Maine is the oldest state in America, with a median age of just under 45 and one of the highest shares of residents over 65. That fact is something we take pride in. It reflects the strength of our communities and the deep roots that generations of Mainers have built here. However, it also means we have a responsibility to lead the nation in helping guide our aging state.
Our health care and hospital system were already under extreme strain, and now Donald Trump and MAGA Republicans’ drastic cuts are accelerating its collapse. At the same time, long-term care facilities have closed in many regions of the state. Families face long waitlists for in-home services. Caregivers are pushed to their limits. Rural hospitals’ doors have shut. And too many older adults are living alone without the social connections that help people live healthy and fulfilling lives. These challenges affect our parents, grandparents, children, neighbors, and friends in communities across our state.
And across Maine, too many families are struggling to find the care and support their loved ones need as they age. Many are part of the “sandwich generation,” balancing jobs and raising children, all while caring for aging parents or relatives. The growing burden of long-term care is falling on families who are already stretched thin.
At the same time, Maine’s older residents are one of our greatest strengths. Older Mainers bring decades of experience, knowledge, and leadership to our communities. Many want to continue working, volunteering, mentoring, and contributing to the places they call home.
Our job is to build a state that supports older Mainers and the families that support them so that people can age with dignity, independence, and opportunity. This plan lays out a comprehensive strategy to strengthen long-term care, support family caregivers, address social isolation, and ensure older Mainers can remain active and engaged in their communities.
While Maine has strong programs in place, they are too often underfunded, fragmented, and unable to meet the scale of need — this plan brings them together, expands them, and ensures they work for every community.
My vision is for Maine to be the best place in America to call home. With the right leadership and the right investments, we can build a system that supports older adults, strengthens families, and makes our communities stronger for everyone. This plan is a crucial step toward that goal.
— Dr. Nirav Shah
Executive Summary: Dr. Shah’s Plan to Make Health Care More Affordable in Maine
Dr. Shah’s plan to support Older Mainers will:
- Launch the Maine Caregiver Corps to recruit, train, and support the next generation of caregivers and address workforce shortages in long-term care.
- Prevent long-term care deserts by identifying regions at risk and expanding access to services through partnerships with providers and community organizations.
- Create Aging-in-Place Innovation Grants to expand adult day programs, memory care services, and other community-based supports that allow older Mainers to remain in their homes.
- Strengthen support for family caregivers, including expanded respite services and increased access to Medicaid self-directed care programs.
- Improve affordability and care navigation by expanding care coordination services and strengthening Maine’s Agencies on Aging as the front door for aging services.
- Launch a Maine Social Connection Initiative to address loneliness and isolation through community programs and pilot the use of social prescribing.
- Expand transportation options for older adults by supporting volunteer driver programs, microtransit, and community shuttle services.
- Establish the Maine Experience Network to connect older Mainers with opportunities to work, mentor, volunteer, and contribute to their communities.
- Expand opportunities for older workers by promoting age-friendly workplaces and supporting training and workforce transition programs.
- Support the Older Mainers Act and work with the Legislature to invest approximately $9.75 million annually to strengthen Maine’s aging services infrastructure.
- Reduce the growing burden on Maine’s “sandwich generation” (families balancing careers, childcare, and caring for aging loved ones) by strengthening caregiver support, expanding in-home services, and improving access to long-term care.
Strengthening Long-Term Care
Maine is the oldest state in America, and the need for long-term care is growing rapidly. Yet too many families struggle to find care for aging loved ones because of workforce shortages, rising costs, and limited options in rural communities.
Dr. Shah’s plan will strengthen Maine’s long-term care system by expanding care options, supporting caregivers, and building the workforce needed to ensure every older Mainer can access affordable, high-quality care close to home.
Launch the Maine Caregiver Corps
To address the growing shortage of long-term care workers, Dr. Shah will launch the Maine Caregiver Corps, a statewide initiative to recruit, train, and support the next generation of caregivers.
The program will partner with Maine’s community colleges, workforce development programs, and health care providers to expand the pipeline of direct care workers and ensure older Mainers can access care in their homes and communities.
The Maine Caregiver Corps will:
- Expand and better coordinate existing training programs through Maine’s community colleges and workforce initiatives to provide paid training and certification opportunities for new caregivers at a scale that meets growing statewide demand.
- Offer scholarships, stipends, or loan assistance for individuals who commit to working in long-term care or home care settings in Maine.
