Table 2 Overview of registered nurses’ (n = 50) perceptions of challenges in their leadership close to older adults

Patients without insight

Motivating for care

Patients are unmotivated to receive care

Patients do not want to receive care

Next of kin do not want to receive care for their relative

Provide care based on each individual’s wishes

Adjusting nursing care to the older adult

Adjust care to patients with dementia

Several care providers involved in patient care

Coordinating care for the older adult

Quick discharges from hospitals

Different journal systems

Lack of material resources to coordinate patient visits

Lack of conditions for teamwork

Regulations

Next of kin’s grief and sadness

Relating to next of kin

Next of kin at distance

Deficient communication with patient due to disease

Managing communication difficulties

Older adult’s language difficulties

Communication with next of kin

Care staff’s language difficulties

Deficient communication with staff

Cultural differences

Reach consensus in situations

Deficient communication with another healthcare organizations

Different social situations in the home

Relating to social situations in the home

Insufficient work environment at the older adult

Perform correct assessments

Managing demands

Next of kin’s demands

Care staff’s needs

More advanced care and few registered nurses

Lack of balance between demands and resources

Work alone

Working alone

Not knowing what is going to happen

Managers’ low support

Difficult to keep up with all work tasks

Having lack of time

Too few staff

Deficient availability of physicians

Collaborating with physicians

Deficient continuity of physicians

Deficient responsibility of physicians

Low competence affects quality of care

Care staff having low competence

Care staff lack competence