When the Elderly Call for Help, a ‘Chain’ Immigrant Often Answers

BURBANK, Calif. — Irma Mangayan was lathering and rinsing a 92-year-old woman in Room 413 one recent afternoon when she received a page from another room. An incontinent resident had an accident, and Mangayan would have to clean it up.

Before her shift was over at Belmont Village Senior Living, Mangayan would hoist women and men into their wheelchairs, escort residents using walkers downstairs to the dining room and perform myriad other tasks that they once could do for themselves.

Mangayan is a personal care aide, a grueling and low-paid profession that happens to be one of the country’s fastest growing. It is also increasingly filled with foreign-born, low-skilled workers like Mangayan, the kind now at the center of a national debate on immigration.

A proposal favored by a number of congressional Republicans and the Trump administration would replace the current family-preference immigration system, which critics call “chain migration,” with one that favors skilled immigrants, while reducing admissions overall. Democrats have balked at the plan, while some Republicans have insisted it be a condition of any bill that legalizes the unauthorized young adults, known as Dreamers, who could soon lose their protection against deportation. Several attempts to reach a deal have failed, and a spending bill passed Friday did not resolve the issue, leaving the fight over immigration reform for another day.

“It is time to create a merit-based immigration system that makes sense for a modern economy,” the White House said in a statement last month, “selecting new arrivals based on their ability to support themselves financially and to make positive contributions to U.S. society.”

But economists do not necessarily agree.

Those who study immigration and labor patterns have questioned the wisdom of restricting family-based immigration, a crucial source of low-skilled workers, many of whom hail from countries like Mexico and the Philippines, where Mangayan, 47, is from.

“In any plausible future scenario, the U.S. needs far more new low-skilled workers than high-skilled workers,” said Michael Clemens, an economist at the Center for Global Development, a Washington think tank, “so many that it will be impossible for native labor to fill all those jobs, even if native workers wanted to.”

A Bureau of Labor Statistics analysis notes that among the 10 occupations expected to grow fastest through 2026, only three require college degrees, all of them digital or data-focused: software developers, statisticians and mathematicians.

The two that will require the most new workers: personal care and home health aides, with 1.2 million new positions between them.

About 10,000 baby boomers turn 65 every day, and more than half will need long-term care, according to the Pew Research Center. Already, home-care agencies and elderly-care facilities are struggling to recruit.

“If one of our aides is sick or has an emergency, it’s very difficult to find a backup,” said Kevin Smith, president of Best of Care in the Boston area, who taps into the large Haitian and Brazilian communities in Massachusetts.

In 2017, 26 percent of personal care aides and home health aides were foreign born, a high, according to an analysis of official data by Brian Schaitkin, a senior economist at the Conference Board. In New York, 62 percent of home aides were foreign born. In California, Massachusetts and New Jersey, foreigners represented nearly half of them.

Lupe Mercado, a Mexican immigrant who works for an agency called 24Hr HomeCare in Los Angeles, has endeared herself to clients with dementia who initially cursed and flung food at her. One of them recently died holding her hand, Mercado noted, brandishing a picture of the woman on her cellphone.

On a recent afternoon, she doted on Olive Tanaka, 92. “I’m spoiled by her,” said Tanaka, a line dancer in her day who is now widowed, blind in one eye and needs round-the-clock care since falling.

Having entered the United States without authorization, Mercado benefited from a 1986 amnesty law signed by President Ronald Reagan, obtaining a green card and eventually becoming a citizen.

“It doesn’t pay so much, but I love my job,” said Mercado, who earns $12 an hour and supplements her pay by taking private clients on her days off.

Proponents of restricting immigration say the low wages in her field — and in other workplaces where immigrants have a foothold, like construction, farms, and restaurant kitchens — are a prime reason immigrants have begun to supplant U.S. workers in the jobs. Some of those other professions, too, face worker shortages. A survey in September by the Associated General Contractors of America found that 70 percent of construction firms had difficulty finding bricklayers, roofers and electricians, among others. Last August, the restaurant and accommodation sector had 742,000 vacancies, a historic high, according to the Bureau of Labor Statistics.

Stemming the flow of low-skilled immigrants could pressure employers to raise wages, compelling many Americans, including millions who are chronically unemployed, to go back to work. “It may draw all these people, or some fraction of these people, into the labor force,” said Steven Camarota, research director of the Center for Immigration Studies, which supports curbs on immigration.

Indeed, more people, but not enough, would do blue-collar work they now shun if wages were higher, said Chris Tilly, a labor economist at UCLA.

“Wage is not the main issue,” he said. “There are also expectations and status. Not everybody wants to work with their hands touching people; not everybody will do dirty work.” Supporters of an immigration overhaul cite other reasons the country should be choosier about whom it lets in. The Trump administration has also framed it as a national security issue, noting several cases in which terror suspects came to the United States through family connections. Immigrants are also more likely to use welfare programs than native-born Americans, owing largely to their comparatively low skill levels upon arrival, the Center for Immigration Studies says, citing Census Bureau data.

Under a House bill introduced by Rep. Bob Goodlatte, R-Va., and supported by the White House, citizens and permanent residents, or green card holders, could continue to bring spouses and children younger than 18 into the United States. But they would no longer be able to sponsor parents, adult children, siblings, nephews and nieces.

The bill would also create a point system for admission based on factors including education, English skills and job offers in the United States, and it would cut the overall number of green cards awarded each year by half, to 500,000.

Employers who rely on immigrant labor are anxious about what will happen in Washington. Senior-care agencies in particular are worried because many are dependent on Medicaid and Medicare and so cannot, they say, easily raise wages to make their jobs more attractive to native-born workers.

If Congress makes it harder for relatives to immigrate, “Where are all these workers going to come from?” asked Patricia Will, founder of Belmont Village, a Houston-based network of upscale facilities that employs 4,000 people in several states. Mangayan, who makes $29,000 a year plus benefits at Belmont Village in Burbank, came to the United States in 1997 after marrying a U.S. citizen, and she is now a citizen herself. She would have been able to immigrate under the proposed rules, though many of her co-workers would not.

Mangayan and her husband, a customer-service representative at the airport, earn enough to afford a $1,200-a-month two-bedroom apartment, their 23-year-old son’s college tuition and occasional travel to the Philippines. Mangayan cuts hair on the side to make extra money.

Mangayan, who also has a 14-year-old daughter, said that one day, “I would like to have at least a condo.”

Not long after arriving for her 3 p.m. to 11 p.m. shift one recent afternoon, she was already darting from room to room.

In Room 411, she improvised sign language to communicate with Bernard Bragg, an 89-year-old who achieved fame decades ago as a deaf-mute actor.

Bragg, asked what he thought of Mangayan, pointed to her, placed his hands over his heart and smiled lovingly. He then flapped his arms to suggest she was an angel.

Velma Vincent, in Room 406, credited Mangayan with restoring her will to live and ability to walk after her husband died.

“I was a goner,” recalled Vincent, 88, who was resplendent in a bright-red blouse and white slacks with matching red necklace, earrings and nail polish. “Irma came in and encouraged me.”

Mangayan had coaxed Vincent to get out of her wheelchair, practice baby steps down the hall, going farther and farther each time. Soon, Vincent was mobile — and independent — with her walker, playing blackjack and Bingo, attending church and visiting Belmont Village’s beauty salon.

“My family will be forever grateful,” said her son, Bob Vincent, “that Irma emigrated from the Philippines to the United States, giving my mom a quality of life that she would not enjoy were it not for Irma.”