It is one experience to talk about Second Amendment rights, mental health issues and gun ownership.  It is another experience completely to hold for the first time a loaded gun, a Taurus .357-magnum with six bullets and no safety lock, in your father’s home, knowing that in the middle of the night your father, who has dementia, might mistake his wife getting up to feed the dog as an intruder, and then the problems really begin.  I had this experience two weeks ago, and as physicians, we know that we have, hopefully, been trained to make the right decision in tough situations.  Making that correct decision is often much tougher than expected.

A 1999 study from the Journal of the American Geriatric Society showed that firearms were present in 60% of households in which someone with dementia lived, and only 17% of those households reported that weapons were unloaded.  The authors felt that their study indicated that family members of patients with dementia do not take proper precautions for unloading or removing weapons, regardless of dementia severity, behavior changes or depression prevalence.  The authors recommended that clinicians should ask family members of their patients with dementia about firearms in the home and recommend removal of the weapons.

The Veterans Administration recommends that in homes with a family member with dementia firearms should be unloaded, have trigger locks and the ammunition be stored in a locked, fireproof safe, away from the weapon.  The VA states, “The safest action is to get rid of the guns.  If you keep guns in a home where someone with dementia lives, the lives you risk may be your own as well as other family and friends.  Firearms are the most common method of suicide in elderly patients with dementia, and the group of dementia patients most at risk for suicide via a gun is white males age 70-79.  See The New York Times article.

New Hampshire gun laws do not require a license to have a loaded gun in the home.  There is reference to mental health issues on the pistol/revolver license application for New Hampshire residents as well as non-residents.  An applicant for a gun license to carry a loaded weapon outside the home must disclose if the applicant has been “adjudicated as a mental defective by a court or committed by a court to any mental institution.”  What does it mean to be a “mental defective”? Looking at other states, it appears to be a situation when a patient has been an inpatient in a mental health facility.

So what was my clinical and moral decision two weeks ago?  I pushed the cylinder latch, moved the cylinder to the left, unloaded the bullets and handed all of it to my father’s wife, recommending that she turn the gun and bullets over to the local sheriff.  Did we violate my father’s Second Amendment rights?  Perhaps.  But the strongest feeling I had was that each of those bullets represented a life, and the most important one saved may have been my dad’s.  As physicians, we should recognize this potential safety issue in our patients with dementia and have honest discussions with them and their families.


Stuart J. Glassman, MD

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... and the exact same argument can be made for families where a child is in the home... thanks for writing on this issue.

Sorry about your Dad. Tough situation but easy and correct decision to make to remove the weapon from his control. Clearly done out of love with no other agenda. You absolutely violated his Second Amendment right and if he contested it as simple theft by illegal taking or on Constitutional grounds he would only reveal to the legal and medical community that he is not competent to posses firearms and the result would be the same. Very thoughtful and reasonable thing you and your mom did. Yes yes yes with the honest discussions but if the patient won't willingly surrender the weapons....what next?

Thank you for sharing this story about such a challenging subject. I hope we all keep in mind, however, that the second amendment says that the GOVERNMENT shall not abridge our right to bear arms. You, Dr. Glassman, are not the government. You did not create a law to take away your father's gun. You made a reasoned, and careful (and I suspect difficult and painful) decision to contribute a bit of safety to the environment of someone you know well and love. That is what family can do, but the government cannot.