title: Ethical challenges: Trust and leadership in dementia care.
abstract: BACKGROUND
  To meet and take care of people with dementia implicate professional and moral challenges for caregivers. Using force happens daily. However, staff also encounter challenges with the management in the units. Managing the caretaking function is also significant in how caretakers experience working in dementia care.
  
  
  OBJECTIVE
  The purpose of this study is to explore the caregiver's experiences with ethical challenges in dementia care settings and the significance of professional leadership in this context.
  
  
  METHODS
  The design is qualitative, and data appear through narrative interviews. A total of 23 caretakers participated in the study. The transcribed interviews were subjected to a phenomenological-hermeneutical interpretation.
  
  
  METHODS
  The respondents signed an informed consent for participation prior to the interviews. They were assured anonymity and confidentiality in the publication of the data. Ricoeur's method for interpretation ensures anonymity as the researcher relates to the data as one collective text. The study is part of a larger research project in ethics, in its entirety approved in line with the Helsinki Convention.
  
  
  RESULTS
  The findings show that the caretakers experienced inadequacy. Some of them described a negative work atmosphere where they experienced that their leaders did not take them seriously. Because of this, informal negative sub-groups functioned as an exclusive debriefing arena. Some of the informants described the opposite experience where the leaders actively supported them.
  
  
  CONCLUSIONS
  The analyses of the findings are discussed in light of the concepts of trust and mistrust in leadership.
  
  
  CONCLUSIONS
  There is a correlation between the leadership and the caregivers' experience of being in difficult situations.
authors.affiliation: Lovisenberg Diaconal University College, Norway Rita.jacobsen@ldh.no.
authors.forename: Rita
authors.initials: R
authors.lastname: Jakobsen
authors.affiliation: Lovisenberg Diaconal University College, Norway.
authors.forename: Venke
authors.initials: V
authors.lastname: Sørlie
mesh_terms: D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing*; D004993:Ethics, Nursing; D066297:Hermeneutics; D006801:Humans; D007857:Leadership; D009735:Nursing Homes / Q000458:organization & administration*; D009740:Nursing Staff / Q000523:psychology*; D015279:Organizational Culture; D036301:Qualitative Research; D035502:Trust
keywords: Caregivers; dementia; experience; leadership; phenomenological-hermeneutical method; trust