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Nurses and other professional caregivers are increasingly recognising the issue of moral distress and the deleterious effect it may have on professional work life, staff recruitment and staff retention. Although the nursing literature has begun to address the issue of moral distress and how to respond to it, much of this literature has typically focused on high acuity areas, such as intensive care nursing. However, with an ageing population and increasing demand for resources and services to meet the needs of older people, it is likely that nurses in long‐term care are going to be increasingly affected by moral distress in their work. This paper briefly reviews the literature pertaining to the concept of moral distress, explores the causes and effects of moral distress within the nursing profession and argues that many nurses and other healthcare professionals working with older persons may need to become increasingly proactive to safeguard against the possibility of moral distress.

The objective of the research reported here was to provide an opportunity to raise issues relevant to the ongoing debate on informal care of older people by exploring the attitudes of both men and women towards the care of dependent older people. The sample (n = 174) was drawn from age cohorts 20‐39 years (n = 90) and 40‐59 years (n = 84). The men and women who participated in the study were members of the general public. The self‐administered survey questionnaire was designed to examine attitudes towards the informal care of older people and to determine if men and women differ not only in attitude but also in their willingness to undertake certain aspects of care, and whether the age of the respondent was likely to be a defining factor. Statistical analysis was conducted using SPSS. The results established that an overwhelming majority of women demonstrated a greater willingness to provide care to a dependent older relative.

Despite the increasing evidence about the inappropriate use of medications by older people, there is very little published evidence about the control and monitoring of neuroleptic drugs used in nursing homes. As others have indicated, this is all the more worrying when set in the context of the paucity of research on nursing home care and the trend to replace registered nurses with untrained care assistants. In the United States, legislation in the form of the Nursing Home Reform Act (OBRA 1987) was introduced, in part, to regulate the prescribing and administration of neuroleptic (antipsychotic) drugs. No such legislation exists in Canada or the United Kingdom. In the case of the latter jurisdiction, the recent Royal Commission on Long‐Term Care for older people (The Stationery Office, 1999) has recommended a national care commission to monitor care, and set assessment and quality benchmarks. In Canada this debate has not even begun, and the purpose of this paper is not to ignite controversy, but to raise questions about the use of these drugs with nursing home residents. Voluntary guidelines and education of physicians, nurses and care attendants would be infinitely better than legislation. In the meantime, we need research to address the following questions: For what reasons should these drugs be given to older people? Are these drugs being used appropriately? Is the risk of side‐effects too great with these drugs? Are the numbers and type of staff employed in nursing homes adequate/qualified to detect and report side‐effects? How well do these drugs manage the behaviours they are given to control? Are they being used as chemical restraints or to make the older person compliant? Are the so‐called ‘atypical’ neuroleptic drugs any better? What we offer in this article is background information that might encourage others to not only review their practice but also to address these questions.