- Create career pathways that allow direct care workers to advance into nursing, geriatric care, and other health professions.
- Focus recruitment efforts in rural communities where caregiver shortages are most severe.
An initial investment of $15–25 million annually could significantly expand Maine’s caregiving workforce and reduce costly institutional care. By strengthening the caregiving workforce, the Maine Caregiver Corps will help ensure older Mainers receive the care they need without leaving their communities.
Prevent Long-Term Care Deserts
According to the Maine Health Care Association, at least 26 nursing homes and residential care facilities have closed or significantly reduced capacity over the past decade, leaving fewer than 80 facilities operating across the state. These closures have eliminated hundreds of beds and strained access across rural parts of Maine.
Dr. Shah will work with providers and community partners to prevent and address long-term care deserts by:
- Working with the Department of Health and Human Services to identify and proactively intervene in regions where long-term care capacity is at risk or insufficient.
- Partnering with health systems, nonprofit providers, and local communities to expand access to long-term care services in underserved regions.
- Supporting innovative models that allow communities to develop regional care hubs that combine services such as adult day programs, memory care, and caregiver support.
Expand Community-Based Care and Aging-in-Place Programs
Most older Mainers want to remain in their homes and communities as they age, but too often the services needed to make that possible are unavailable, especially in rural areas.
Dr. Shah will create Aging-in-Place Innovation Grants, investing approximately $12–15 million annually, to expand beyond current funding levels and help communities scale programs that allow older adults to live safely and independently at home.
These grants will support initiatives such as:
- Developing adult day and memory care programs that provide safe daytime care and social engagement.
- Expanding community-based services that help older adults remain independent.
- Supporting local partnerships that expand services such as home safety modifications, community-based assistance, and other programs that help older adults remain safely at home.
Expanding these services will help reduce reliance on institutional care while improving quality of life for older Mainers and their families.
Support Family Caregivers
Family members provide the majority of long-term care in Maine, often balancing caregiving responsibilities with work, raising children, and supporting their own households. Many of these caregivers are part of the “sandwich generation,” responsible for both younger and older family members at the same time.
Without stronger support systems, these families face emotional, financial, and logistical pressures that can affect entire households across multiple generations.
Dr. Shah’s plan will strengthen support for family caregivers by:
- Expanding respite services that give caregivers temporary relief and help prevent burnout.
- Expanding and modernizing Maine’s existing Medicaid self-directed care programs to ensure more family caregivers can be compensated for providing in-home care.
- Expanding training, counseling, and caregiver support programs through Maine’s network of Agencies on Aging.
Supporting caregivers will help families remain stable while allowing older adults to stay in their homes and communities.
Improve Affordability, Access, and Care Navigation
Long-term care can be financially devastating for families, and many older adults struggle to navigate a complex system of services and benefits. We need to make it easier for people, both seniors and family members, to navigate the system of services and benefits.
Dr. Shah will work to make care more affordable and easier to access by:
- Expanding Medicaid reimbursement for care coordination and case management, helping older adults connect with services earlier.
- Strengthening and better resourcing Maine’s Agencies on Aging as the front door for aging services, ensuring older adults and caregivers can easily access benefits counseling and support across all regions of the state.
- Working with providers to reduce administrative barriers that limit access to services.
Improving affordability and navigation will help ensure that older Mainers and their families can access the care and support they need without unnecessary barriers.
Building Social Connection and Combatting Isolation
Social isolation and loneliness are among the biggest factors shaping how people age. Too many older Mainers, especially those living in rural communities, face long periods without meaningful social interaction, increasing the risk of depression, cognitive decline, and poor health outcomes.
This is not just a social challenge; it is also a cost driver in our health care system. National research shows that loneliness and isolation are associated with higher rates of hospitalization and increased Medicare spending, with some estimates suggesting an additional $6–7 billion annually in federal health costs tied to social isolation (AARP Public Policy Institute).
Dr. Shah’s plan will strengthen programs and community networks that keep older adults connected, engaged, and supported.
Launch a Maine Social Connection Initiative
Dr. Shah will establish a statewide Social Connection Initiative that treats loneliness as a public health challenge and connects older adults to the people, programs, and resources that help them stay engaged in their communities.
The initiative will:
- Partner with healthcare providers, community organizations, and Maine’s Agencies on Aging to identify older adults who may be experiencing isolation.
- Pilot the use of “social prescribing,” allowing health providers and community organizations to connect older adults to local programs such as volunteer opportunities, social groups, exercise classes, arts programs, and community events.
