Supporting Family Carers in Vulnerable Communities: A local approach from Bulgaria
Our members from Alzheimer Bulgaria Association present their “Strong Communities Without Age Barriers“ project.
In many small towns and villages across Bulgaria, people caring for their loved ones are often left without access to information or support. The picture is even starker in vulnerable communities, including parts of the Roma population, where topics such as dementia are rarely discussed openly.
In these settings, care falls almost entirely on the family. Family carers, most often close relatives, take on the role informally. They rarely have any training, and frequently they do not even have access to basic information about the condition they are responding to. As a result, decisions are made on the fly, under pressure and with a great deal of uncertainty. This lack of information has a direct impact on the quality of care: the symptoms of dementia are often recognised late or misread. The behaviour of the person affected may be perceived as “odd” or “difficult“, rather than understood as part of an illness, which creates strain both for carers and for the families themselves.
Social factors compound the picture – in many communities, dementia is still wrapped in stigma. People feel uncomfortable speaking about it openly and some avoid seeking help altogether; others simply do not know that any help exists. Care therefore stays inside the home, and carers gradually become isolated. These dynamics are even more pronounced in vulnerable groups. Parts of the Roma community, for example, face additional barriers: limited access to information, low trust in institutions, and a lack of intermediaries who can „translate“ the topic in a way that resonates. This is not a sign of indifference – on the contrary, care is often deeply committed and family-centred, but it takes place without support and without sufficient knowledge.
It is in this context that the project “Strong Communities Without Age Barriers“, carried out by Alzheimer Bulgaria Association in partnership with local organisations in the town of Byala Slatina, sets out to respond to precisely this kind of situation. Its main focus is on reaching people who tend to fall outside the scope of standard information campaigns and services. The approach is rooted entirely in work on the ground. Instead of relying on centralised channels, the project builds on local partners: cultural and municipal institutions, active community members, and informal leaders. They are recognised within the community, they are trusted and it is through them that information reaches people most easily.
A large part of the effort goes into making information understandable. That means not only translating content, but also adapting how the topic is spoken about. Plainer language is used. Concrete examples are given. Time is left for questions. This approach matters especially in communities where formal communication often does not work.
Particular attention is paid to family carers themselves. They rarely describe themselves in those words. In most cases they are simply „a daughter“, „a husband“, „a grandchild“. That is exactly why this role needs to be recognised. When someone realises they are not alone, and that other people are in a similar situation, it changes the way they experience caring. Creating space for conversation is a central part of the work. These are not formal training sessions, but rather gatherings in which people can listen, share and ask a question. Little by little, the topic starts to be normalised. Stigma does not disappear overnight, but it begins to ease.
The first meetings show that this kind of approach works: when information comes through familiar people, in a familiar setting, it is taken in more easily. People are more willing to take part – and more willing to seek help afterwards. This is a small but important shift. Another important outcome concerns the visibility of the topic – once dementia is talked about openly in the community, it stops being an „invisible problem“. That, in turn, lays the groundwork for more active involvement by local institutions and professionals in future.
The approach in use is relatively low-cost and it does not require complex infrastructure. It rests on partnerships and on local structures that already exist, which is precisely what makes it transferable to other small communities. Challenges of this kind are not unique to Bulgaria. In many parts of Europe, an ageing population goes hand in hand with a shortage of services and limited support for informal carers. In vulnerable communities, these problems are often sharper still. That is what makes local models such as this one particularly valuable: they show what real-world solutions can look like.
The experience from Byala Slatina shows that even small steps can make a difference: access to information, a single conversation, a meeting in a familiar place. These are the foundations on which more sustainable support for carers can be built.
The project „Strong Communities Without Age Barriers“ is implemented with the support of the Swiss-Bulgarian Cooperation Programme, under the Civic Engagement and Transparency Mechanism 2024-2029.
