A Proactive Approach to Seniors, Guns and Dementia

When my grandfather was 91, my parents sat him down and broached the idea of him giving up his car keys.  As you can imagine, that idea was not met with a lot of enthusiasm.  However, my parents felt that because of his physical limitations, safety required him to stop driving.  After a long discussion and a lot of convincing, he handed over the keys. I bring this story up because I recently learned our country arguably has more safeguards in place that govern who can drive a vehicle than those that govern who can own a firearm. Obviously, the purpose of this blog is not to advocate for the confiscation of guns from all people, but to discuss when conditions like dementia make gun ownership amongst our older American population a deadly problem.

So, how much of an issue is firearm ownership amongst seniors around the country? The Pew Research Center reported 45 percent of seniors live in a household with a firearm, and the United States Census Bureau indicated that 4.3 million seniors have dementia.  Also, the Center for Disease Control and Prevention stated that in 2016, about 8,200 older Americans (65+) committed suicide. Furthermore, according to the New York Times, amongst men in this age group who committed suicide, three quarters of them used a gun.  Dr. Yeates Conwell, a psychiatrist and director of the Office for Aging at the University of Rochester School of Medicine, said, “Suicide risk is elevated in people with dementia.”

In 2018, Kaiser Health News and PBS NewsHour studied aging Americans, dementia and gun ownership. While there is no formal office which keeps records on this matter, the investigation was able to study over 100 instances in the United States since 2012, where someone with dementia killed themselves or someone else with assistance of a firearm. Often, the shooter suffered from confusion, paranoia, delusion or aggression, frequently associated with dementia. Regrettably, their victims were the people closest to them, including caretakers, spouses and children.

For instance, according to the report, Larry Dillon of West Virginia, upon turning 65, started exhibiting several signs of concerning behavior such as being frightened of intruders entering and burning down his house. In addition, Dillon went to bed at night with a 9 mm semiautomatic Glock pistol in his nightstand.  Consequently, Dillon’s daughter made an appointment with a neurologist. However, it was unfortunately too late. One night, Dillon heard what he thought were people breaking into the house, so he took his Glock and fired bullets into the room where his wife and granddaughter were watching television. Sadly, his wife died, and his granddaughter has experienced horrific trauma witnessing the event. After a medical examination, a diagnosis revealed that Dillon had Lewy body dementia, which manifested itself in warning signs like vivid visual hallucinations.

Statistics and stories like these have caused the American Medication Association to declare gun violence a public health crisis! They have called for common sense reforms like banning assault style weapons and removing guns from those people who pose a high risk for violence.

Fortunately, seventeen states have passed red flag laws, which allow the government to be more proactive to ensure that firearms are not in the possession of individuals who are determined by the court to be a risk to themselves or other people. Many times, the court is alerted to concerning behavior because of friends or family of the individual. Recently, red flag laws having been gaining traction throughout the country, with 12 states having passed legislation since the tragic shooting at Marjory Stoneman Douglas High School in Florida. Obviously, further action is desperately required.  Presently, Senators Richard Blumenthal (D-Conn.) and Lindsey Graham (R-S.C.) have advocated for a federal red flag law that would provide financial resources to states that choose to implement the policy.  However, predictably, this legislation, along with countless other gun control efforts, has stalled, with the White House and too many members of Congress woefully neglecting their responsibilities by failing to pass common sense gun violence laws.  Until the federal government can govern on this matter, I hope the remaining 33 states pass their own red flag statutes to curb the epidemic of gun violence.   
What makes the federal government’s inaction on this matter even more disappointing is that there is overwhelming public support.  In 2017, the Pew Research Center indicated that 89 percent of the United States supports regulating firearm purchases to people with mental illnesses. Politically, this sounds like a slam dunk. However, to the surprise of nobody, we still don’t have red flag laws on the books that govern the entire country. 

