Gun Ownership And The Elderly: People Over 65 Have Highest Rates Of Ownership And Dementia

gun owner
Researchers propose a series of red flag questions about gun ownership to be asked by physicians when interviewing elderly patients. Photo courtesy of Shutterstock.

Guns and the rights of those who own them are contentious issues in contemporary America, matters that speak directly to the heart of our beliefs about what it means to be an American. What many people do not know is that people over the age of 65 have the highest rate of firearm ownership in the nation... yet they also have a high prevalence of dementia, depression, and suicide as well. Clearly, on the wrong day, this combination of odd factors could potentially lead to a lethal situation and for this reason, gun safety among the elderly is a pressing, if unnoticed issue. In her exploration of the medical and legal problems posed by gun ownership among the aging, Dr. Ellen Pinholt proposes a series of red flag questions to be asked by physicians and caregivers.

“Whereas there are well-accepted guidelines for the assessment and counseling of older drivers, there is little to help guide clinicians in their discussions with older gun owners,” wrote Pinholt and her co-authors in an article published in the Journal of American Geriatrics Society.

What does the law say?

Though there is a minimum age for owning a gun, no upper age limit exists for doing so; and, while mentally incompetent people are prohibited from possessing a firearm, this only applies to a formal finding by a court and may not include a physician’s diagnosis of dementia. The law, then, routinely does not address diminished capacity in a person who already owns a firearm, either inherited or purchased when he or she was younger and more competent. Even when guardianship is established, laws prohibiting possession of firearms by someone incompetent would presumably apply, but how many guardians are aware of this fact? Interestingly, nearly a fifth of all guns in the home are not intentionally purchased, instead they have been given to or inherited by their owners. This suggests more than a few inexperienced widows have guns which they may not know how to use stored in unlocked drawers or on closet shelves.

For all of these reasons, Pinholt and her co-authors make their case for questioning the elderly about owning a firearm. “’Is there a gun in the home?’ is a legal and relevant question during a home visit and pertains to the safety of the patient, family members, and home health worker,” note the authors in their study. “Make the inquiry as automatic as asking about driving when interviewing individuals with dementia or their families.”

Following this suggestion, Pinholt and her colleagues establish general guidelines for a physician or caregiver referred to as the Five L’s:

  1. If there is a gun present, is it Locked?
  2. Is it Loaded?
  3. Are Little children present?
  4. Does the gun owner feel Low?
  5. Is the gun owner Learned?

The authors suggest the Five L's be asked during any interview of an older person with depression or with grandchildren in the home. Significantly, they also advise physicians to be aware of those who might be available to help when intervention or the removal of firearms may be needed. Such a scenario could involve family members, the police, or Adult Protective Services.

Pinholt and her co-authors clearly tread on dearly cherished beliefs, nevertheless their article raises important questions for anyone of strong beliefs on either side of the gun issue.

 

Source: Pinholt EM, Mitchell JD, Butler JH, Kumar H. "Is There a Gun in the Home?" Assessing the Risks of Gun Ownership in Older Adults. Journal of the American Geriatrics Society. 2014.

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