FIREARM INJURY PREVENTION

Close to 40 percent of households in the United States with older adults have at least one firearm on the premises. Handling a gun safely requires good vision, eye-hand coordination, motor skills, strength and balance. Age or medical conditions can affect any of those, says Emmy Betz, M.D., MPH, the founding director of Firearms Injury Prevention Initiative and a professor of emergency medicine at the University of Colorado School of Medicine. If the medical condition involves memory loss, the dangers increase.

“Ideally, it’s not about confiscation or restriction. Ideally, it’s about helping people make these decisions ahead of time.”

Betz’s Firearm Injury Prevention Initiative surveyed caregivers of people with memory loss who had firearms in their homes. They asked if the person had any plans of what to do with their guns when it became unsafe for them to use them. Only slightly more than half said they did. She urged people to think about the gun now.

The sooner people can start this process the better. “This could be part of the tool kit of things that people are given to think through, like finances, housing and medication options, when a diagnosis is made. Home safety should be on the list.” “All this in many ways is easier said than done. Making these changes is difficult and I don’t want to minimize that. For some people firearms are deeply tied to their identities and sentimental,” says Betz.

Considerations

With someone in the early stages of memory loss, consider whether they are having judgment changes, insight changes or personality changes. “Are there any depressive symptoms or are they saying things about wanting to die or about not wanting to be around people? We know that among older adults firearms are the most common method of suicide.”

Some people may have the motor skills, the mechanics of firing, but they may not have the judgment, the insight anymore. In fact, “This is the space where it might be reasonable to think about going to the range with dad to see how he’s doing and determine if he still seems safe.”

Keep in mind, “The person with dementia may have been a lifelong hunter, firearms user, police officer, military service member, and perhaps even the protector of the family their whole life,” said Betz. “Remember, it’s not the person, it’s the disease. It can be hard for family members to realize that the person has changed. It can be hard for someone to accept that your spouse of 40 years poses a risk to you now in the middle of the night if they still have a gun.”

Taking away ammunition is not always enough either. Depending on the level of impairment, the person could go out and purchase more. Guns can be disabled in a way that the person with memory loss can’t tell that they are no longer operational, but that isn’t always the solution, Betz says. “The downside to that option is that to a visitor or a physical therapist coming over, the gun would still look like a regular gun, so it could lead to some issues.”

She acknowledged this could turn dangerous if the person with the disabled gun was standing on the front porch with it and police officers arrived. The person might not be able to respond to police commands promptly.

A Solution: Firearm Life Plan

Betz wanted to develop resources that could help caregivers deal with all these difficult issues.

The Firearm Life Plan, available at firearmlifeplan.org, helps people think about important questions related to their firearms and to protect their families from the burden of making difficult decisions without guidance.

It features worksheets and resources that can be downloaded. The inventory worksheet outlines what you want done with your firearm, where it is stored and access codes. The legacy map lets you share the importance of firearms in your life and preserve your memories. Another worksheet deals with broaching the conversation with a loved one who might need to give up their gun and how to assess when that time has come.

Messages about gun safety need to be spread through national and local dementia groups, health care professionals, national firearms organizations and retailers, Betz says.

“As a health care provider, absolutely, I believe that we in health care have a role to play here, but it can’t just be us.’’

CONVERSATION STARTERS FOR FRIENDS & FAMILY

“I know we’ve never talked about it, but what do you want to do with your firearms as you get older?”

“I’ve noticed [shaky hands, difficulty seeing] are giving you trouble lately. Next time you go to the shooting range, may I go with you? I’d like to see how you’re shooting these days.”

“I care about you, which is why I wanted to talk to you about your firearms. I’ve noticed some changes over the years that I was hoping to talk to you about.”

“I know that a lot of things have changed over the years. I think it might be a good time for us to talk about how things are going with your firearms.”

“You always taught me about firearm safety. That’s why I wanted to talk about some changes I’ve noticed lately.”

“It’s hard to think about anything ever happening to me or you, but making a plan just to be safe is always a good idea.”

Source: Firearmlifeplan.org