Balancing integrity vs. risk of falling – nurses’ experiences of caring for elderly people with dementia in nursing homes Inger Johansson Professor Faculty of Nursing Science, Gjøvik University College, Gjøvik, Norway Department of Nursing, Karlstad University, Karlstad, Sweden Margareta Bachrach-Lindström Senior Lecturer Division of Nursing Science, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden Solveig Struksnes Lecturer in Nursing Faculty of Nursing Science, Gjøvik University College, Gjøvik, Norway Birgitta Hedelin Professor Faculty of Nursing Science, Gjøvik University College, Gjøvik, Norway Department of Nursing, Karlstad University, Karlstad, Sweden Abstract Dementia is recognized as being a major risk for falls that cause suffering and increase dependency for the individual. The purpose of this study was to explore registered nurses’ and nurse assistants’ experiences of caring for elderly people with dementia who are at risk of falling, and factors that contribute or reduce falls in this group. A phenomenographic design was chosen. Ten nurses and 18 nurse assistants with experience of fall events were strategically selected for a recorded interview. The informants were chosen from 10 nursing homes in Sweden and Norway. They were asked to describe a fall situation they had been involved in when caring for elderly people with dementia. The findings shed light on an ethical dilemma in the main category ‘Balancing integrity and autonomy versus risk of falling’ which was comprehensively related to two descriptive categories. The first one was ‘Adjusting to the older person’s condition’ with the concepts of forgetfulness, anxiety and confusion, ability to express oneself and understand, bodily build and function. The Journal of Research in Nursing ©2009 SAGE PUBLICATIONS Los Angeles, London, New Delhi and Singapore VOL 14 (1) 61–73 DOI: 10.1177/ 1744987107086423 ORIGINAL PAPER 61