LOS ANGELES -- She rides three buses from her Panorama City home to her job as a caregiver for an 83-year-old Sherman Oaks woman with dementia, and lately she's been worrying about getting nabbed by federal agents.

When I asked what she'll do if she gets deported, B., who's 60 and asked me to withhold her name, paused to compose herself.

"I don't want to cry," she said, but losing her $19 hourly job would be devastating, because she sends money to the Philippines to support her family.

The world is getting grayer each day thanks to an epic demographic wave. In California, 22% of the state's residents will be 65 and older by 2040, up by 14% from 2020.

"At a time where it seems fewer and fewer of us want to work in long-term care, the need has never been greater," Harvard healthcare policy analyst David C. Grabowski told The Times' Emily Alpert Reyes in January.

So how will millions of aging Americans be able to afford care for physical and cognitive decline, especially given President Trump's big beautiful proposed cuts to Medicaid, which covers about two-thirds of nursing home residents? And who will take care of those who don't have family members who can step up?

There are no good answers at the moment. Deporting care providers might make sense if there were a plan to make the jobs more attractive to homegrown replacements, but none of us would bet a day-old doughnut on that happening.

Nationally and in California, the vast majority of workers in care facilities and private settings are citizens. But employers were already having trouble recruiting and keeping staff to do jobs that are low-paying and difficult, and now Trump administration policies could further shrink the workforce.

Earlier this year, the administration ordered an end to programs offering temporary protected status and work authorization, and the latest goal in Trump's crackdown on illegal immigration is to make 3,000 arrests daily.

"People are worried about the threat of deportation … but also about losing whatever job they have and being unable to secure other work," said Aquilina Soriano Versoza, director of the Pilipino Workers Center, who estimated that roughly half of her advocacy group's members are undocumented.

In the past, she said, employers didn't necessarily ask for work authorization documents, but that's changing. And she fears that given the political climate, some employers will "feel like they have impunity to exploit workers," many of whom are women from Southeast Asia, Africa, the Caribbean, Mexico and Latin America.

That may already be happening.

"We've seen a lot of fear, and we've seen workers who no longer want to pursue their cases" when it comes to fighting wage theft, said Yvonne Medrano, an employment rights lawyer with Bet Tzedek, a legal services nonprofit.

Medrano said the workers are worried that pursuing justice in the courts will expose them to greater risk of getting booted out of the country. In one case, she said, a worker was owed a final paycheck for a discontinued job, but the employer made a veiled threat, warning that showing up to retrieve it could be costly.

Given the hostile environment, some workers are giving up and going home.

"We've seen an increase in workers self-deporting," Medrano said.

Conditions for elder care workers were bleak enough before Trump took office. Two years ago, I met with documented and undocumented caregivers and although they're in the healthcare business, some of them didn't have health insurance for themselves.

I met with a cancer survivor and caregiver who was renting a converted garage without a kitchen. And I visited an apartment in Panorama City where Josephine Biclar, in her early 70s, was struggling with knee and shoulder injuries while still working as a caregiver.

Biclar was sharing a cramped studio with two other caregivers. They used room dividers to carve their space into sleeping quarters. When I checked with Biclar last week, she said four women now share the same space. All of them have legal status, but because of low wages and the high cost of housing, along with the burden of supporting families abroad, they can't afford better living arrangements.

B. and another care provider share a single room, at a cost of $400 apiece, from a homeowner in Panorama City. B. said her commute takes more than an hour each way, and during her nine-hour shift, her duties for her 83-year-old client include cooking, feeding and bathing.

She's only working three days a week at the moment and said additional jobs are hard to come by given her status and the immigration crackdown. She was upset that for the last two months, she couldn't afford to send any money home.

Retired UCLA scholar Fernando Torres-Gil, who served as President Clinton's assistant secretary on aging, said "fear and chaos" in the elder care industry are not likely to end during this presidential administration. And given budget constraints, California will be hard-pressed to do more for caregivers and those who need care.

But he thinks the growing crisis could eventually lead to an awakening.

"We're going to see more and more older folks without long-term care," Torres-Gil said. "Hopefully, Democrats and Republicans will get away from talking about open borders and talk about selective immigration" that serves the country's economic and social needs.

The U.S. is not aging alone, Torres-Gil pointed out. The same demographic shifts and healthcare needs are hitting the rest of the world, and other countries may open their doors to workers the U.S. sends packing.

"As more baby boomers" join the ranks of those who need help, he said, "we might finally understand we need some kind of leadership."

It's hard not to be cynical these days, but I'd like to think he's onto something.

Meanwhile, I'm following leads and working different angles on this topic. If you're having trouble finding or paying for care, or if you're on the front lines as a provider, I'm hoping you will drop me a line.

_____

©2025 Los Angeles Times. Visit latimes.com. Distributed by Tribune Content Agency, LLC.