Years ago, when I was writing a book about Alzheimer’s disease, many of the family members and caregivers with whom I spoke told me that one of the hardest accommodations involved in the disease was to convince the patient to give up the car keys. Maybe it’s because driving a car has come to mean so much about being an American, that it’s so much a part of our identity growing up and that it is the very definition of being an adult in this country. Meanwhile, it’s an acknowledgement by the family that the patient is gradually becoming someone other than the person they knew. Whatever the reason, the decision to surrender the keys is hard on everyone involved.
(For what it’s worth, my father’s disease first became critical when he drove to the flower store in our town in Massachusetts and ended up in Montpelier, Vermont. He gave up his car keys with no resistance at all. Truth be told, I think he was glad to be rid of them.)
However, during the course of my research, I met a woman named Lisa Gwyther, a social worker attached to the Alzheimer’s and related illness unit at the Duke Medical Center in North Carolina. Part of her work was outreach to Alzheimer’s patients who lived way up in the hills and mountains in the western part of North Carolina. She told me that getting the car keys away from the patients was not the worst part of that job.
“It’s getting them to give up the shotgun,” she said. The idea of being confronted by a symptomatic Alzheimer’s patient brandishing a firearm with only a clipboard and good intentions to protect you is a chilling prospect for anyone who’s looked the disease full in the face.
Recently, Kaiser Health News published the results of its four-month investigation into the intersection of dementia patients and firearms. To call the report alarming is to understate it badly. To call the report tragic is to minimize its inherent horror.
From news reports, court records, hospital data and public death records, KHN found 15 homicides and more than 95 suicides since 2012, although there are likely many more. The shooters often acted during bouts of confusion, paranoia, delusion or aggression - common symptoms of dementia. They killed people closest to them - their caretaker, wife, son or daughter. They shot at people they happened to encounter - a mailman, a police officer, a train conductor. At least four men with dementia who brandished guns were fatally shot by police. In cases where charges were brought, many assailants were deemed incompetent to stand trial. Many killed themselves. Among men in the U.S., the suicide rate is highest among those 65 and older; firearms are the most common method, according to the Centers for Disease Control and Prevention. These statistics do not begin to tally incidents in which a person with dementia waves a gun at an unsuspecting neighbor or a terrified home health aide.
Here’s the worst statistic of all.
Only five states have laws allowing families to petition a court to temporarily seize weapons from people who exhibit dangerous behavior.
Because freedom, I guess, although it’s hard to see Dee Hill’s story as having anything to do with being free.
Dee Hill had ignored her husband’s demands and sold Darrell’s car when it became too dangerous for him to drive. But guns were another matter.“He was just almost obsessive about seeing his guns,” Dee said. He worried that the weapons were dirty, that they weren’t being maintained. Though she’d locked them in a vault in the carport, she relented after Darrell had asked, repeatedly, to check on the guns he’d carried every day of his nearly 50-year law enforcement career. She intended to briefly show him two of his six firearms, the Glock handgun and a Smith & Wesson .357 Magnum revolver. But after he saw the weapons, Darrell accidentally knocked the empty pouch that had held the revolver to the floor. When Dee bent to pick it up, he somehow grabbed the Glock and fired. “My concern [had been] that someone was going to get hurt,” she said. “I didn’t in my wildest dreams think it was going to be me.”
Surely, even the most devoted of gun obsessives must concede that having armed dementia patients is lunatic public policy, right?
Are you kidding? Because…freedom!
Proponents of gun ownership say guns are not to blame. The National Rifle Association declined to comment for this story. Dr. Arthur Przebinda, who represents the group Doctors for Responsible Gun Ownership, said researchers raising the issue want to curtail gun rights guaranteed by the U.S. Constitution, and are “seeking ways to disarm as many people as possible.” Focusing on the potential of people with dementia shooting others is a “bloody shirt-waving tactic that’s used to stir emotions to advance support for a particular policy endpoint,” he said. “I’m not disputing the case that it happens. I know it can happen,” Przebinda said. “My question is how prevalent it is, because the data is what should be driving our policy discussion, not fear or fear-mongering. It’s bad science.”
Pray tell us, Dr. Prezbinda, how much “science” do you need to have to conclude that Grandpa, who now thinks Grandma is a thief who is stealing his money, really ought not to have a Glock with which to live out his delusions? Hippocrates is going to come down from Olympus and slap you silly.
Two decades of NRA-backed political pressure that quashed public health research into the effects of gun violence partly explain the lack of data, experts said. But that doesn’t mean there’s no problem, said Dr. Garen Wintemute, director of the Violence Prevention Research Program at the University of California-Davis. “[Critics] are arguing as if what we have is evidence of absence,” he said. “We have something quite different, which is absence of evidence.”
One of my lasting memories of my father before his illness transformed him is of him sitting at our kitchen table. Somehow, he had come into possession of the service revolver carried by his father, a detective sergeant with the Worcester Police Department. He and his four siblings were raised with a healthy respect and fear of ever going near Pa’s gun, which was locked away after every shift in a box on the mantelpiece.
My father sat at the table, methodically taking the revolver apart, piece by piece, and putting each couple of pieces into their own small plastic bag. He then drove to three different town dumps, tossing some of the bags containing the disassembled firearms into each of them, so that nobody ever would be able to put the gun back together again. (He used to joke that, if a gun wasn’t bolted to the deck of a ship, he didn’t want any part of one.) Later in his life, as he faded into the disease, I was happy he’d done that. It only made sense.
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