As an increasing number of older people struggle with dementia, what happens to their guns?

 

The following article written by Melissa Healy of the LA Times describes a growing concern – especially in countries where widespread gun ownership was the norm… and while her article relates to the USA, to a degree the problem is relevant in South Africa.

 

As the number of adults with Alzheimer’s disease and dementia steadily increases, questions around their access to guns remain largely unaddressed. That needs to change, doctors say. One such example relates to a man who had retired from a career in which firearms were a part of the job. He was enjoying his day’s hunting, or at the shooting range with friends. But episodes of confusion had led to a suspicion of dementia, and the nights were the worst: At sundown, he became disoriented, anxious and a little paranoid, and had started sleeping with his loaded pistol under the pillow. One night, he pointed it at his wife as she returned from the bathroom. It wasn’t clear whether he recognized her, but he was certainly confused — and she was terrified. Thankfully, the incident did not end in disaster.

 

I’ve had that patient several times,” said Dr Michael Victoroff, then a primary care physician in Denver. What Victoroff knew then is something that has now entered the conversation among primary care physicians across the country: It was high time to have “the talk” with his patient about the safety of his guns when dementia had apparently set in … As a patient’s memory falters and cognitive skills fade, what is to become of the firearms that have long been a source of pride and a mark of responsible adulthood? Should they be locked up; disabled; entrusted to someone else? These are the questions that a group of physicians challenged their colleagues to discuss with their patients.

 

Doctors have been debating for years when and how to counsel their patients about gun ownership and safety … and are confident that few would question a doctor’s motives in raising the safety of gun ownership when a person’s mental competence has come into question. “No one would challenge you about discussing driving safety with a patient having memory trouble,” said Dr. Donovan Maust, a University of Michigan psychiatry professor … So this feels like it would be negligent not to discuss this with a patient and his or her family.”. In households where dementia patients have access to firearms, the doctors raised concerns about suicides, accidental shootings, theft and unauthorized use of guns.

 

The numbers undergirding those concerns are striking. Roughly 1 in 3 adults over 65 in the United States is thought to own a gun. An additional 12% live in a household with someone who does. As seniors turn 70, their odds of developing Alzheimer’s disease in a given year jump from less than 1% (among those 65 to 69) to 2.5% (among those 70 to 74), and keep rising from there. By 2050, the number of older Americans with Alzheimer’s is expected to reach 13.8 million.

 

“It’s not about us vs. them, or taking away people’s guns. It’s about us helping people make choices in the interest of safety,” said Dr. Emmy Betz, an emergency physician at the University of Colorado at Denver and lead author of the essay. “It would be awesome if all our older patients would think ahead about where and when and how they would hang up their keys and or safeguard their guns,” Betz said. “Most of us don’t do that because we’re human. But we can try.”

 

A real tragedy

The following article describes the consequences of not removing firearms from people with dementia:

 

Guns and Dementia Don’t Mix

I once worked for a home-based agency that served the needs of older adults who lived in the crime-ridden neighbourhoods of Chicago. Guns were abundant, as they still are today. An 87-year-old man with dementia was cared for by his wife but he often did not recognize her. One morning when she got out of bed first to fix breakfast, he then woke up and thought an intruder had entered their home. He reached for a handgun and when she returned to their bedroom, he shot her dead. On many levels, this was a terrible tragedy. However, it could have been prevented if the gun had been removed, hidden or locked up. 

 

So what to do?

The following precautions could assist in controlling unwise gun ownership:

  • If possible ban gun ownership entirely in respect of people living in retirement complexes.
  • Prohibit firearms from being brought on to the property.
  • Insist that all guns on site should be handed in at the complex office; and locked in a safe, until such time as the firearm has been sold/ handed into South African Police Services, or collected by family members.
  • Encourage people to voluntarily relinquish their gun ownership.
  • Where an elderly person suffering from dementia, who is known to be in possession of a firearm, either denies it,; or refuses to comply with relevant village conduct rules in respect of firearm ownership, report the matter to other external family members – and as a last resort to the police.
  • In situations where removing the weapon from the owner with AD would prove very difficult, arrange to have the weapon disabled by a gunsmith. This is fairly readily accomplished by either filing down the firing pin, removing it altogether, or exchanging real ammunition for fake bullets. (These procedures may need to be arranged ahead of time, as they could require tools or workshop facilities, but given the danger inherent in a person with dementia continuing to own a firearm, would be well worth the effort).

 

Do I hear you say – this seems harsh! Not at all! Village management and Boards of Trustees have the collective responsibility, and duty, to safeguard all residents residing in their estates; or entrusted to their care.

 

Article By Henry Spencer