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The Politics Of Caregiving And Struggles Of An Unexpected, Immigrant Caregiver


Vilma Rozen never expected to become a full-time caregiver in a foreign country thousands of miles away from her family.

The 55-year-old Costa Rican is one of thousands of immigrants caring for aged and ill seniors in the U.S.

“It’s extremely hard work,” said Rozen, who appears in the powerful new caregiving documentary, Care. “It takes everything out of you.”

Vilma and Dee in a scene from 'Care'
Vilma and Dee in a scene from ‘Care’

Today, about one in five direct care workers is foreign born; many of them are here illegally. As millions of American baby boomers age and learn to live with chronic diseases, the nation will rely heavily on millions of full-time caregivers, many of whom will be women from Central and Latin America.

According to recent findings by the Bureau of Labor Statistics, the nation will require more than 1.3 million new paid caregivers in the next decade.

The Paraprofessional Healthcare Institute has published even more startling findings: by 2020, the direct care work force could become the largest occupation in the nation, surpassing the number of retail salespeople, fast food workers and teachers.

The same report found that median weekly pay for female in-home care workers is $308, more than $250 less than average female workers in the U.S. Undocumented care workers are reported to be vulnerable to exploitation, such as lower wages and abuse.

According to the Institute for Women’s Policy Research, undocumented care workers have great difficulty in finding an employment-based legal path to come to the U.S. or a way to obtain legal status once they have arrived. The immigration system demands overhaul, according to the institute’s findings, for caregiving needs to be met in the years to come.

Rozen spoke with Life Matters Media from her home in New York about her experiences caring for some of the nation’s most vulnerable people. She also shared her concerns for care workers in more tenuous positions than her own.

Were you a caregiver in Costa Rica?

No. I was the owner for 17 years of a catering service, working for the embassy, for corporations, universities and the state.

When did you come to the U.S.?

I came in 2007, because I was married to someone here in 2006. I came here the year after.

I married my husband in January. In April 2006, he lost a kidney and started dialysis. His health was really deteriorating.

I was in love with my husband, and I made the decision to leave my family and have my sister take care of my children (in Costa Rica). It was a very hard decision. Because I loved my husband, I made the decision to come to the U.S. to take care of him.

It was never my plan to come here and stay here. My husband was planning to buy a house in Costa Rica, because he was in real estate. But, he died in 2012. His name was Mark Rozen. He was Jewish.

After he died you continued to live in the U.S.?

I still live in the same apartment.

I pay my rent. I pay my credit card. I do everything I have to do. I pay for the university of my children. I do everything, but I make money here.

What was your first job here?

When I came here, I didn’t have choices. So, I became a cleaning lady. There is no money in cleaning houses, and there wasn’t enough to support my family and my husband.

I started looking around, and I learned that I could become a caregiver.

Before coming to America, I got advice. I was told, ‘If you want to live in the United States you have two choices: technology or helping elderly people.’ I like technology, but I don’t have much knowledge in that. I chose to become a caregiver.

I would work six, seven, 12 hours a day all through the week.

How would you describe your work?

It’s extremely hard work. It takes everything out of you.

You have to basically learn the body language of your patients, because they can’t always communicate. You start to learn when a patient has a need for something – if they are thirsty, have a problem with circulation, have to be changed or go to the bathroom.

It’s a 24-hour job. You have to give 150 percent of your life to the people that you are caring for.

You send money back to Costa Rica?

Of course.

I make payments every month, because I have five children in Costa Rica. They go to the university and college. That can give you a clear idea of how much I have to work to pay the bills here and pay for what I need to in Costa Rica.

At this point, I work independently for four people.

That’s a lot.

The population in the United States needs to learn how important caregivers are.

We are immigrants. Some of us are without documents. If every six seconds in America someone turns 65, how many people are you going to need? It will be a catastrophe by 2020. The U.S. is not prepared for this. A country without immigrants will not work. Who will take care of the elderly people?

In Care you looked after Dee, a 90-year-old living alone and without family to support her. She died from complications associated with various medical conditions. How did you deal with her death?

It was terrible. I was terrible for one month.

I had to pray. I had to put the pieces back in place and re-focus on my priorities. It’s tough to be selfish, because this was the best thing for her.