Planning for Dementia Diagnoses: The Physician’s Role in Developing Firearm Retirement Plans in Aging Populations

Abstract

Introduction: Firearm ownership poses a critical risk to people living with dementia (PLWD) and their caregivers. Out of 241 veteran suicides that took place from 2001-2005, 73% were carried out using firearms with most suicides occurring in patients newly diagnosed with dementia. However, little is understood regarding how clinicians can effectively approach the subject of gun safety and cognitive decline.

Methods: A prospective survey was given to patients over 60 to assess attitudes and preferences regarding physician intervention in firearm safety planning in the case of cognitive decline. A second survey was distributed by the Marion County Youth Violence Prevention Coalition to determine the rate at which physicians discussed firearm safety with the caregivers of aging patients.

Results: Before participating in this study, 67% (n=12) of participants stated that they had never had a conversation about firearm safety and cognitive decline. 50% (n=9) reported that they were open to discussing firearm safety with their physician, with 11% (n=2) selecting that they were “undecided.” After the survey, 72% (n=13) of participants planned on having a conversation related to firearm safety planning in the case of cognitive decline. The survey directed toward caregivers reported that 21% (n=5) of participants discussed firearm safety with a healthcare provider.

Conclusion: Before taking this survey, only 33% of participants had discussed firearm safety in the case of cognitive decline. After participating, 72% planned to have that conversation. We will continue this project by determining the preferences of caregivers regarding physician intervention in firearm safety planning and discover the resources physicians need to assist in these conversations. When the most efficacious intervention strategy is understood, physicians can use their influential roles to equip aging populations with the ability to protect themselves and their families from firearm related injuries and deaths in the case of cognitive decline.