The Future of Long-Term Care in Czechia: Ten Strategic Priorities for a Sustainable System

Czechia no longer needs to ask whether population ageing will transform long-term care. The practical question is whether the system can change quickly enough, and coherently enough, to support many more people living into advanced age without allowing avoidable dependency, workforce pressure or geographic inequality to determine their choices.

The challenge brings together almost every issue examined across the Czechia Ageing, Long-Term Care & Community Support Knowledge Hub: the division between health and social care, the role of regions and municipalities, the care allowance, family caregiving, home and residential capacity, workforce sustainability, housing, quality, digital infrastructure and the continuing transition towards community-based support. None can be resolved entirely within its own policy silo.

The policy environment is also moving. The National Strategy for the Development of Social Services 2026–2030 provides a new strategic framework, explicitly responding to demographic change while supporting the transformation of residential provision and stronger ambulatory and field-based services. A new deinstitutionalisation action plan covers 2026–2028. Recent predictive work has also sharpened the scale of the long-term care capacity challenge ahead.

This final article therefore looks beyond one service model or reform. It identifies ten strategic priorities whose interaction will determine whether Czechia develops a long-term care system capable not simply of accommodating demographic ageing, but of supporting independence, dignity and sustainable care across very different communities.

1. Build capacity around where people want to live

The first priority is not simply to create more long-term care capacity. It is to decide what kind of capacity Czechia wants to build.

Demographic projections indicate substantial growth in the population aged 80 and over and rising demand for social, health and social-health support. Residential capacity will need to expand in some areas, particularly for people whose needs cannot safely or sustainably be met at home. But treating additional institutional places as the default response would conflict with the direction of Czech social policy and with many people's preference to remain within ordinary homes and communities.

The National Strategy for the Development of Social Services 2026–2030 places greater emphasis on field-based and ambulatory provision and on enabling people, with informal support where available, to remain within their natural social environment for as long as possible. The direction matters because service expansion decisions made during the next decade will shape the system for far longer.

A balanced capacity model needs several layers: accessible prevention and community support before needs become intensive; sufficiently available pečovatelská služba, personal assistance and related field services; day and respite provision around families; home healthcare where clinically appropriate; community-based alternatives for people with disabilities; and good residential and nursing capacity for people whose needs require it.

The strategic mistake would be to frame these as competing models. Czechia needs all of them. The question is their balance and geographic distribution.

This connects directly with homecare demand and capacity management. Increasing national capacity is not enough if the additional services are concentrated where providers can recruit staff rather than where unmet need is greatest.

Regions therefore need increasingly sophisticated forecasts connecting population ageing, dependency, workforce availability, existing services, family-care capacity and geography. Municipal intelligence adds the local detail: which villages are becoming older, where transport creates barriers and which communities have little realistic alternative to family care.

The objective should be a network rather than a collection of individual services.

2. Make the health-social boundary easier for people to cross

Czech long-term care remains shaped by an institutional distinction between healthcare and social services. Healthcare operates principally through the health system and statutory health insurance, while social services are governed primarily through Act No. 108/2006 Coll. on Social Services and financed through a combination of public subsidies, regional and municipal resources, care allowance expenditure, user payments and other sources.

The distinction has legal and financial logic. For an older person living with frailty, dementia, multiple chronic conditions and reduced ability to manage everyday life, however, health and social needs frequently occur at the same time.

The stronger opportunity is not necessarily to abolish institutional boundaries. It is to make those boundaries less disruptive operationally.

Recent legislative development illustrates how this can occur incrementally. Changes to the Social Services Act have created an optional activity allowing pečovatelská služba and personal assistance services to provide specified help with ordinary health-related tasks, including assistance with taking medicines and selected non-invasive measurements. These remain assistance rather than healthcare services. The distinction is important, but the change recognises a practical reality: rigid task boundaries can create unnecessary complexity in somebody's home.

Future integration should concentrate on the interfaces where people experience fragmentation:

• assessment and care planning across health and social needs;
• hospital discharge and the period immediately after returning home;
• medication and delegated or supportive health-related activity;
• dementia, frailty, palliative care and complex multimorbidity;
• information exchange between organisations; and
• responsibility when a person's needs change rapidly.

The objective is continuity rather than organisational uniformity.

