to a country so plagued by gang violence and poverty that many believe it would amount to a death sentence.

“I’m afraid all the time,” says a Haitian man working at a Brooklyn nursing home who asked for anonymity because of concerns for the safety of himself and his family. “I pay tax to the country. I’m a good person. … All I want is to work. When you work, you are a person.”

Outside a simple brick house in Queens, Nelson stands guard as French steps through her door. On the porch, you might mistake the two for old friends, their bond as much an illustration of what is at risk as it is of how much things have changed.

The women made the same journey, from Port-au-Prince to New York, four decades apart.

French was drawn here in 1970 by the potential opportunities she saw. She built businesses as a hairdresser and seamstress. Her late husband made his way as an electrician and contractor. They bought their home. Their children got good educations. They believed they achieved the American dream.

Nelson came after an earthquake flattened Haiti in 2010. At home, she ran a butcher shop, but after arriving in New York she found work in caregiving roles. She began working for French about three years ago after French fell and broke her hip. Nelson, now 69, has been with her nearly every weekday since.

Both women felt welcomed by the U.S. when they arrived. But French is saddened to see how views on immigrants have evolved.

“America is a good country,” French says, “but it has changed.”

Nelson brings leftovers, tends to French’s chores and is a source of companionship. They watch the news together and talk in Haitian Creole about their families. On weekends, Nelson calls to make sure French has gotten up from bed and nags her to eat.

“On my days off, I think about her,” Nelson says.

French says Nelson has become like family. Nelson agrees, saying she sees French as if she’s her own mother, a show of affection and the source of the pair’s one ongoing dispute.

“You’re not like my daughter,” French protests. “You’re like my sister.”

For now, the two continue their routine, knowing each shift may be Nelson’s last. She keeps a copy of her work authorization zipped in a black cloth pouch that she carries everywhere, in case she is stopped. Each Sunday, she sinks to her knees in church, praying for an answer. She worries for herself and for French.

“It makes me feel depressed,” Nelson says. “It could be difficult for her without me.”

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Salomon reported from Miami.

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Matt Sedensky can be reached at msedensky@ap.org and https://x.com/sedensky