Although debates about gun control often focus on the safety of children around guns, older people who own guns are also at risk for injury, doctors say.
In fact, older people are more likely than the average person to suffer self-inflicted gunshot wounds, asaccidental or intentional injuries, said Dr. Marshall Kapp, director of the Center for Innovative Collaboration in Medicine and Law at Florida State University College of Medicine.
Doctors who treat older adults should routinely ask patients whether they have access to guns, Kapp said. In some cases, doctors may need to take action to ensure patients will not harm themselves or others, including speaking with family members about either removing the gun from the home, or storing it under lock and key, Kapp said.
However, such action should be taken only if, after an evaluation, the doctor judges that a patient's physical or mental state puts him at risk for firearm injury, Kapp said.
Conditions such as dementia and depression disproportionately affect older people, and can also increase the risk of firearm injury, but a diagnosis of such conditions does not automatically mean guns should be removed from a home, Kapp said. Rather, doctors should evaluate patients on a case-by-case basis, he said.
"Different people can have the same clinical diagnoses — such as dementia or depression — but function at different levels," Kapp said.
Discussions with family members about confiscating a gun are, in a sense, similar to conversations that doctors already have about restricting or eliminating driving or cooking for some older patients, Kapp said.
If families are unwilling to cooperate, doctors may need to turn to the law for help, Kapp said. Failure to address firearm safety for adults who are at substantial risk for harm can be considered a form of neglect that should be reported to the Adult Protective Services agency, Kapp said.
"Maintaining a home environment that contains weapons that pose a significant risk of danger to an older person who can't protect him or herself, arguably constitutes elder mistreatment," Kapp said.
Kapp outlined his views in a commentary published in today's (July 9) issue of the journal Annals of Internal Medicine.
Another commentary published in the same journal discusses gun restrictions for people with mental illness. While such restrictions have been a big part of the gun control debate, focusing on mentally ill people is unlikely to solve gun-related problems such as mass shootings, experts say.
"On one hand, we certainly support the idea of increased controls on the access to firearms," said Dr. Jeffrey A. Lieberman, chairman of psychiatry at Columbia University College of Physicians and Surgeons in New York. However, "The idea that restricting firearms from people who are mentally ill is going to solve the problem is just plain wrong," Lieberman said.
People with mental illness contribute to just 4 percent of violent crimes, Lieberman said. Substance abuse and a history of violence are much better predictors of violent crime, he said.
Lieberman said many recent mass shootings have involved people who either did not have access to, or did not continue, mental health treatment. "If one did want to try and limit the potential for persons with mental illness to become violent, the best way to do it would be to improve mental health care," Lieberman said.
"Providing much-needed mental health treatment may have some impact on reducing the small subset of violence attributable to mental illness," although advocating for better mental health care should be seen as an end in itself, Lieberman said.
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