That requires better interoperability and system integration, but also clear professional boundaries, funding arrangements and escalation routes. Digital connectivity cannot resolve ambiguity about who is responsible for acting on the information being shared.

Scenario: discharge exposes the whole system

An 82-year-old man in a regional hospital is medically ready to leave following treatment for pneumonia. Before admission he lived with his wife, who provided most everyday support. His mobility has deteriorated during the admission, he now needs help with personal care and his wife is unsure whether she can manage transfers safely.

A narrow discharge decision asks whether acute hospital treatment is complete. A long-term care decision asks something larger: what combination of home healthcare, social services, equipment, rehabilitation and family support will make returning home sustainable?

If those elements are considered sequentially, the family can become the system coordinator. His wife phones services, repeats information and waits while different eligibility, availability and funding questions are resolved. A technically successful discharge may then result in rapid deterioration, carer exhaustion or readmission.

A stronger pathway starts earlier. Functional ability and the home environment are considered alongside clinical recovery. Social-service availability is tested before discharge. His wife's capacity and willingness to provide care are discussed rather than assumed. Responsibilities for medication, mobility and monitoring are explicit.

Governance also follows what happens next. If similar discharges repeatedly fail because field services cannot respond quickly enough, the pattern becomes regional capacity intelligence rather than being treated as a series of unrelated individual events.

This is what integration needs to achieve in practice: not a new organisational label, but fewer points at which the person or family has to bridge institutional boundaries themselves.

3. Treat the workforce as long-term infrastructure

No Czech long-term care strategy can succeed without a workforce capable of delivering it.

Expanding services while the working-age population is under pressure creates a structural problem. Residential facilities, field services, healthcare and community support compete for workers, while demographic ageing increases demand across all of them. Rural and less prosperous areas may face particular recruitment difficulties.

The response therefore has to move beyond annual recruitment campaigns. Czechia needs a workforce model covering pay, occupational status, training, career development, supervision, working conditions, technology, migration and productivity.

Care work also needs to be understood in relation to service design. Expanding labour-intensive models without considering workforce availability can create nominal capacity that cannot be staffed. Conversely, attempting to solve shortages primarily through technology risks weakening continuity and human relationships.

The more productive question is which tasks require skilled human presence and which administrative or logistical burdens can be redesigned.

Digital records can reduce duplicate entry if systems work together. Better scheduling can reduce unnecessary travel. Remote specialist input can extend expertise into underserved areas. Assistive technology can help some people complete activities independently. None removes the need for a stable care workforce, but each can affect how that workforce is used.

Workforce sustainability also requires attention to resilience and continuity. High turnover has consequences beyond recruitment cost. It reduces relational continuity, weakens organisational memory and increases the supervision burden placed on experienced staff.

The Predictive Workforce Risk Module offers organisations examining similar pressures a structured way to consider vacancy, turnover, retention and service-continuity risks. It is not a Czech workforce-planning instrument, but the underlying principle is highly relevant: workforce indicators should be treated as forward-looking service-risk intelligence rather than retrospective human-resources statistics.

4. Make family care visible without making it compulsory

Family carers are already a major component of Czech long-term care. Future demographic pressure makes their contribution even more important, but sustainability cannot be built on the assumption that families will automatically absorb whatever formal services cannot provide.

The care allowance, příspěvek na péči, is central to Czechia's support architecture. It is awarded according to assessed dependency and can support formal or informal care. From January 2026, amounts for adults at dependency levels I and II increased, while higher levels continue to provide substantially greater support, with different level IV amounts depending on whether care is provided in specified residential social services or elsewhere.

Financial support matters, but cash alone does not create a sustainable care arrangement.

A daughter providing daily care may also need employment flexibility, respite, practical instruction, reliable home services and somebody to contact when her parent's condition changes. A spouse may themselves be old or unwell. A family living at a distance may coordinate care but be unable to provide it physically.

Family-care policy should therefore distinguish willingness from availability. It should also recognise the unequal distribution of unpaid care, including its disproportionate impact on women and the consequences for employment, income and later-life financial security.

The strongest model treats family carers as partners without converting them into an invisible substitute workforce. That means making carer support and family partnership part of mainstream long-term care planning rather than an additional service available only after strain becomes severe.

Respite capacity, advice, training, psychological support and contingency arrangements should be viewed partly as system-stability measures. Supporting a carer before breakdown can preserve a preferred home arrangement and prevent emergency demand elsewhere.

