Last year, the president of the Massachusetts Senior Care Association warned the Trump administration that terminating Temporary Protected Status (TPS) would “have a devastating impact on the ability of skilled nursing facilities to provide quality care to frail and disabled residents.” Nationally, “1 in 4 direct-care workers are immigrants,” and a large number of Haitian TPS recipients work as “nursing assistants, home health aides and personal care attendants.” But the administration went ahead and announced the end of TPS anyway, leaving them—and the many vulnerable people who depend on them in their day-to-day life—approaching crisis:

“What people don’t seem to understand is that people from other countries really are the backbone of long-term care,” said Sister Jacquelyn McCarthy, chief executive of Bethany Health Care Center in Framingham, Mass., which runs a nursing home with 170 patients. She has eight Haitian and Salvadoran workers with TPS, mostly certified nursing assistants, who show up reliably for 4:30 a.m. shifts and never call out sick, she said. She already has six CNA vacancies and can’t afford to lose more, she said. “There aren’t people to replace them if they should all be deported,” McCarthy said.

Paul Osterman, professor at the Massachusetts Institute of Technology’s Sloan School of Management, said that “the Trump administration’s immigration restrictions may exacerbate a serious shortage of direct-care workers. He forecasts a national shortfall of 151,000 workers by 2030 and of 355,000 workers by 2040. If immigrants lose their work permits, the gap would widen further.” One of those Haitian TPS recipients includes Nirva, who works 70 hour weeks at chiropractor’s office, a Boston rehabilitation center, and in the private home of Isolina Dicenso, a 96-year-old senior:

She started caring for Dicenso in her Boston home as the older woman recovered from surgery in 2011. With support from Nirva, another in-home aide and her daughter, Dicenso has been able to continue living alone. She now sees Nirva once a week for walks, lunch outings and shopping runs. The two have grown close, bonding in part over their Catholic faith. At home, Dicenso proudly displays a bedspread that Nirva gave her, emblazoned with the word LOVE.

Nirva said that she came into her line of work following a devastating earthquake struck Haiti. When she tried to help at a Red Cross station, but was rebuffed because she wasn’t a nurse. “So, when I came here,” she said, “I feel, people’s life is very important.” Our hospitals and clinics, our patients, and our most vulnerable would benefit from thousands of Nirvas, but instead, this administration continues to try to drive them out, all in the name of a white supremacist agenda. “There’s not a lot of people in this country who would take care of the elderly,” Dicenso’s daughter said. “Taking care of the elderly is a hard job.”