Dementia & Firearm Safety - Harborview Injury Prevention & Research Center

Worldwide, 55 million people are living with Alzheimer’s and other Dementias.

In Washington:

120,000 people aged 65 and older are living with Alzheimer’s in Washington
11.1% of people aged 45 and older have subjective cognitive decline
297,000 family caregivers bear the burden of the disease in Washington
429 million hours of unpaid care provided by Alzheimer’s caregivers
$9.7 billion is the value of the unpaid care
$547 million is the cost of Alzheimer’s to the state Medicaid program

What is Dementia? There are many forms of dementia, all referring to problems with the brain. Mild Cognitive Impairment (MCI) is an early change in the brain that may eventually lead to Dementia, but sometimes resolves.

Is Alzheimer’s Disease the same as MCI? MCI is not as severe as Alzheimer Disease (AD), the most common form of dementia or other AD-related Dementias (ADRD). People living with MCI are more likely to develop AD or ADRD, but sometimes the condition may improve or remain the same.

Sources: National Institute on Aging (nia.nih.gov), National Institute of Health (nih.gov), and Alzheimer’s Association (alz.org)

10 Early Signs of Alzheimer's Disease or other Dementia:

According to the Alzheimer’s Association, there are 10 early signs of Alzheimer’s disease, many are common to other forms of Dementia.

These include the following:

Memory loss that disrupts daily life
Challenges in planning or solving problems
Difficulty completing familiar tasks
Confusion with time or place
Trouble understanding visual images and spatial relationships
New problems with words in speaking or writing
Misplacing things and losing the ability to retrace steps
Decreased or poor judgement
Withdrawal from work or social activities
Changes in mood and personality

Why are we concerned about Firearm Safety for Persons with Dementia (PWD)?

Safety is a major concern for PWD. They are at a greater risk of injury due to the potential for problems with their memory, judgement, and mood. One safety concern that is often overlooked is firearm safety. Approximately 40% of older adults, including persons with Dementia may have a firearm in the home and many do not keep them stored safely.

What can care partners or family members do to promote firearm safety?

Having discussions with your loved ones about firearms is important. Scheduling a time to discuss firearm safety, and coming prepared with a discussion template might help facilitate the conversation. Guides such as the Firearm Life Plan offer documents to help plan for firearm safety. These conversations should start before any signs of memory loss or cognitive impairment but can still be helpful if your loved one has been diagnosed with MCI or Dementia. If there is an immediate safety risk, some of the resources available in our Three Interventions Toolkit may be helpful to guide you in immediately removing the firearm from the home.

What can clinicians do to help promote firearm safety?

Clinicians can and should, ask their patients about access to firearms and firearm safety in routine clinical care. Asking patients about firearms in the context of other safety issues may make it more comfortable to address. If a patient acknowledges they have a firearm. The clinician may follow up to ask if the firearm is stored unloaded in a locked safe, with ammunition locked separately. If it is not, a clinician may provide their patient with information on resources for safer firearm storage.

When should we ask patients about firearms?

Routine wellness visits, as part of a standard clinical template
After a diagnosis of a serious health problem
If they have chronic pain
If they face changes in functional status requiring more assistance
Revisit the discussion about firearms annually (or more frequently, if necessary)

How should we ask patients about firearms?

Ask in the context of a safety assessment and include other safety issues
Ask how they value and enjoy using their firearms, and allow them to share stories if they wish
Ask if they currently have firearms in the home, then ask if they have a plan for the future

What should we do if a patient says they have a firearm in the home, and there is a risk factor for suicide?

Call the National Suicide Prevention Lifeline: 1-800-273-8255 (TALK) (warm hand-off, if necessary)
If not an immediate risk, provide them with resources such as our Three Interventions Toolkit and University of Colorado’s Firearm Life Plan
Ask how the firearm is stored and counsel your patient on the safest options for storage (which is storing the firearm unloaded and ammunition separately, and securely locked)

Please download & share HIPRC's Dementia & Firearm Safety Resources

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Dementia & Firearm Safety – (PDF)

BLOG

Dementia & Firearm Safety – (Click to view)

SLIDE DECK

Dementia & Firearm Safety – (PDF)

INFOGRAPHICS

Intro Graphic: Dementia & Firearm Safety – (PNG) | (JPG)

What is Dementia? – (PNG) | (JPG)

Resources – (PNG) | (JPG)

10 Early Signs of Alzheimer’s Disease or Dementia – (PNG) | (JPG)

RESOURCE GUIDE

For Families & Caretakers:

Dementia & Firearm Safety Resource Guide
English – (PDF)

Guía de recursos de seguridad para la demencia y las armas de fuego
Spanish / Español – (PDF)

For Clinicians or Medical Professionals:

Dementia & Firearm Safety Information – (PDF)

RESOURCE FLIER

Firearm Safety & Suicide Prevention Resources – (PDF)

VIDEO

Watch & share!
Dementia & Firearm Safety – (Click to view)

The Dementia & Firearms Safety guide is part Dr. Laura Prater’s R21/R33 titled, Shared Decision-Making for Firearm Safety among Older Adults with early changes associated with Alzheimer’s Disease/Alzheimer’s Disease-Related Dementias (AD/ADRD). This project is funded by the National Institute of Health; National Institute on Aging.

For more information on Dementia & Firearm Safety:

Morgan ER, Rowhani-Rahbar A. Firearm Safety in an Aging United States
Erlangsen A, Zarit SH, Conwell Y. Hospital-diagnosed dementia and suicide: A longitudinal study using prospective, nationwide register data.
Schmutte T, Olfson M, Maust DT, Xie M MS. Suicide risk in first year after dementia diagnosis in older adults.

Do you need immediate assistance? CALL 9-1-1*

( *9-8-8 will be available July 16, 2022 )

HIPRC’s Three Interventions Toolkit is a FREE digital toolkit featuring three interventions which address firearm injury and death: Firearm Safe Storage, Voluntary Waiver of Firearm Rights, and Extreme Risk Protection Order (ERPO).Learn more at: hiprc.org/3interventionstoolkit
University of Colorado’s Firearm Life Plan was developed to help people think about important questions related to their firearms and protect their families from the burden of making difficult decisions without guidance.Learn more at: firearmlifeplan.org
Forefront Suicide Prevention provides suicide prevention programs, trainings, and resources.Learn more at: intheforefront.org
Find safe storage for firearms outside your home with the Washington Safe Storage Map.Learn more at: hiprc.org/firearm/firearm-storage-wa
Use Voluntary Waiver of Firearm Rights to confidentially restrict immediate access to firearm purchase, stopping impulsive suicide attempts.Learn more at: courts.wa.gov/forms
Petition for an Extreme Risk Protection Order (ERPO) when an individual’s behavior indicates substantial risk of suicide or harm to self or others.Learn more at: protectionorder.org/erpo
Contact the King County Regional Domestic Violence Firearms Enforcement Unit for help with petitioning for an ERPO.Learn more at: kingcounty.gov
King County Crisis Connections focuses on serving the emotional and physical needs of individuals.
They can be reached by calling 2-1-1.Learn more at: crisisconnections.org
In emergencies, call the National Suicide Prevention Lifeline: 1-800-273-8255 (TALK)Learn more at: suicidepreventionlifeline.org