So what’s the holdup?  For starters, gun advocate groups have been a major roadblock to responsible gun safety legislation.  These groups argue that red flag laws allow the government to take away firearms from citizens who have yet to commit a crime. Kaiser Health News and PBS NewsHour reported that Dr. Arthur Przebinda from the group Doctors for Responsible Gun Ownership “balks at any formal assessment of firearm use among people with dementia, saying it could lead to “a totalitarian system that decides when you can have rights and when you cannot.”

Dr. Przebinda is taking an absolutist stance on a law which could save lives.  Exactly what is his argument? Everyone can own a gun? I hope everyone accepts that young children shouldn’t own guns because they don’t have the appropriate cognitive abilities. So why would we accept adults with limited cognitive abilities be allowed to own a gun?  It’s absurd to argue that we should wait for people to die before taking proactive measures regarding an individual’s firearms, if they show clear signs of dangerous behavior. Let me be clear, I am not arguing for the confiscation of everyone’s guns. I am advocating for a process which respects due process and gets firearms out of the hands of someone the government believes doesn’t have the mental capacity to own a gun. Is that such an unreasonable position? Taken one step further, I can’t falsely yell “fire” in a crowded theatre because it puts people’s safety into danger, so why should someone who exhibits behavior that threatens themselves or other people be allowed to own a gun? I will take my chances we won’t spiral into a totalitarian government.

Florida is one of the states which has enacted red flag laws and Kendra Parris, a local attorney, has represented individuals in court who are at risk of losing their guns.  Parris told the Pew Charitable Trust in regard to due process and red flag laws,  “Rather than find clear and convincing evidence, [courts are] basically saying, ‘Better safe than sorry.”  I find Parris’ observations fantastic news! No gun owner should lose their property without due process. However, let’s neutralize any potential danger, and then the court can rule on the matter. Around 40,000 people die a year from gun violence. I can sleep at night having the court securing everyone’s safety and applying due process second.  

Organizations like the National Rifle Association (NRA) have argued that households that have firearms and people with dementia can safely secure their gun with trigger locks and gun safes.  However, the Alzheimer’s Association believes the NRA’s recommendations don’t go far enough, because people with dementia will still believe they are in danger and look for ways to crack safety precautions. The organization suggests the best way to protect your family is to not have the gun in your home.

So in the absence of further laws, what can people do? Well, the good news is that there is momentum in the medical community to help stop gun deaths.  In 2017, after the Las Vegas shooting that left 58 people dead, over 1,300 health care providers promised to start talking with their patients about guns when certain risk factors are identified. In addition, the Veterans Health Administration and Alzheimer’s Association both suggest asking about firearms when evaluating a patient for dementia. However, the medical community has been too limited for years because the Center for Disease Control (CDC) was basically unable to do gun violence research. Regarding the past twenty years, Giffords: The Courage to Fight Gun Violence’s (an organization led by former Congresswoman Gabby Giffords) website states, “In 1996 Congress took away dedicated federal funding for gun violence research from the CDC. For more than 20 years, federal investment in gun violence research has remained virtually absent at the nation’s primary health protection agency, despite gun deaths increasing for the past three years in a row to levels not seen in decades.” Fortunately, Congress, in the last government spending bill, finally appropriated $25 million to study gun violence.
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As we look to the future, the University of Colorado School of Medicine predicts by 2050,  8 to 12 million people will live in the U.S. who suffer from dementia and own a gun. As a country, we can’t be afraid to pass basic common sense gun violence legislation that could save countless lives. Congress and the White House must find the political courage to stand up to outside influences that believe common sense gun reform legislation is by definition against the Second Amendment. Until that day, hopefully, the individual states can lead the charge to ensure a safer America. 

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Evan Carmen, Esq. is the Legislative Director for Aging Policy at the B’nai B’rith International Center for Senior Services. He holds a B.A. from American University in political science and a J.D. from New York Law School.  Prior to joining B’nai B’rith International he worked in the Office of Presidential Correspondence for the Obama White House, practiced as an attorney at Covington and Burling, LLP, worked as an aide for New York City Council Member Tony Avella and interned for Congressman Gary Ackerman’s office. Click here to read more from Evan Carmen.

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