International Journal of Integrated Care, 22 June 2009 - ISSN 1568-4156
Conference abstract
Bridging the breach in services for ageing people with disabilities in a country with challenging demographic prognoses
Hristo Dimitrov, Director, Public Health Association, Sofia, Bulgaria
Correspondence to: Hristo Dimitrov, E-mail:

Introduction: The demography of Bulgaria is characterized by a steady trend for a negative natural growth and increase of the relative share of elderly people. This is a challenge to the health and the social systems. Social reports point out: a) unsatisfactory pensions, and b) impoverishment of the group of elderly persons above retirement age. In this context a greater number of people with disabilities will reach old age.

Description: Even though in Bulgaria there are no functioning programs specifically targeted to the needs of ageing people with disabilities, programs exist that serve both the ‘normally ageing’ and adults with disabilities. Such is the ‘Social assistant’ service package comprising 50 basic main types of care (i.e. help with grooming, shopping) provided in clients’ homes by briefly trained, previously unemployed non-professionals. The program boasts a need-driven, individually tailored approach, and financial sustainability. Over the years social assistants have gone through different training modules, none so far targeted to assessment and treatment of problems that emerge with ageing.

Conclusions: Even within a social service system with scarce resources examples can be found of functioning and sustainable social services’ programs that could be easily adapted to the needs of an ageing disabled population.

Discussion: To improve the focus and the efficacy of such programs we need: 1) research of social, health and psychological status of ‘normally’ ageing population compared to situation of ageing disabled people; 2) equity policy based on that research; 3) improving the knowledge of carers as to changes, concomitant with ageing.

national service system; demographic trends; equity