“We had no choice”: family caregiving for older people experiencing cognitive decline in Albania

Purpose This study aims to explore the daily and emotional experience of family care for an older person with cognitive decline in Albania and the support caregivers consider necessary. Design/methodology/approach Fifteen family caregivers in urban and rural Tirana County took part in semi-structured interviews. Recordings were transcribed verbatim and analysed manually in Albanian using reflexive thematic analysis. Findings Care involved constant watchfulness, disrupted sleep, reduced personal freedom and social isolation. Family duty gave care meaning but made it difficult to refuse or share responsibility. Women carried most intimate and organisational work. Support was scarce, while rural caregivers also faced costly journeys to urban health services. Affection and faith helped some continue but did not replace practical help. Research limitations/implications Cognitive decline was reported by caregivers and not independently assessed. The small Tirana County sample cannot represent caregiving across Albania. Practical implications Primary care and municipal social services should identify caregivers, assess their needs and offer information, referral, home-based assistance and short breaks. Social implications Family care should not remain a private duty that families, especially women, manage alone. Originality/value The study examines family care when cognitive decline is visible in daily life but diagnosis and organised support may still be absent, and identifies workable service responses.