Everyday ethics in dementia day care: narratives of crossing the line

The purpose of this study was to gain understanding of the ethical aspects of the experience of providing day care to people with dementia. Telephone interviews were conducted to elicit phenomenological narratives of satisfying and dissatisfying experiences from staff members of a state-wide random sample of dementia day care facilities. The analysis was guided by the concept of situated ethics. Findings reveal that ethical challenges of dementia day care are embodied in the everyday incidents when participants, staff, or family members "cross the line" of acceptable behavior. An ethical hierarchy of staff responses ranges from benign manipulation to termination of day care. These findings help us understand the situated ethics of dementia day care and heighten our sensitivity to the lived experience of dementia day care staff.