An 80-year-old man living alone with Alzheimer’s received regular care from a health aide whom he shot and killed during period of confusion. In other cases, patients with dementia, who have an increased risk for depression and suicide, have shot themselves in the head.
According to a recent article in Scienmag, there’s a growing dilemma among law makers about extending laws for removing firearms from people with mental illness to include those with dementia.
The American Osteopathic Association notes high rates of gun ownership and dementia risk among baby boomers. In an article published in the Journal of the AOA, study authors note that the lack of public policy could lead to an increase in suicide and accidental shootings among older adults. While physicians can alert authorities if a patient should no longer drive a vehicle, no such process exists for firearm owners with cognitive impairment.
“Nothing about this is easy. People’s identities are formed in a large part by the ways and degree to which they feel self-sufficient,” says lead author Katherine Galluzzi, D.O., 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.”
Researchers say that older adults have the highest rates of gun ownership, with 27 percent of people 65 and older owning one or more firearms, and 37 percent living in a home with a firearm present.
One study of patients with dementia or related mental health issues reveals that 18 percent lived in a home with one or more firearms. Of that group, it was reported that 37 percent had delusions and 17 percent had documented hallucinations.
Another survey found that 60 percent of households with individuals with a diagnosis of dementia had one or more firearms. Study authors noted that even homes with severely impaired patients were as likely to have firearms in their homes as those with mild cognitive impairment.
In an article published in the Annals of Internal Medicine, doctors and experts worried not only about the risk of suicide by gun owners with dementia, because the condition itself is a risk factor, but they also warned that dementia patients might put family members and caregivers at risk by becoming confused and mistaking them for intruders.
The doctors suggested drawing up an advance directive that sets up a “firearm retirement date,” according to AARP.
While “red flag laws” offered in some states allow family and law enforcement to petition a judge for temporary removal of firearms from someone who may be a danger to themselves, Dr. Galluzzi notes that the same principle could apply to patients with dementia.
She urges patients and their doctors to discuss these matters. In addition, Dr. Galluzzi encourages patients and their families to make a plan for transferring the gun ownership before the dementia sets in.
“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,” she says. “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 themselves.”
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