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About a third of people with Alzheimer’s disease have access to a firearm in their home, according to a newly published survey of caregivers.

Few caregivers, however, have discussed what to do when their loved ones are unfit to handle the guns.

“Alzheimer’s and other kinds of dementia can cause changes in thinking and memory that could make someone unsafe to handle a gun, even if that person has a lifetime of experience,” said lead researcher Dr. Emmy Betz, an associate professor of emergency medicine at the University of Colorado School of Medicine, in a statement.

“As healthcare providers, family members and friends, we can help older adults think about what they would want to happen with their firearms, if they become unsafe to use them,” said Betz, who leads the Firearm Injury Prevention Initiative at UC’s School of Medicine. “This approach promotes respect for independence and preferences while also ensuring safety.”

Guns common in homes of older Americans

Up to half of older adults in the United States live in a home with firearms, statistics have shown. Among that population, the greatest risk for firearm misuse is for suicide.

Yet less than 20% of the caregivers in the survey, published Wednesday in the journal JAMA Network Open, were worried about their loved one with Alzheimer’s intentionally injuring themselves or others. Instead, nearly 70% of the caregivers indicated their greatest concern was accidental injury by gun misuse.

And while the majority of caregivers said they would welcome discussing gun safety with doctors or other health care providers, only 5% said their providers had brought up the subject.

“Figuring out what to do about firearms can be stressful for family members and other dementia caregivers. Our study shows that few caregivers, including spouses and family members, have received professional counseling about how to address gun safety,” Betz said.

That lack of dialogue may help explain that among caregivers worried about their loved one’s access to firearms, “only 53% reported that they or family and friends acted on that concern,” wrote Erin R. Morgan and Dr. Ali Rowhani-Rahbar in an accompanying commentary.

Keeping loved ones safe

Rowhani-Rahbar, an associate professor of epidemiology at the University of Washington’s School of Public Health, and Morgan, a postdoctoral epidemiologist at the school, point out discussion and decisions on when to safeguard firearms is not just the responsibility of clinicians.

“Friends, family, and caregivers for PWD [people with dementia] all have an obligation to keep their loved ones safe,” they wrote, suggesting that having a conversation early in the course of the disease, while the loved one is more lucid, may be the best strategy.

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The study analyzed responses to the 2019 National Firearms Survey from adults 35 years or older who said they were making decisions about medical, financial, housing or other needs for a person of dementia. The online survey, conducted last year between July 30 and August 11, is conducted among a nationally representative sample of US adults living in homes with firearms.