This image is seared into my mind and the collective conscience of St. Paul: Chongly “Scott” Thao, a 56-year-old Hmong elder and U.S. citizen, shivering in the biting January cold, wearing nothing but his underwear and a thin blanket. On Jan. 18, Immigration and Customs Enforcement (ICE) agents shattered the door of his East Side home without a warrant. They dragged him out in front of his weeping grandson, detained him for hours, and eventually released him with a shrug, citing “mistaken identity.”
If this can happen to a U.S. citizen in his own private residence, what guarantee do we have that the doors of our nursing homes and long-term care (LTC) facilities will hold?
For the past four weeks, Minnesota has lived under the shadow of an aggressive DHS occupation that has turned our neighborhoods into surveillance zones. While the headlines focus on protests and political standoffs, a quieter, more insidious crisis is unfolding in the corridors of our elder care facilities. The raid on Mr. Thao was not just a violation of one man’s dignity; it was a signal fire that has incinerated the psychological safety of our state’s most vulnerable population and the people who care for them.
The erasure of ‘safe spaces’
Long-term care facilities are not merely clinical environments; they are homes. They are the final sanctuaries for our parents and grandparents. The aggressive enforcement tactics we have witnessed this month—unmarked vans idling on corners, warrantless entries, and the militarized presence of federal agents—threaten to pierce the protective bubble of these facilities.
The question keeping administrators and families awake at night is simple: Could this happen here?
The answer, terrifyingly, appears to be yes. If agents are willing to break down the door of a private home based on faulty intelligence, there is little to suggest they will respect the sensitive nature of a memory care unit or a skilled nursing floor. The specter of armed agents walking past residents in wheelchairs, demanding papers from staff in the middle of a shift, is no longer a dystopian fiction—it is a plausible Tuesday.
Exacerbating the staffing crisis
The direct impact on staffing is immediate and catastrophic. Minnesota’s long-term care sector was already buckling under a historic labor shortage before “Operation Metro Surge” began. Now, it is breaking.
A significant portion of the direct support professionals, certified nursing assistants (CNAs), and housekeeping staff in our LTC facilities are immigrants. Many are U.S. citizens or legal residents, but in the current climate of “mistaken identities” and indiscriminate detention, papers offer little comfort.
Fear is keeping staff at home. We are hearing reports of call-outs skyrocketing not because staff are sick, but because they are terrified to drive to work. They are afraid of being pulled over. They are afraid of being detained while changing a bedpan. When a caregiver is too frightened to come to work, an elder waits longer for medication. A resident who needs help eating goes hungry for an extra hour. The DHS occupation is not just an immigration issue; it is a public health crisis that is actively degrading the quality of care for Minnesota’s seniors.
The collective trauma
As a mental health provider, I would be remiss to not also focus our attention on the psychological impact of what we are observing. We must also talk about the trauma being inflicted on residents. Many of our elders, particularly in Minnesota’s refugee communities (Hmong, Somali, and others), have fled war zones and authoritarian regimes. The sight of uniformed agents, the sound of shouting, or even the palpable tension of fearful staff can re-trigger profound PTSD.
Witnessing the abduction of a caregiver, or simply living in an environment where that fear is pervasive — is a form of elder abuse. Mr. Thao’s grandson was left crying at the window and many others have been left in a moment of shock or loss as a person is pulled from their presence; how many residents with dementia will be left in a state of agitated confusion if their daily routines are shattered by enforcement actions?
Reclaiming psychological safety
We cannot wait for federal policy to change. Facility administrators, community leaders, and families must act now to create buffers of safety around our elders.
- Know Your Rights (and Theirs): Every LTC facility must immediately train staff on their rights. Agents generally cannot enter private areas of a healthcare facility without a judicial warrant (not just an administrative one). Reception staff must be empowered to act as gatekeepers, protecting the privacy of the “home” within the facility.
- Sanctuary Principles: Facilities should adopt strict non-cooperation policies regarding voluntary information sharing with ICE, to the fullest extent of the law. We must signal to our staff that we have their backs. Without safety, staffing will suffer during this “surge”, regardless of status.
- Visible Solidarity: We need to normalize the presence of legal observers and community escorts for staff. If fear is the contagion, solidarity and community is the cure.
- Trauma-Informed Leadership: Administrators must acknowledge the fear. Don’t pretend it’s business as usual. Offer ride-shares for staff afraid to drive. Create safe spaces for staff to decompress.
The dignity of Scott Thao was stripped away on a cold sidewalk in St. Paul. We cannot allow the dignity of our elders in care facilities, or the brave staff who serve them — to be the next casualty. LTC administrators must draw a line at the nursing home door and say: Not here.
