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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