<p>Aim To investigate the experiences of patients and nursing staff in relation to the care delivered to, and received by, older people with dementia in an acute hospital setting.</p> <p>Method An ethnographic approach was used. Data were collected thorough observation and interviews involving patients and nursing staff.</p> <p>Findings Care for older people with dementia in acute hospital settings is not always satisfactory. Generally, people with dementia find the delivery of care and the experience of being in hospital distressing. Nurses strive to provide optimum care, but this is not always achievable. Sub-optimal care can be explained by considering the effect of empathy and Bourdieu’s theory of practice.</p> <p>Conclusion There is a need to improve current practice when caring for older people with dementia. Approaches to education and practice development need to engage nurses in both cognitive and affective domains, so that nurses gain knowledge and an understanding of patients’ feelings and experiences.</p>