5. Put sustainable financing behind strategic ambition

Long-term care reform ultimately requires decisions about money as well as models.

Czech social services have a mixed financing architecture. Provider funding can combine state resources distributed through established mechanisms, regional and municipal contributions, care allowance expenditure, user payments and other income. Healthcare components operate through the health-insurance system. Informal care contributes substantial additional value outside formal provider expenditure.

This plurality can provide flexibility, but it can also make the real cost of long-term care difficult to see. Financial responsibility is distributed across public budgets, health insurers, households, providers and families.

Demographic ageing makes several questions increasingly important. How should funding follow rising dependency? How can regions plan multi-year capacity when parts of provider financing remain exposed to shorter funding cycles? How should the balance between individual benefits, provider funding and direct public investment evolve? How should home and community services be financed so that policy preference is supported by operational capacity rather than rhetoric?

The care allowance is particularly important because it gives individuals resources linked to dependency, but the benefit does not itself guarantee that an appropriate service exists locally. Increasing an entitlement in an area with severe workforce or provider shortages can improve purchasing power without creating additional supply.

Financing reform therefore needs to connect three questions that are often considered separately: what support people are entitled to, what services regions need available, and what providers require to maintain viable capacity.

Value should also be understood broadly. A field service that prevents avoidable residential admission may create benefits outside its own budget. Respite can sustain family care. Rehabilitation can reduce later support needs. Better discharge coordination can reduce hospital utilisation. Fragmented budgets can obscure these effects.

The long-term goal should not be to select the cheapest service category. It should be to understand total system cost alongside independence, quality of life and sustainability.

Scenario: more money does not automatically create more care

A Czech region identifies rapid growth in the number of older residents with significant dependency. Care allowance expenditure is rising, but families report difficulty purchasing sufficient field-based support. Providers have waiting lists and cannot recruit enough staff to extend coverage into some rural municipalities.

From the individual's perspective, there is a mismatch: a recognised need and financial support exist, yet practical access remains constrained.

The regional response could focus only on additional residential beds. Instead, planners examine why community supply is not expanding. Travel time makes some rural routes expensive. Short visits create inefficient schedules. Pay competition affects recruitment. Several small providers have little capacity to invest in technology or workforce development.

The region begins modelling capacity rather than simply counting registered services. It examines service hours, geographic coverage, workforce vacancies, unmet requests and likely demographic demand. Municipalities contribute local intelligence about isolated residents and transport.

Funding decisions can then distinguish between nominal provision and viable delivery. Additional resources may support capacity where the market will not expand spontaneously, while residential development continues where higher-intensity demand genuinely requires it.

The lesson is not that Czechia needs one national purchasing mechanism. Regions differ too much for that assumption. It is that financing and capacity planning need to describe the same reality. An entitlement has limited practical value if the service it is intended to purchase cannot be accessed.

6. Turn data into decisions about capacity and quality

Czechia has more long-term care data than is sometimes assumed. Social-service registers and reporting, care allowance information, health-system data, regional planning information, provider records and national statistics all describe parts of the system.

The harder task is connecting data to decisions.

The predictive work developed jointly from Ministry of Labour and Social Affairs and health-information data has demonstrated the value of looking across traditional boundaries when forecasting long-term care demand. As demographic change accelerates, this approach should become increasingly operational.

Regions need to know not only how many services are registered but how much effective capacity exists. National policymakers need to distinguish growth in expenditure from changes in need, access and outcomes. Providers need information that shows whether quality is improving rather than merely whether activity is increasing.

Data systems should consequently connect several dimensions: population need, service availability, workforce, expenditure, quality and outcomes.

This is where data quality, metrics and performance dashboards become strategically important. A dashboard that reports hundreds of indicators but does not change a decision creates administrative burden rather than intelligence.

The Quality Dashboard Builder can help organisations working on comparable assurance questions structure a more balanced view of performance. It is not designed as a Czech national reporting framework, but the principle transfers: measures should combine operational activity with quality, workforce, risk and outcomes rather than allowing one dimension to dominate.

National standardisation also needs restraint. Some indicators need consistent definitions to allow comparison, but local services need enough flexibility to measure what matters to their populations. The objective is comparable intelligence, not uniformity for its own sake.

