Family Caregivers and the Gun Debate
Experts offer guidance on a sensitive issue.
A poll in the November 2012 issue of the Caring Right at Home online newsletter asked: "What is the most difficult topic to discuss with elderly loved ones?" Readers named "the need for outside help" and "driving safety" as the top two issues. Since then, a new topic has emerged as a subject of concern: seniors and gun safety.
Recent events in the U.S. have drawn more attention than ever to the debate about gun laws and gun safety. News stories focus on the need for keeping children safe from firearms-related injury. But what about the safety of older adults? And when a senior has Alzheimer's disease or other dementia, what should family do?
Researchers from the University of Pennsylvania School of Social Policy and Practice examined the public health considerations related to firearm ownership among the elderly. Study authors Susan B. Sorenson and Brian Mertens reported that more than 17 million seniors own at least one firearm, and with the aging of our population, this number will grow. This is an issue of concern, in part because, according to the Alzheimer's Association, almost one-third of all seniors will develop Alzheimer's or another type of dementia by the end of life.
Alzheimer's and other dementia can make gun ownership dangerous for seniors, as well as for their families and other caregivers. A person with dementia becomes increasingly less able to safely handle and store a firearm. The Alzheimer's Association reports on tragic situations in which a person with dementia mistakenly believes that a family member or caregiver is an intruder. The University of Pennsylvania study authors suggest that it can be helpful to think of weapon ownership in the way we think about driving, and that insights into taking away the car keys might be applied in this situation as well. Said Sorenson, "Memory, thinking and judgment as well as physical and behavioral competence issues related to the elderly person's safe operation of a motor vehicle also apply to firearms. People with Alzheimer's disease can have memory loss, personality changes, confusion, anxiety, fluctuating lucidity and other symptoms that can affect a person's ability to responsibly, competently and safely own and operate a firearm."
The authors suggest that family caregivers, along with nursing homes and other supportive living facilities, should have guidelines for the possession of firearms. Says Sorenson, "Like most Americans, the elderly have the constitutional right to own firearms and there are many elderly people who are responsible gun owners. However, public-health policies must take action to promote the health of elderly persons and the safety of their caregivers."
The National Association of Professional Geriatric Care Managers (NAPGCM) recently issued a set of tips on how best to deal with guns in the home at the point when older family members begin to lose capacities. Geriatric care managers are professionals who help families locate support services for older family members. They also can step in to serve as a mediator when seniors and family members aren't seeing eye to eye on a topic, such as whether the senior can live independently, needs in-home care or other outside help, should still be driving and, increasingly, the issue of firearm ownership.
"Geriatric care managers are regularly in and out of elders' homes and are equipped to understand their physical and cognitive functioning which relates to this issue. Does a person have tremors? How is their eyesight? These are the kinds of questions we address," said NAPGCM member Suzanne Modigliani, a professional geriatric care manager in the Boston area. "Geriatric care managers are trained to act as a guide, advocate and resource for families caring for older relatives and persons with disabilities — among other things, we identify risks facing older adults and help make plans to address safety issues, many of which are often complex, before they happen."
The NAPGCM reports that dealing with guns in the home is one of the most sensitive and important issues children of aging parents can face. Modigliani offers these tips for family members:
- Determine if the gun owner is competent to keep a weapon. Ask questions such as: Why did they have it in the first place? Was the gun historically used for work? Was it used for sport, such as target practice or hunting? Was the weapon used as protection? Is the gun an antique? Does it have sentimental value? Are these uses still valid at the present time?
- If the answers to these questions suggest the gun should no longer be in a person's home, try to get their permission to remove the gun. Having the support of others, like siblings or a geriatric care manager or attorney, may be more effective than trying to convince a person on your own.
- If you can't make headway, if your family member has cognitive issues, or if you think the situation is dangerous, you'll want to get it out of their house regardless. Call your local police department and ask them what to do. Should you bring it to the station? They may be willing to come to your house and pick up the gun.
Another sobering statistic: Older adults are at higher risk of suicide, and they are more likely to use a gun for this purpose. The NAPGCM says that a time to be particularly vigilant is when an elder is overcome by grief, such as after the death of a spouse.
The website of the National Association of Professional Geriatric Care Managers (www.caremanager.org) offers information for family caregivers.
The U.S. Department of Veterans Affairs offers a free online brochure, "Firearms and Dementia."