Introduction: Dementia represents one of the greatest challenges of modern health and social care, as the progressive deterioration of cognitive function affects an individual's ability to live and make decisions independently. In the care of people with dementia, ethical challenges often arise related to preserving their autonomy. Purpose: The aim of the thesis is to identify ethical challenges in preserving the autonomy of people with dementia based on a review of the literature. Special emphasis is placed on examining the balance between respecting their self-determination, ensuring their well-being, and the role of family members and healthcare professionals in their care. Methods: A descriptive research method based on a review of scientific and professional literature was used. The literature search was conducted from April to August 2025 in the databases Medline/PubMed, CINAHL Ultimate, Scopus, ScienceDirect, and Web of Science, as well as through the bibliographic systems COBISS.SI and DiKUL. Additional sources were identified using the web search engine Google Scholar. A total of 12 scientific articles were included in the analysis. Results: The results of the literature review showed that preserving the autonomy of people with dementia in nursing care is primarily achieved by involving the individual in decision-making about their own care and by respecting their rights, dignity, and remaining abilities. Effective communication, person-centered care, and cooperation between family members and healthcare professionals play an important role in maintaining autonomy. At the same time, several ethical challenges, particularly in assessing the decision-making capacity of people with dementia and in balancing their self-determination with ensuring safety and well-being. Discussion and Conclusion: Preserving the autonomy of people with dementia requires an adapted and individualized approach that enables the individual to participate in decision-making in accordance with their remaining abilities. In nursing practice, this requires thoughtful and ethically grounded decision-making that balances respect for the individual's self-determination with ensuring their safety and well-being. Such an approach enables more holistic and respectful care for people with dementia and contributes to preserving their dignity.
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