Want to stay out of a nursing home? Live in places with immigrants

Seniors in the US are much more likely to live independently and avoid a nursing home if there are more immigrants in an area, a study has found. The findings are important in light of the aging US population and the ongoing debate over immigration policy.

“Given that older adults report that they would prefer to avoid living in institutionalized settings, it is important to understand what might help them realize their preferences,” write economists Kristin F. Butcher (Wellesley College), Kelsey Moran (MIT) and Tara Watson. (Williams College) in research published by the National Bureau of Economic Research (NBER). “This study suggests that the supply of a less educated immigrant labor force affects care arrangements and allows more older Americans to age in the community.”

The study found that a 10-percentage-point increase in the population of less-educated immigrants in an area reduces the likelihood that someone age 65 and older will live in a nursing home or other institutional setting by 29 percent. For a person aged 80 and over, a 10 percentage point increase in the less educated immigrant population in an area reduces the probability of institutionalization by 26%.

Caring for an aging US population will become more difficult in the coming years. “Currently, 16.5% of the US population of 328 million people, or 54 million, are over the age of 65, according to the latest census,” Reuters reports, citing US government statistics. “By 2030, this number will increase to 74 million. The number of people over 85, who generally need the most care, is growing even faster.”

Americans with older parents or people who expect to reach seniority soon enough already face a dilemma. People’s preferred setting to receive care is a person’s home. Elected officials in other countries have taken steps to address the challenge.

Canada leads the United States in using immigration to care for its aging population, providing temporary work permits for foreign-born caregivers with a direct path to permanent residency in Canada (ie, the equivalent of a green card in the United States ).

“The federal government is implementing a designated and recently revamped Caregiver Program aimed at helping seniors as well as providing support for childcare,” according to Toronto-based immigration lawyer Peter Rekai. “It selects applicants (along with their immediate families) initially as temporary workers, but with a clear path to permanent residence.”

Canadian provinces can also choose to “nominate” caregivers for permanent residence as part of their annual immigrant allocation. Rekai anticipates a recent reclassification of Personal Support Workers, who can work in hospitals and long-term care homes, as “skilled” workers, giving them access to the much larger pool of skilled permanent resident applicants eligible for the federal government’s Express Entry program . This will facilitate the entry of educated and experienced health workers, an important issue as Canada faces similar demographic pressures.

Many Cubans, Venezuelans, and Nicaraguans now coming to the U.S. border could be young workers entering the United States legally to help provide care for the elderly—if the U.S. immigration system allowed that option. In addition, these workers will likely adapt their skills to future labor market needs. Canada’s experience is that many foreign workers admitted under previous iterations of Canada’s Caregiver program came from the Caribbean, the Philippines and elsewhere, initially to provide home care for the elderly and children, but returned to school and eventually , as Canadian citizens, filled tens of thousands of positions in Canada’s hospitals and long-term care homes, Rekai said.

Surveys show that younger Americans are generally more welcoming of immigrants than older Americans. This is ironic because older Americans are the most likely to benefit from greater immigration.

“Migrants currently play a disproportionate role in care and household services, particularly in roles that can be critical complements to aging in place,” note Butcher, Moran and Watson. If the average American would rather live at home as they age than in a nursing home, America should welcome more immigrants and refugees.

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