Suddenly, I’m an Expert on Immigration

Robyn's Read | June 22, 2016

The U.S. has much more experience with immigration than other countries in the world. So, when the topic of foreign-born direct care workers comes up at international conferences, Robyn Stone's global colleagues seek her advice. Here's what she tells them.

Several times a year, I have the opportunity to attend conferences in such places as Australia, China, South Korea, Singapore, and Japan. It’s a wonderful opportunity to meet with researchers from around the globe and to compare notes about how our respective countries are preparing for a much-anticipated explosion in the world’s older population.

I’m usually the one asking the questions at these meetings. That’s because my colleagues have more first-hand experience with the global aging phenomenon than I do.

They live and work in countries that are aging at a much faster rate than the U.S. They’ve seen how the global demographic shift is affecting their own countries. And they’ve had more time to think about how countries can go about seizing opportunities – and addressing challenges – associated with that shift.

For this reason, I’ve always felt that Americans can learn much more about global aging from other countries than those countries can learn from us. But that thinking changed a few months back.

During a home care conference in Tokyo, my colleagues from Germany and Japan wondered aloud about the role that foreign-born workers might play in helping their countries recruit and retain enough workers to provide hands-on care to a growing older population.

Suddenly, I became the expert in the room.

My colleagues wanted my advice. They know that a large portion of America’s direct care workforce is made up of immigrants. They also know that the United States has much more experience with immigration than other countries. And, despite recent presidential campaign rhetoric, they still view Americans as being far more accepting of foreign-born workers than the citizens of their own countries.

The conversation convinced me that other countries do, indeed, have a lot to learn from the United States about how to recruit and retain immigrant workers.

Here’s why:

We are Welcoming

As a nation of immigrants, the United States has embraced diversity within our society, and within our direct care workforce, for many years. That’s an important step that not all countries have taken.

To be clear, I’m not talking about illegal immigration. As I pointed out in the Spring 2016 issue of Generations, an estimated 79% of the foreign-born direct care workers entering the U.S. are legal. The vast majority of these migrant workers remain in the United States permanently and many become naturalized citizens.

We Want to Understand

American providers of aging services actually lead the world in efforts to understand and embed cultural competence into our workplaces and our training programs for direct care workers.

Don’t get me wrong. There is plenty of room for improvement in the area of cultural competence. But I’m still proud of the fact that we have at least started to recognize how we can make our diverse workplaces run more smoothly.

I tell my global colleagues that their countries must put far more emphasis on cultural competency training. This isn’t workforce training in the traditional sense of the word. It doesn’t take place in a classroom, and it doesn’t have a finite time schedule.

Instead, cultural competency really is an ongoing process to understand the different cultures represented in your workforce.

In a culturally competent workplace, managers take the time to learn about how different cultures view aging, dementia, death and dying, and a host of other issues that affect aging services. They try to understand how workers from different cultures communicate with others, including how they use body language.

And then they educate staff and residents with an eye toward building understanding, respect, and appreciation for diversity in the workplace.

This is the way we build good relationships among workers, and between workers and clients or residents. This is the way we support and empower our foreign-born workers so they can succeed in their new country.

We Are Willing to Train

Many countries around the globe impose harsh restrictions on immigrant workers. In Japan, for example, proficiency in the Japanese language is a firm prerequisite for employment. This restriction often gets in the way of that country’s ability to recruit and retain the foreign-born workers that it so desperately needs.

I encourage my global colleagues to advocate for policies that allow foreign-born workers to gain some skills – including language proficiency – on the job.

That on-the-job training can and should be supplemented with intensive language instruction provided through programs that are based on our successful “English as a Second Language” model. But less-than-perfect language skills should not keep talented workers from bringing their skills to our care settings.

We’re Not Perfect

Finally, I honestly admit to my global colleagues that the United States isn’t perfect when it comes to compensating its direct care workers, 28% of whom are immigrants.

That imperfection was clearly illustrated in a recent Boston Globe article reporting that U.S. home health aides earn a median annual salary of $21,380 and a median hourly wage of $10.28. Half of them qualify for public benefits like Medicaid or food stamps.

The Globe is correct in suggesting that we have a problem on our hands. We want older people to age in community, but we’re facing a shrinking pool of family caregivers and a diminishing supply of direct care workers to support a rapidly growing older population.

I told the Globe that foreign-born workers could help us fill this care gap.

But first, the United States and other countries around the world need to make sure that our treatment of those workers adequately reflects their importance to the future of aging services.