Refugees in Tempe are learning to be caregivers. More immigrants could help the shortage
Download mp3 (6.59 MB)
Shantelle Harker is a registered nurse and clinical educator at Tempe Post Acute, a skilled nursing facility in Tempe, Arizona.
“So when we’re done with this, we’re going to do handwashing today. Anyone watch the handwashing video from last night?” she asks her class.
On this day, she’s teaching a group of refugees who are part of AHCA Works. An eight-week program that trains individuals to become certified nursing assistants or CNAs. CNAs are on the frontlines of long-term care in this state.
It’s tough work — both physically and emotionally.
“Finding those people who are willing to be nursing assistants and to ask them to do some of the most invasive things with patients of cleaning you, bathing you, feeding you,” Harker said. “It does take a very special person to do that.”
Like 22-year-old Chingeneye Nyilabageni.
“My motherland is Congo,” she said. “But we immigrated to Uganda, and from Uganda to America.”
That was seven months ago. Now, she’s here at Tempe Post Acute, along with her two older sisters.
For Nyilabageni, this training is a foot in the door. “My goal is to graduate and help people with disabilities. And after, I [want to] go into medicine and to become a nurse.”
Doing a job many Americans don’t want
David Voepel is the CEO of the Arizona Health Care Association, which created AHCA Works in 2022 and has since partnered with organizations like Arizona State University and the Arizona Refugee Resettlement Program.
“A lot of folks in the United States don’t necessarily want that kind of job,” he explained.
So welcoming a workforce from other countries is “a demographic reality.”
“It’s similar to what we find in the agricultural sector where we don't have a lot of folks in the U.S.; U.S.-born folks that don't want to take those jobs, which is fine, because we have, we need the immigrant side of things to help fill those in,” he said.
There are a lot of migrants who, like Nyilabageni, would like training for health care jobs. But only a relative handful are legally allowed to work. Some refugees are, but not the vast majority of people who enter the U.S. illegally.
Robert Espinoza would like to see that change. He’s the CEO of the National Skills Coalition, a bipartisan organization that advocates for skills training for America’s workforce.
“And so I think offering a pathway to citizenship for undocumented workers who are already here, and I think would welcome the opportunity to support a sector that needs them would be one major intervention,” he said.
In 2023, Espinoza authored a study about the role of immigrants in the caregiving workforce. He estimated that, at the time, the long-term care sector would need to fill 9.3 million job openings by 2031.
“Another opportunity is for the U.S. Department of State to create a special caregiver visa for direct care workers,” Espinoza said.
Politics versus problem solving
Ideas like Espinoza’s are unlikely to gain traction in an election year, especially when Southern border crossings are still a concern for many Americans and expanding the border wall with Mexico is a popular idea.
“We’re trying to break the wall down,” said Voepel. “We want people to come in here and to help because they're the ones that have the know-how to do it because they are very family oriented.”
In 2030, all of America’s baby boomer generation will be 65 or older. If the country can’t start filling hundreds of thousands of long-term care jobs nationwide, the responsibility for elder care will likely fall on family members. And research shows that it can have a massive impact on people’s ability to earn a living, especially for women.