7. Make quality about life, not only compliance

Czechia already has a statutory quality architecture for social services. Registration, standards, inspection, provider responsibilities and individual planning establish important safeguards. Future reform should strengthen these foundations while increasing the emphasis on outcomes.

Compliance remains essential. People need safe services, competent staff, lawful practice and protection of their rights. But a service can complete required processes without necessarily producing a good life.

For an older person receiving support at home, meaningful outcomes may include continuing to prepare a meal, reaching a local shop or maintaining relationships. For somebody living with dementia, success may involve familiarity, reduced distress and sustained connection with family. For a person with a disability, it may involve greater control over everyday routines and community participation.

Some long-term care outcomes are also about maintenance rather than improvement. Preventing deterioration, preserving function or sustaining a family-care arrangement can represent substantial success even where a person's underlying condition progresses.

This requires a quality model combining:

• statutory standards and safety;
• individual experience and rights;
• functional and quality-of-life outcomes;
• workforce stability and competence;
• complaints, incidents and safeguarding intelligence; and
• evidence that identified problems lead to improvement.

The last point is critical. Quality systems become credible when information changes practice.

A provider that records repeated missed visits but treats each as an isolated incident is collecting data without learning. A region that observes persistent access differences but never adjusts planning has the same problem at system level.

Future Czech quality development should therefore strengthen learning, incidents and continuous improvement. Inspection can identify weaknesses, but sustainable quality depends on providers and public authorities detecting patterns before external intervention is required.

8. Use digital transformation to reduce fragmentation, not digitise it

Digital development will influence almost every part of Czech long-term care: records, scheduling, workforce management, assessment, communication, telecare, remote health support, data analysis and planning.

The strategic risk is assuming that digitisation automatically creates integration.

If social services, healthcare, municipalities, families and providers each adopt systems that cannot exchange useful information, paper fragmentation becomes digital fragmentation. Staff may spend less time writing by hand but more time entering similar information into separate platforms.

Czechia's future digital model therefore needs a clear purpose. Interoperability should support continuity where lawful and necessary. Information governance needs to protect privacy without creating avoidable barriers to coordinated support. Systems should be usable by the workforce and accessible to people who interact with them.

Digital exclusion also needs to remain visible. Older people are highly diverse in their use of technology. Some will manage online services confidently; others will require support or non-digital routes. Making a process digital-only can transfer administrative work from organisations to families.

Artificial intelligence may eventually assist demand forecasting, administrative workflow, scheduling and identification of emerging patterns, but these uses require governance. Predictive systems can amplify poor data, obscure assumptions or encourage excessive confidence in outputs that remain probabilistic.

The Digital Transformation Readiness Assessment offers a framework for organisations considering similar questions about strategy, workforce adoption, cyber resilience and implementation capability. The relevant lesson for Czech long-term care is that technology needs operating discipline around it. Procurement is not transformation.

Scenario: a digital solution creates a second workload

A social-service provider operating across several municipalities introduces electronic care records and mobile devices for field workers. The expected benefits are clear: faster recording, better oversight and less paper administration.

Within months, managers discover that staff still duplicate some information because health partners use different systems and municipal reporting requires separate formats. Mobile connectivity is inconsistent in parts of the service area. Experienced workers vary in confidence with the new application, while rushed implementation has created inconsistent recording practices.

The technology has not failed technically. The operating model around it is incomplete.

The provider changes its approach. It maps which information genuinely needs to be collected, removes internal duplication and strengthens training. Managers examine data quality rather than merely system usage. Information that cannot yet move electronically between organisations is supported by clearer agreed communication processes rather than informal workarounds.

At regional level, recurring interoperability problems are recorded as a strategic issue rather than left to individual providers to solve independently.

The improvement comes from treating digitalisation as service redesign. Technology reduces workload only where processes, responsibilities and information requirements are redesigned with it.

This distinction will become increasingly important as Czechia invests in more sophisticated digital infrastructure. Poorly governed technology can increase administrative burden; well-designed technology can release scarce professional time for direct support.

9. Connect housing, prevention and community infrastructure to care policy

Long-term care demand is shaped before somebody enters a social service.

Housing accessibility, transport, physical activity, social connection, chronic-disease management and the availability of ordinary community support can all affect how long a person remains independent and how much formal assistance becomes necessary.

