Strengthening Long-Term Care Through Community Action: Jack Kupferman’s Presentation at the Doha Summit, 11.04.25

I am Jack Kupferman, co-chair of the Stakeholder Group on Ageing, a global constituency supporting the implementation of the Sustainable Development Goals.

It is my hope to inspire each of you to spark grassroots initiatives that expand community- and home-based long-term care options. I invite you to help identify real-world examples of “connected communities”—local models that are already providing effective long-term care where people live.

All of us are social entrepreneurs. We are building support systems, doing the hard work, and shaping what quality care can and should look like. So here is my call to action:

Who among us is ready to help create a global compilation of grassroots long-term care initiatives?

We know the world is ageing rapidly—and we know long-term care systems are not keeping pace. People want to remain at home, with appropriate supports. And while government funding is helpful, it is not the only pathway to building high-quality services. Community ingenuity can, and does, create powerful solutions.

You can do this. Here’s how grassroots efforts begin:

1. Identify the need and determine what services are most important in your community.

2. Map existing supports already available locally.

3. Define who will form the care workforce—family caregivers, paid caregivers, residential support, or other models.

4. Create recruitment standards and clear measures of success.

5. Prioritize person-centered care—no one-size-fits-all approach.

6. Consider flexible physical design, adaptable to each individual’s circumstances.

7. Assemble a continuum of care services that can exist locally—or recognize where gaps remain.

8. Empower caregivers through training, education, and compassion.

9. Secure the resources needed: financial, human, partnerships, professional expertise, and digital tools.

Examples of Grassroots Innovation

Let’s look at successful and inspiring community-based long-term care initiatives happening around the world.

1. Beacon of Hope for the Elderly — Rural Malawi

Inspired by the spirit of Mai Mbandabe, this initiative began during COVID-19 when a 25-year-old woman recognized the vulnerability of older adults displaced by the pandemic. The center now shelters 80+ seniors—those needing light care, those cast out due to accusations of witchcraft, and those rejected due to declining health. They receive daily care, housing, and food. The foundation even built a home for a vulnerable elder, Gogo Nasitima, and has launched its own farming operation to help sustain the program. It is a remarkable success story of compassion and local action.

2. Caregiver Training — Ageing Nepal

Ageing Nepal pioneered national training for family caregivers in geriatric care, in collaboration with care homes and the Ministry of Women, Children, and Senior Citizens. Hundreds have been trained—both family caregivers and care-home workers. Through strong advocacy, this training is now included in Nepal’s national program. Local, provincial, and central governments are allocating budgets to ensure it continues.

3. “Connected Communities” — United States

In the U.S., the demand for long-term care is expanding rapidly, yet financing and regulations remain challenging. Despite this, innovative community and digital models are emerging. “Connected Communities” is a conceptual continuum-of-care model offering grassroots information and referral resources within a geographic community. It supports a range of home-based services—medical care, light-touch assistance, moderate and intensive support—so people can remain at home as long as possible. When home care is no longer viable, brick-and-mortar options provide workforce housing, community amenities, and multigenerational opportunities.

4. Thome Riverton Campus — Detroit, Michigan

This campus delivers a continuum of care for seniors with low and moderate incomes, combining well-designed community-based and home-based supports. The goal, aligned with Connected Communities, is to maximize aging in place while raising the quality of skilled-nursing options when needed. To me, this represents an HCBS system worth replicating globally.

5. Digital Tools for Grassroots Care

Nearly everything is digital now, and an abundance of free online resources can support your efforts to create community-based, home-based long-term care models. There are too many to list here, but we will share them in the chat box for your exploration.

Building the Global HCBS Movement

Now that we’ve sparked your imagination, we encourage you to share your enthusiasm, your concerns, and your expertise with the HCBS Action Network. Contribute your grassroots examples and help us build a global database of community-driven long-term care innovations.

Together, we can accelerate the future of long-term care—one community at a time.

Thank you.