Background <p>As the global population continues to age, home-based care has gained increasing popularity as a way to address the growing need for long-term care among older adults. At the same time, healthcare and social care providers working in home care settings are experiencing a rise in ethical conflicts. This qualitative meta-synthesis aims to explore the ethical conflicts experienced by healthcare and social care providers in home-based care, offering insights and guidance for resolving moral dilemmas in this setting.</p> Methods <p>Qualitative systematic review utilizing meta-ethnography. A systematic search was conducted across four databases (Web of Science, Embase, MEDLINE, and CINAHL) from their inception through April 2025. Two reviewers independently screened articles against the eligibility criteria, appraised them using the JBI critical appraisal tools, and extracted qualitative data in duplicate. 16 studies met the inclusion criteria and were analyzed using thematic synthesis.</p> Results <p>The sixteen included studies were synthesized into three main themes and seven subthemes. The three main themes were Paternalism versus Respect for Autonomy, Blurred Boundaries, and Shortcomings of the Health System.</p> Conclusion <p>Our findings reveal that healthcare and social care providers experience diverse forms of moral conflict during home care; these experiences jeopardize their physical and mental well-being and urgently call for targeted support and intervention.</p>