A Fatal Threat in Aging America: Firearms and Dementia

Gun Rights

Diagnosed with early-stage dementia, a close relative of mine recently celebrated her 90th birthday with her son and grandson, with whom she now lives. Although her memory is still strong, she suffers from late-night panic attacks, “night terrors,” and hallucinations.

She repeats the same stories over and over, and sometimes converses with people who aren’t there. The computer “tells” her things that scare and confuse her. Yet, legally independent and making her own financial, personal and medical decisions, she still does not trust doctors and sometimes not even her son.

As a young mother in the late 1950s, living in rural New England, she could handle her husband’s shotgun with poise, those who know her say, but preferred her own .38 revolver for target shooting and protection. Alone with her two children in a small house — her husband worked nights — the revolver gave her peace of mind, she told them.

She turned in the revolver to the police decades ago when her husband died and no longer owns a gun. But what if she had not turned it in?

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One study shows that 60% of people with dementia live in gun-owning households.

Senior man looking through the window at home
Delusions and paranoia can put people with dementia at higher risk of firearm injury, accidental death or suicide.Getty Images

People with dementia are at high risk of firearm injury, accidental death or suicide. Delusions and paranoia may lead them to harm family members and caregivers. This threat needs to be addressed now because America’s elderly population is only going to grow.

However, there is no systematic data to track the prevalence of suicide, injury or homicide involving people who suffer from neurodegenerative diseases. And when the potential for problems does occur, a solution can be hard to come by.

Unless a gun owner with neurodegenerative disease voluntarily transfers the firearms to a family member, or turns them in to police, it is not easy for families to remove firearms from the person’s home, even if they recognize the danger.

Locking up firearms can save lives, researchers suggest. However, when it comes to people with neurodegenerative disease, hiding and locking up firearms in the home may not be sufficient because, in a moment of clarity, they may remember the code. Or, amid a panic attack, they may break into a gun safe.

According to Pew Research Center, 45% of Americans 65 and older live in households with firearms. A third of all seniors personally own a firearm.

A 2022 study estimated that 10% of all Americans 65 or older have some form of dementia, and 22% have mild cognitive impairment. The rate of dementia climbs with age: 35% of those in their 90s suffer from the disease.

Other neurodegenerative diseases, such as Parkinson’s, ALS, and multiple sclerosis, are also prevalent among America’s elderly. Such diseases can impair sufferers’ motor skills and often their cognitive abilities.

As America’s population ages, the number of people with cognitive and motor impairments is expected to double. By 2060, some 13.9 million people may suffer from such diseases.

Studies show that neither transfer nor removal of firearms is always easy and straightforward. Transfers may require the involvement of a federally licensed dealer and background checks on purchasers. Family members may be required to show proof of ownership, which can be complicated if records do not exist.

In addition, states vary widely in the type of resources that are available to families who wish to protect their aging loved ones and others from potential gun violence, including suicide. This information is not always easily accessible.

Some states, such as Illinois, New York and California, allow caregivers to file for an Extreme Risk Protection Order (ERPO), but this can be costly and time-consuming because it involves police, courts and lawyers. It is not a long-term solution since the orders are temporary.

The U.S. Supreme Court in 2008 recognized gun ownership as a protected constitutional right. In 2022, the Court imposed additional hurdles on gun regulations, which now must conform to a “history and tradition” standard.

As a result, even ERPO laws have come under challenge in the courts; the Supreme Court is reviewing one major case. Should the justices find these protection orders unconstitutional, families will have even fewer ways to protect their loved ones and themselves. This would be a tragic decision.

Legislators, policymakers, activists, advocates for gun safety, and family and community members must push for easier ways to reduce harm by removing guns from the homes of those living in compromised conditions. These efforts can include regular drives to relinquish guns to police without questions, or options for owners to lock up firearms off-site.

The care of someone enduring dementia or other neurodegenerative diseases is difficult enough. It need not be fatal because of access to a firearm.

Alexandra Filindra is an associate professor of political science and psychology at the University of Illinois Chicago, a Public Voices Fellow through The OpEd Project, and the author of “Race, Rights, and Rifles: The Origins of the NRA and America’s Gun Culture.”

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