Pretty much all old people who live in places where public transporation is scarce resist the idea of giving up their car keys and dread reaching the day when it might become necessary. Who can blame us.
In recent years, families, physicians and caregivers are becoming more conscious of the need to help elders decide when it is time to stop driving, but what about firearms?
Do you own a gun or two or more? Does an elder you know or care for have access to guns? What about someone you know with dementia, even early dementia?
The size of the elder gun-owning population is larger than I had imagined. According to a Pew Social Trends survey, about 33 percent of people aged 65 and older in the U.S. owns a gun, and another 12 percent of that cohort lives with someone who does.
In addition, “A 1999 study estimated that 60% of persons with dementia (PWDs) live in a household with a firearm.” And, reports The New York Times,
”More than 8,200 older adults committed suicide in 2016, according to the Centers for Disease Control and Prevention. Among men, those over age 65 are the likeliest to take their lives, and three-quarters of them use a gun.”
Obviously the potential for tragedy involving elders with dementia who have access to guns is an important issue that hasn't been well addressed.
Last month, a group of physicians got together to publish an essay in Annals of Internal Medicine about this. In particular, they made a plea for the medical community and others to find a way to make life safer for people with dementia and their potential victims.
The doctors note that federal laws do not prohibit purchase or possession of firearms by people with dementia and only Hawaii and Texas mention those conditions in firearm statutes:
“Hawaii prohibits possession by any person under treatment for 'organic brain syndromes', which could include dementia or similar neurodegenerative conditions. In Texas, persons diagnosed with 'chronic dementia' are ineligible for a license to carry a handgun in public but may purchase and possess firearms.
“Many questions on firearm access in dementia remain unanswered,” wrote the doctors, “but the need to address the problem is here now.
“We believe that a concerted, cooperative effort making the best use of the data at hand can help prevent injuries and deaths while protecting the dignity and rights of older adults.”
There are plenty of anecdotes about near catastrophe involving guns and people with dementia. The authors note in the “Annals” essay that as dementia progresses, family members, health aides and other visitors can be at extreme risk. The Times article includes a story from Dr. Michael Victoroff, a family medicine specialist at the University of Colorado School of Medicine (and a certified firearms instructor):
”One of his patients, a retired police officer, had long slept with his service revolver by his bed. But as he neared age 80 and his dementia deepened, 'he would wake up at night and not recognize his wife, see her as a stranger in his house,' Dr. Victoroff said.
“Once Dr. Victoroff learned that the man had pointed the loaded .38 at his wife, the situation grew urgent. They turned to the man’s former partner on the police force, someone he trusted, to persuade him to give up his weapon.”
The essay doctors compare the firearms safety issue with that of driving and suggest that families should discuss giving up guns with relatives diagnosed with dementia. The best time to do that, they say, is when the person can still make decisions for him- or herself:
”Families might consider a so-called 'firearms retirement date,' when they will give up any guns in the home to avoid the potential for these weapons to be in the house when they’re no longer able to store them or use them safely, the paper’s authors suggest.
“Or, in much the same way that people may set up an advance directive giving a loved one the ability to make medical decisions on their behalf, older adults might designate someone they trust to have the authority to take away their guns when the time for this comes.”
Lead “Annals” author, Dr. Marian E. Betz, told Reuters,
“'In later stages of dementia, behavioral issues like paranoia or aggression should raise concern, as should threats about suicide or threats towards others,' Betz said. 'Families and friends can then lock up or disable guns or move them out of the home, depending on what works for the family and according to state firearm transfer laws.'
“When guns do remain in the home, they should be locked so that the person with dementia doesn’t have unsupervised access to firearms, and they should be stored unloaded and separate from ammunition, the doctors also recommend.”
To me, never a gun user or owner, implementing these (and even stronger) safety recommendations for people with dementia seem as obvious as giving up driving licenses when the time comes. But according to The New York Times article, it is not as clearcut as I believe:
”Many gun enthusiasts argue that while driving is a privilege, the Constitution protects keeping and bearing arms. And they find firearms a crucial part of their identities and sense of security.
Here we go again – the same old Second Amendment argument, even for people with dementia. There has got to be a middle ground, don't you think?