Caregivers of those with dementia may need advice on firearm safety, study finds
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Home firearm access among adults with Alzheimer’s disease and related dementias may present safety risks, according to results of a survey study published in JAMA Network Open.
Thus, this patient population may benefit from their caregivers receiving enhanced education and resources regarding this access, researchers suggested.
“Many people with dementia in the community live in homes with firearms and have access to those guns,” Marian E. Betz, MD, MPH, of the department of emergency medicine at University of Colorado Anschutz Medical Campus, told Healio Psychiatry. “The majority of dementia caregivers thought that health care providers should talk about firearm safety in dementia, yet only 5% said they’d ever had a provider talk to them about it.”
Results of a recent small, nonrepresentative survey of caregivers of individuals with dementia showed one-quarter of these individuals with dementia lived with firearms. Further, half of the caregivers said firearm safety was a concern.
Currently, limited research exists regarding firearm access among this patient population or firearm safety counseling for their adult caregivers. Thus, existing guidelines for practitioners who care for individuals with dementia largely rely on common sense and do not contain specific information about firearm exposure among this patient population or caregiver perceptions and concerns related to firearm safety, according to Betz and colleagues.
To address this research gap, the investigators sought to evaluate views on firearm safety risks among caregivers of those with Alzheimer’s disease and related dementias, experiences of caregivers with counseling delivered via health care professionals and caregivers’ preferred sources of information about firearm safety. They analyzed data of the National Firearms Survey, a probability-based online survey conducted between July 30, 2019, and August 11, 2019, with weights used to create nationally representative estimates of adults who lived in households with firearms to determine firearm safety views of adults aged 35 years or older who spoke English. Respondents were drawn from a database of 55,000 U.S. adults selected according to address-based sampling methods.
The researchers asked caregivers whether the individual with Alzheimer’s disease or a related dementia had access to or owned firearms. Support for firearm safety counseling by health care professionals regarding dementia, history of ever having received such counseling and the likelihood of types of firearms injuries involving this patient population served as additional perception measures.
A total of 4,030 individuals completed the survey. Betz and colleagues excluded participants aged 18 years to 34 years, which left 3,532 remaining participants. Of these, 124 reported being caregivers for individuals with Alzheimer’s disease or related dementias. Women comprised 51% of caregivers, and the mean caregiver age was 60 years. Most (71%) participants believed individuals with Alzheimer’s disease or related dementias were more likely to unintentionally hurt someone else than intentionally hurt themselves or someone else. Moreover, many participants believed health care professionals should always (45%) or sometimes (34%) discuss firearm safety with caregivers or patients in this population; however, only 5% of caregivers said that a health care professional had ever discussed firearm safety with them.
Betz and colleagues also reported that of 41% of caregivers who lived with a person with dementia, 31% said the individual could access firearms in the home.
“As health care 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," Betz said in a press release. "This approach promotes respect for independence and preferences while also ensuring safety."
In a related editorial, Erin R. Morgan, MS, and Ali Rowhani-Rahbar, MD, MPH, PhD, both of the department of epidemiology at University of Washington School of Public Health, highlighted opportunities for improving the safety of this patient population.
“These opportunities may include, but are not limited to, collecting additional data on firearm ownership, acquisition and use among [people with dementia] and their households; providing training for clinicians and families on firearm safety for [people with dementia], including written plans of action for safe storage and removal if or when symptoms of [Alzheimer’s disease and related dementias] worsen; communicating to families that extreme risk protection orders are available should [Alzheimer’s disease and related dementias] symptoms warrant the removal of a firearm; and improving messaging about firearm safety among older adults to the community,” they wrote. “Only through such concerted efforts can we meaningfully reduce the burden of firearm injury and death in this vulnerable population.”