Dementia Care Work Situated Between Professional and Regulatory Codes of Ethics

Abstract

Safety, dignity and autonomy are keywords in care work for older people. Dementia, however, complicates the relationship between care workers and care receivers, in part because it affects memory, thought, perception, reasoning and speech. Thus it potentially influences the voice and consent competence of the individual. In such contexts, care work can become ethically challenging. This paper investigates how care workers in social care services ensure the safety and well-being of those receiving care and how these responsibilities must be weighed against the sometimes conflicting duty of upholding and respecting civil rights and individual choices when the older person has dementia. The empirical stage is home care and nursing home services in Norway. These settings provide a comparative foundation. Two different forms of ethical orientation are found to be active in the care workers’ accounts in this study: ethics situated in the care work profession, and ‘regulatory codes of ethics’ situated in organizational rules backed by legislation. Whether these forms create tension or strengthen each other in care work practices is an open question. The implications for care work services are discussed.