Just as the seasons change, so do the needs of dementia care partners during their care journeys.

One consideration often neglected by medical providers after a dementia diagnosis is proactively addressing firearm safety and suicide prevention. By intentionally discussing these issues, both care partners and people living with dementia can be safe while coping with their new realities. It may even save a life.

The dangers

A dementia diagnosis can be overwhelming. This is especially true for people who have seen friends or family members experience dementia-related decline. A person can feel a myriad of emotions once they become aware they are having symptoms yet maintain many of their abilities. Some may even contemplate suicide as they try to cope with the diagnosis, especially if their internal and external supports are exhausted.

Dr. Emmy Betz is an emergency medicine physician and professor at the University of Colorado School of Medicine. She serves as the director of the Firearm Injury Prevention Initiative at the Colorado School of Public Health and conducts research at the Veterans Health Administration and Eastern Colorado Geriatric Research, Education, and Clinical Center.

Dr. Betz describes how, during the process of a person grappling with an overwhelming stressor, suicidal thoughts escalate into a suicide attempt in an often rapid and impulsive manner. But suicide attempts can be prevented by ensuring that lethal means — especially firearms — are unavailable during these dangerous moments.

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In fact, nine out of 10 suicide attempts with firearms result in death. Other means are often less lethal, and frequently lead to successful mental health crises interventions, hospitalizations, medical care, mental health care or enough time to allow for suicidal thoughts and emotions to pass.

By ensuring lethal means are not readily available, people can — and do — survive, often to experience quality of life afterward.

However, firearm possession can also harm those who care for a person living with dementia. For example, later in dementia’s progression, some people can experience frightening hallucinations due to brain decline.

These hallucinations can be consuming and can cause an understandable need to defend oneself. There have been cases where persons living with dementia have injured care partners and family members with firearms during active hallucinations.

While acknowledging the dangers associated with guns, many people in the early stages of dementia can safely possess firearms. For example, veterans, first-responders and hunters can participate in healthy recreational activities, social bonding and a sense of security by keeping their firearms during the early stages of dementia.

Tips for dementia-inclusive decision-making on gun safety

Here are three tips on how to ensure gun safety while including a person living with dementia in decision-making:

1. Plan and communicate

Dr. Betz recommends that the person living with dementia communicates to their family their desires for when they become unable to safely possess firearms.

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2. Create a Gun Trust

A person living with dementia can draft a document, called a Gun Trust, which says who they would like to give their firearms to once it becomes unsafe to possess them.

3. Share your legacy

A gun trust can also help the person share their legacy with any other family members who hold reverence for these items. While drafting the trust, share unique stories or experiences related to the firearm that the person wants to pass on, such as a significant hunt, military service or marksmanship competitions.

By following these tips, instead of feeling like a punitive stripping away of a freedom once enjoyed, it can become an intentional and thoughtful transition — not only of personal property, but of a person’s most treasured thoughts and memories.