This makes prevention broader than healthcare.

A person who loses mobility because an inaccessible building makes leaving home difficult may become more isolated and physically inactive. A family carer without respite may reach crisis sooner. An older person discharged into an unsuitable home may require more formal support than their functional impairment alone would predict.

Future Czech policy therefore needs to connect long-term care with health inequalities, prevention and early intervention. This does not mean placing responsibility for structural problems on individuals by telling them to age more healthily. Prevention includes changing environments and services as well as personal behaviour.

Housing is particularly significant because it changes slowly. Accessible and adaptable homes can reduce avoidable dependence, while neighbourhoods with transport, shops, healthcare and community facilities make ageing at home more realistic.

Municipalities consequently have an important role even where they are not the principal funder of a person's formal care. Spatial planning, housing, public space and local community infrastructure influence future care demand.

The same applies to social participation. Loneliness and isolation cannot be solved by increasing personal-care minutes. Community organisations, informal networks and ordinary public services all contribute to a person's ability to remain part of society.

A sustainable system therefore invests both downstream and upstream: sufficient long-term care for people who need it, alongside communities that delay avoidable dependency where possible.

10. Create governance capable of managing a twenty-year transition

The final priority connects all the others.

Czechia's long-term care transformation will extend across multiple governments, budget cycles and strategic documents. Demographic ageing will continue regardless of short-term political or administrative priorities. Sustainable reform therefore requires governance capable of maintaining direction while adapting implementation.

The Ministry of Labour and Social Affairs has the central coordinating role in ageing policy and the statutory responsibility for the national strategic framework for social services. The Ministry of Health and health-insurance system are essential where health and long-term care intersect. Regions plan social-service networks and distribute important funding. Municipalities understand local populations and shape many of the environments in which ageing occurs. Providers control day-to-day service quality. Families and people using services contribute knowledge no administrative dataset can replace.

The governance challenge is not to collapse those responsibilities into one organisation. It is to make accountability visible across them.

The National Strategy for the Development of Social Services 2026–2030 creates an important current framework. Its implementation needs measurable milestones, transparent assessment of progress and mechanisms capable of responding where national ambition does not translate into local capacity.

Long-term governance should repeatedly test a small number of strategic questions:

• Is capacity growing in line with projected need, and in the right service models?
• Are geographic inequalities narrowing or becoming more entrenched?
• Is the workforce becoming more sustainable?
• Are family carers receiving enough support to make care arrangements viable?
• Are health and social interfaces becoming easier for people to navigate?
• Are quality, rights and personal outcomes improving alongside capacity?

Organisations exploring comparable assurance challenges can use the Governance Maturity Assessment to structure questions about responsibility, evidence and oversight. It is not a substitute for Czech public governance, but its central principle is applicable: strategy becomes meaningful only when decision-makers can see whether implementation is producing the intended result.

Scenario: a region moves from annual service funding to strategic capacity intelligence

A Czech region enters its medium-term planning cycle with evidence that its population aged over 80 will increase sharply. Each service category presents a reasonable case for expansion. Residential providers report waiting lists. Home-support organisations report workforce shortages. Municipalities identify isolated older residents. Hospitals describe discharge difficulties. Family organisations ask for more respite.

If each issue is considered separately, the region risks funding whichever proposal is most immediately visible.

Instead, it creates a shared capacity picture. Demographic projections are mapped against existing residential, field and ambulatory services. Workforce vacancy and turnover data are added. Hospital discharge problems identify areas where community capacity is weak. Care allowance patterns provide additional information about dependency. Municipalities contribute housing, transport and local-access intelligence. People using services and carers describe where formal data understate practical difficulty.

The result does not produce one mathematically correct investment plan. It improves the choices.

The region can distinguish areas needing additional residential capacity from those where stronger field services may prevent unnecessary moves. It can identify municipalities where workforce constraints make conventional expansion unrealistic and test alternative service configurations. Respite is considered alongside family-care sustainability rather than as an isolated service.

Progress is reviewed over several years rather than judged solely by annual expenditure. Where waiting, workforce or outcome indicators move in the wrong direction, assumptions are revisited.

This is the governance capability Czechia increasingly needs: not perfect prediction, but a disciplined connection between demographic evidence, local reality, investment and learning.