- Support community “connectors” who help older adults navigate local programs and find opportunities for engagement.
Expand Programs that Build Social Connection
Across Maine, community organizations and volunteers play a critical role in helping older adults stay connected.
Dr. Shah will support programs that strengthen social connections by:
- Expanding programs such as Meals on Wheels and volunteer visitor programs, which provide both practical support and regular social contact.
- Supporting Age-Friendly Communities initiatives that help towns remove barriers to participation and make communities more welcoming for older residents.
- Encouraging partnerships among community organizations to expand opportunities for older adults to stay active and engaged.
Improve Transportation Access
Transportation barriers are a major contributor to isolation in rural Maine. When older adults cannot access transportation, they often lose access to social activities, medical appointments, and community services.
Dr. Shah will work to:
- Expand and better coordinate existing volunteer transportation networks that provide rides to medical appointments, grocery stores, and community events.
- Expand innovative transportation options such as microtransit and community shuttle programs, building on existing efforts to better serve rural areas where traditional public transportation is limited.
Harnessing the Experience and Talent of Older Mainers
Older Mainers are one of the state’s greatest resources. With decades of experience, skills, and leadership, they contribute enormously to Maine’s workforce, civic life, and communities.
Across Maine, many organizations already help older adults stay engaged, from volunteer programs like RSVP and the Senior Companion Program to initiatives like the Encore Leadership Corps and Maine’s growing network of Age-Friendly Communities. These programs provide important opportunities for older adults to mentor, volunteer, and contribute to their communities.
But too often these efforts operate independently and reach only a portion of the older adults who want to remain active and engaged.
Dr. Shah’s plan will build on these efforts by creating a stronger statewide network that connects older Mainers with opportunities to share their skills, experience, and leadership.
Launch the Maine Experience Network
Dr. Shah will launch the Maine Experience Network, a statewide initiative that connects and expands existing programs that help older adults work, volunteer, mentor, and contribute to their communities.
Rather than creating a new program from scratch, the Maine Experience Network will bring together organizations already doing this work and make it easier for older Mainers to find meaningful ways to stay engaged.
The initiative will:
- Partner with organizations such as the University of Maine Center on Aging, RSVP, Area Agencies on Aging, Age-Friendly Communities, and nonprofit partners to coordinate opportunities for older adults to serve and contribute.
- Create a central statewide platform where older adults can easily find opportunities to volunteer, mentor, work, or participate in civic initiatives.
- Expand mentorship programs that connect experienced older adults with students, young workers, and community organizations.
- Work with employers to expand flexible and part-time employment opportunities for older workers who want to remain in the workforce.
By connecting and strengthening existing programs, the Maine Experience Network will ensure that more older Mainers can remain active, engaged, and connected to their communities.
Expand Opportunities for Older Mainers in the Workforce
Many older Mainers want to continue working or return to the workforce but struggle to find opportunities that fit their needs. Dr. Shah will work with employers, workforce development programs, and community organizations to:
- Expand flexible and part-time job opportunities for older workers.
- Promote age-friendly workplace practices that value the experience of older employees.
- Partner with Maine’s workforce system and community colleges to help older adults update skills and transition into new roles.
Supporting older workers will help strengthen Maine’s economy while giving individuals the opportunity to remain active and financially secure.
Support the Older Mainers Act
Maine’s aging population requires a coordinated statewide strategy to ensure older adults can remain healthy, connected, and independent in their communities.
Dr. Shah will work with partners including the Maine Council on Aging, AARP Maine, Area Agencies on Aging, and community organizations to advance the goals of the Older Mainers Act, a proposal aimed at strengthening services and supports for older adults across the state.
A central component of this effort is expanding funding for Maine’s Area Agencies on Aging, which provide essential services to older adults and caregivers across the state, including benefits counseling, care coordination, Meals on Wheels, caregiver support, and programs that address social isolation.
Dr. Shah will work with the Legislature to increase annual state funding for these services, supporting efforts to invest approximately $9.75 million per year to strengthen Maine’s aging services infrastructure and reduce long waitlists for support.
This investment would help:
- Expand care navigation and case management services that help older adults access benefits and supports.
- Reduce waitlists for services that allow older Mainers to remain safely in their homes and communities.
- Strengthen programs that support caregivers and address social isolation among older adults.
Encouraging partnerships among community organizations to expand opportunities for older adults to stay active and engaged.