A rethink of dementia and gun ownership is needed, experts say.
An 80-year-old man with Alzheimer’s mistook his home health aide, who had been providing care for him for several months, for an intruder. When she tried to reason with him, he retreated to his bedroom, then fatally shot her. That’s just one of the cases researchers uncovered in a recent study on dementia and gun ownership.
When higher rates of dementia risk and higher rates of gun owners converge, as they do in the baby boomer population, it puts people at a greater risk of killing themselves or others, warned scientists in an article in The Journal of the American Osteopathic Association.
The scientists found that older adults—defined as age 65 and older—are more likely to own guns than any other age group. They’re also at the highest risk for dementia. Researchers found that 27 percent of people over 65 own a gun, and 37 percent of people over 65 live in a home with a gun.
In a small study of 495 patients, a group of researchers discovered that 89 of them—18 percent—lived in a home with at least one firearm. Of those 89, 70 percent had a diagnosis of dementia, 37 percent had delusions and 17 percent had hallucination documented in their medical records. Sixty-five percent of those with a firearm in the home had a diagnosis of depression.
In a 1999 survey, doctors found that 60 percent of patients with dementia had a firearm in the home. Forty-four percent said the gun was loaded; another 38 percent said they didn’t know if the gun was loaded or not. Only 17 percent could say for sure that the guns in the home of the dementia patient were unloaded.
When adults experience an illness like dementia, families often express concern about driving. Some states are even required to report a dementia diagnosis to the DMV. But laws around alerting authorities that someone has dementia and firearm access are loose.
“Nothing about this is easy. People’s identities are formed in large part by the ways and degree to which they can feel self-sufficient. That doesn’t end with the onset of dementia,” says author Katherine Galluzzi, DO, chair of the department of geriatrics at the Philadelphia College of Osteopathic Medicine. “However, as physicians and family members, we need to be able to do the hard thing in the interest of public safety.”
The study concluded that physicians and families need to be more stringent with firearm access, starting by asking what they called the “5 Ls:”
1. Is there a Loaded gun in the home?
2. Is there a Locked gun in the home?
3. Are there Little children in the home?
4. Has anyone been feeling Low in the home?
5. Is there a Learned operator (someone with prior safety training) in the home?
Asking these questions can start a conversation about transferring ownership once dementia is a factor.
“Whether it’s a question of taking away a person’s car or gun, these difficult discussions don’t get easier as the patient’s mental state deteriorates,” says Dr. Galluzzi “It’s critical for families to talk about this early and decide on power of attorney so someone can act in the best interest of the patient when they are no longer able to do it for themselves.”