A sustainable system needs balance rather than a single reform

The ten priorities are deliberately interdependent because no single reform can make Czech long-term care sustainable.

More money without workforce may raise costs without increasing access. More workers without better service design may reproduce inefficient models. More homecare without housing adaptation may compensate for environmental barriers. More digital technology without interoperability may increase workload. More reliance on families without respite may postpone rather than prevent crisis. More residential capacity without community alternatives may lock future expenditure into models that do not reflect people's preferences.

Conversely, a policy focused only on prevention and community support would be equally incomplete. Advanced dementia, profound disability, complex health conditions and severe frailty can require intensive long-term support. Good residential provision remains an essential component of the system.

The central strategic task is therefore balance: between formal and informal care, home and residential provision, national standards and local adaptation, individual entitlement and service supply, digital efficiency and human relationships, safety and autonomy, present demand and future capacity.

This balance should remain grounded in quality, safety and governance for an ageing population. Capacity expansion that weakens quality is not sustainable. Neither is a high-quality model available only to people living in particular regions or able to supplement public support privately.

What Czechia can contribute to international long-term care learning

Czechia's future pathway will be shaped by institutions that cannot simply be exported: its Social Services Act, care allowance, regional system, health-insurance structure, municipal landscape and particular history of residential and community provision.

Its experience nevertheless highlights several principles relevant across ageing societies.

First, demographic forecasting is most useful when it changes investment decisions rather than remaining a national statistic. Second, community care requires infrastructure; preference for ageing at home does not create homecare workers, accessible housing or respite capacity. Third, informal care is part of system capacity whether or not public accounts capture its full value. Fourth, integration is experienced at interfaces rather than in organisational charts. Finally, long-term care sustainability depends on outcomes and legitimacy as well as finance.

Different countries will make different choices about insurance, taxation, entitlements and provider organisation. The transferable lesson lies less in any particular Czech mechanism than in the need to connect those mechanisms around the person's life.

A sustainable system is one in which an older person does not need to understand institutional boundaries in order to receive coherent support, a family is not expected to compensate indefinitely for missing services, and geography does not determine access more than can reasonably be avoided.

From strategy to implementation

Czechia enters the 2026–2030 strategic period with stronger evidence about the scale of future demand and a clearer policy direction towards community support, individualisation and transformation. That creates an important foundation, but the decisive test will be implementation.

National strategies need to become regional capacity plans. Regional plans need to reflect municipal reality. Funding needs to support the service models policy is trying to develop. Workforce policy needs to recognise the scale and duration of future demand. Digital investment needs to reduce rather than relocate administrative burden. Quality systems need to show what changes in people's lives.

Implementation also requires patience without complacency. Long-term care infrastructure cannot be redesigned in one budget cycle. Workforce pipelines take years to develop. Housing takes even longer. Institutional transformation needs careful support for the people whose homes and lives are affected.

The appropriate response is therefore staged reform with visible direction: clear milestones, transparent evidence and the ability to adjust when implementation reveals consequences that policy design did not anticipate.

That approach also creates public confidence. Demographic ageing is often discussed as an abstract future burden. A more useful narrative is one of preparation: identifying foreseeable needs early enough to make deliberate choices about how Czechia wants later life and long-term support to work.

Conclusion

Czechia's long-term care challenge is substantial, but its direction is not predetermined by demography. Population ageing establishes the scale of the task; policy, investment and implementation will determine how that task is experienced by older people, people with disabilities, families, workers and communities.

The strongest future model is unlikely to emerge from one institutional reform. It will come from sustained alignment: enough community and residential capacity, clearer health-social interfaces, a valued workforce, stronger support for family carers, financing connected to real service supply, useful data, outcome-focused quality, purposeful technology and housing and communities capable of supporting independence.

National strategy matters because it creates direction. Regional and municipal implementation matters because long-term care is ultimately experienced locally. A statutory entitlement has to become an available service; a quality standard has to become everyday practice; a digital system has to make somebody's support more coherent; and a commitment to ageing at home has to be matched by the workforce, housing and community infrastructure that make it possible.

The next phase of Czech long-term care should therefore be judged not simply by how much the system expands, but by whether expansion produces a more balanced, accessible and sustainable model. If Czechia can connect demographic foresight with disciplined local implementation, it has the opportunity to enter the coming decades with a system better prepared not only to provide more care, but to support better lives.