In dementia care, ethical practice often lives in the tension between compassion, autonomy, and professional responsibility. As a person’s cognitive capacity declines, decisions about treatment, risk, and safety become increasingly complex. In late-stage dementia, even the most experienced Dementia Carer Specialist (DCS) may find themselves questioning whether a decision truly represents the person’s best interests — or whether it reflects the fear, emotion, or legal caution of those involved.
Understanding Ethical Conflict
Ethical dilemmas in dementia care rarely have clear answers. The balance between biomedical ethics — autonomy, beneficence, non-maleficence, and justice — becomes blurred when the person’s voice can no longer be directly heard. The challenge is not only in following procedure but in interpreting values, preferences, and identity that continue beyond verbal communication. Professionals are called to interpret what ‘best interest’ means when the person cannot articulate it themselves.
Rethinking “Best Interests”
Launex promotes a collaborative model that views “best interests” not as a fixed endpoint but as an evolving ethical dialogue between DCS professionals, health teams, and families. This reframing recognises that the person’s lived experience, emotional state, and previously expressed wishes remain central even in advanced cognitive decline. Ethical decision-making must therefore integrate evidence-based knowledge with intuitive awareness — the empathy that grows from truly knowing the person.
The Reflective Professional
In practice, this means recognising emotional labour as part of professional ethics. DCS professionals often experience moral discomfort when institutional expectations conflict with personal and professional integrity. Reflection is not a weakness but a necessary act of self-regulation — ensuring care remains humane and person-centred despite systemic pressures. Ethical resilience, supported by supervision and continued learning, forms part of professional accountability.
Reflection in Practice
True professionalism in dementia care often emerges in moments of uncertainty — when evidence, policy, and human emotion intersect. For the DCS, ethical confidence is not about always having the answer, but about creating space for reasoning, empathy, and respectful dialogue. In these moments, ethics becomes less about compliance and more about compassion guided by critical thought — a value that sits at the heart of the Launex approach to reflective dementia care.
The Launex Perspective
At Launex, ethical confidence begins with understanding the person behind the condition. Every Dementia Carer Specialist (DCS) is encouraged to pause before acting, to reflect on intent, and to communicate from a place of respect rather than reaction. Ethical dilemmas in dementia care are not solved by rigid rules, but through empathy, collaboration, and transparent decision-making with families and professionals. Launex supports this balance through reflective coaching practices and values-based training that empower DCSs to uphold dignity, autonomy, and trust in every care decision.
Launex Compliance Statement
This article aligns with the standards and frameworks of the World Health Organization (WHO), International Classification of Functioning, Disability, and Health (ICF), Care Quality Commission (CQC), and International Coaching Federation (ICF).