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  • Q&A with Australian Health Practitioners

    How do I respond to threats of self harm in someone with dementia?

    Related Topics
    Dementia Geriatrics & Ageing Well Mental Health
    My father (94) who has been diagnosed with early onset Dementia has lost the motivation to walk or do the things he likes to do. It had become so bad he got to the point where he could barely walk for fear of falling and not having the strength.

    We have had him admitted to a care facility and guess what? After just 5 days he now says he has learnt the error of his ways by being lazy and wants to go back home. He has developed a mantra which is ‘if you don’t let me go home I will harm myself'.

    Is this normal for someone with Dementia? And if it is, how best should I respond as he has become very persistent?
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    Jennifer Grant

    Psychologist

    New practice opened Feb 2018. Seewebsite www.coffspsychneuro.com.au I'm passionate about working with people from all walks of life to help them create a more vital, … View Profile

    There’s no easy answer to this question. Whatever way you respond (or don’t respond) will give rise in you to fear – anxiety and worry – as well as sadness. I’m guessing you’ve already know come to know these emotions well as you’ve watched your father’s condition deteriorate. A fail-safe response to anyone who is suffering is compassion. The genuine expression of compassion to your father, along with empathy as you demonstrate you understand his struggle, communicates both his inherent self-worth and your love for him.
    Thoughts of self-harm and expression of intent to self-harm are “normal” for anyone, with or without dementia, who is experiencing what seems to them to be intolerable, interminable and insoluble distress. Whether or not the intent of the self-harm is to “manipulate” others, it’s unmistakably a desperate cry to be heard and understood. You can’t “fix” his failing health. Nor can he. You can’t suddenly give him the independence he once cherished. You can however, hear him in his suffering, frustration and anger. You can collaborate with him in finding ways he can do things that bring some sense of pleasure or meaning, ways in which he can still exert influence and power over his world. You can tell him of your love for him. And you can seek the support of those who care about you. Others will be concerned for you. I encourage you to accept whatever help is available to you as you share your father’s difficult journey.
    A health professional who specialises in geriatric psychiatry/ psychology may be able to offer more specific advice. 
    I wish you well.

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    Alicja Weidner

    Counsellor, Hypnotherapist, Social Worker

    Alicja Weidner is an Accredited Mental Health Social Worker, Counsellor, and Clinical Hypnotherapist with a particular interest in working with people with anxiety disorders, depression, … View Profile

    The Alzheimer's Association   (https.www.alz.org) has a wide range of resources and information pages discussing strategies for dealing with a variety of issues commonly experienced by people with dementia and their families.  It may be worth looking through their website and perhaps also connecting with some carer educations groups that are run by the association.  The Alzheimer's Association also provides a 24/7 National Dementia Line which may be useful if disteressed and uncertain.  Phone:   1800 272 3900

    Specialist counselling can also obtained from the Alzheimer's Association.  It may be a good idea to talk with someone impartial to explore various options and pro and cons to assist future decision making for you and your dad. 

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