Assistant nurses management of ethical dilemma and emotionall strain in dementia care. : "Then you hope someone restricts you when you don’t have that ability, for that is why you live like this"

The aim was to increase understanding of the ethical dilemma that assistant nurses in special accommodation for people with dementia experienc, how they handle them, and how they perceive and deal with emotional stress. We used a qualitative approach in form of semi-structured interviews and vignettes. Our selection were assistant nurses working in dementia care in southern Sweden. We found that ethical dilemmas in dementia care are many and affects different areas. The one thing they have in common was that at least two choices conflict with each other and none of them lead to any positive result for the residents. We have found three common categories for how the caregivers handle the dilemmas: attract and clamoring, white lies and the healthy. The caregivers experience and are influenced by ethical in different ways. But everyone finds it hard when plans don’t turn out the way they thought from the beginning. The assistant nurses found that external factors were most stressful because external factors are difficult to change. All the assistant nurses are affected, but in which way, and to what degree, depends on the individual. They handle the emotional stress in similar ways by taking a walk, taking a five minutes break or to consider the residents best interest. Our conclusion was that nurses deal on a daily basis with ethical dilemmas and that they experience a lot of stress because of them