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The purpose of the paper is to explore why it was considered useful and how it was possible to conduct a participatory action research (PAR) in a health‐care service experiencing conflictual dynamics (which affected service quality) and on the challenges this entailed. Specific attention is given to the action researchers’ role.

A methodological reflection is developed starting from theoretical considerations and a case study. In response to the committee group's request concerning the need to better understand and manage the criticalities and conflict episodes faced by a service for sufferers of Alzheimer's disease, the authors proposed and realized a PAR. The PAR is described considering: the process, some outcomes, the functions and actions performed by the action researchers, and the dilemmas and challenges they faced.

The case study revealed it was fundamental for the action researchers to perform a constant mediating function when conducting a PAR in an organization experiencing conflictual dynamics. How this function was carried out is described. Furthermore, the dilemmas, challenges and risks faced by the action researchers in proposing this PAR are addressed.

In this PAR the main limitations and open issues concern both the possibility of assessing outcomes and processes in a medium to long time frame and the cyclical turnover of patients and caregivers, raising the question of legacy.

In analyzing a specific case, the authors focus upon both the indicators that allowed them to assess usefulness, feasibility and sustainability of the PAR in a conflictual context and the functions assumed, actions realized, and challenges faced by the action researchers.