Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member Latest Breaking News General Discussion The DU Lounge All Forums Issue Forums Culture Forums Alliance Forums Region Forums Support Forums Help & Search
 

SecularMotion

(7,981 posts)
Sun Jul 27, 2014, 06:58 AM Jul 2014

"Is There a Gun in the Home?" Assessing the Risks of Gun Ownership in Older Adults

Abstract

An important ethical and safety concern that geriatricians, primary care providers, and home health professionals need to address is gun ownership by elderly adults. Those aged 65 and older now have the highest rate of gun ownership in America, and they also have a high prevalence of depression and suicide. Dementia can add additional layers of risk. Even older gun owners who are otherwise intellectually intact may benefit from information about gun safety with the increasing numbers of children being cared for by grandparents. Health professionals should ask patients, "Is there a gun in the home?" in the clinic and during home visits. Healthcare professionals must have knowledge and skills to address safe gun ownership in elderly adults. The 5 L's (Locked, Loaded, Little children, feeling Low, Learned owner) will assist professionals in addressing all aspects of safe ownership.

Introduction

Gun safety in the United States is receiving unprecedented attention and is increasingly being framed as a public health concern.[1] Considering the aging of the typical gun owner and the potential risks when dementia may be present, geriatric professionals and home health providers have a unique and increasingly important role to play, but there are no national guidelines and a paucity of assessment tools to aid providers in assessing gun safety.

The concerns are clear. Reversing long-standing patterns of middle-aged persons as owners, U.S. residents aged 65 and older are now the most likely of all citizens to own a gun.[2] These older persons also have high rates of suicide.[3] The suicide rate for men aged 80 and older from 2005 to 2010 was 41.11 per 100,000 (80% using a firearm), more than double the national average.[3] Risks are compounded in individuals with dementia,[4] who frequently have access to unlocked firearms and easily accessible ammunition.[5,6] Additional concerns revolve around the increasing number of children being cared for by their grandparents.[7]

Whereas there are well-accepted guidelines for the assessment and counseling of older drivers,[8] there is little to help guide clinicians in their discussions with older gun owners. This article addresses legal concerns regarding physician–patient discussions on gun safety, discusses the importance of involvement of primary care physicians (PCPs) and home health providers, and presents the 5 L's to help with the gun safety assessment of older adults (Locked, Loaded, Little children, feeling Low, Learned owner). Cases from home visits help establish a framework for the discussion.

http://www.medscape.com/viewarticle/826918_1
22 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
"Is There a Gun in the Home?" Assessing the Risks of Gun Ownership in Older Adults (Original Post) SecularMotion Jul 2014 OP
"Is there alcohol in the home?" and "Is there a person with prior criminal history in the home?" Nuclear Unicorn Jul 2014 #1
Welcome back! SecularMotion Jul 2014 #2
Are you interested in the topic at hand or is this just another non-serious post? Nuclear Unicorn Jul 2014 #3
It looks like he is scared to answer. (NT) blueridge3210 Jul 2014 #6
The OP actually has a point to debate, i.e. what are the relevant points to identify to assess Nuclear Unicorn Jul 2014 #8
I agree completely Duckhunter935 Jul 2014 #11
So you have a comment on the article? blueridge3210 Jul 2014 #4
I am sure not Duckhunter935 Jul 2014 #5
Comments are obviously readily forthcoming when they are personal towards other posters. nt Nuclear Unicorn Jul 2014 #9
very true Duckhunter935 Jul 2014 #10
care to comment on your Google cut and paste? Duckhunter935 Jul 2014 #7
That's right, your sole mission is to insult and bait and avoid discussion. NYC_SKP Jul 2014 #17
Why would those be more accurate predictors? MH1 Jul 2014 #13
Alcohol is a significant contributing factor to suicide regardless of whether or not the patient is Nuclear Unicorn Jul 2014 #14
Ok, do you have a link for that? But in any case, doctors DO ask if the patient uses alcohol. MH1 Jul 2014 #15
Message auto-removed Name removed Jul 2014 #18
Message auto-removed Name removed Jul 2014 #19
By all means: Let's take MORE personal decisions OUT of the hands of individuals. loudsue Jul 2014 #12
Isn't it astonishing how the "pro-choice" crowd does a complete reversal pablo_marmol Jul 2014 #20
It makes me dizzy how quickly they reverse themselves. loudsue Jul 2014 #22
"increasingly framed as public health?" When did it stop? Eleanors38 Jul 2014 #16
Your pandemic of propaganda won't convince persons with integrity pablo_marmol Jul 2014 #21

Nuclear Unicorn

(19,497 posts)
1. "Is there alcohol in the home?" and "Is there a person with prior criminal history in the home?"
Sun Jul 27, 2014, 07:19 AM
Jul 2014

Would be more accurate predictors but I doubt anyone would suggest those questions be asked.

Biases make for poor science.

Nuclear Unicorn

(19,497 posts)
3. Are you interested in the topic at hand or is this just another non-serious post?
Sun Jul 27, 2014, 07:37 AM
Jul 2014

But for the record -- life goes on and life is good. There is no "break;" merely another day.

Nuclear Unicorn

(19,497 posts)
8. The OP actually has a point to debate, i.e. what are the relevant points to identify to assess
Sun Jul 27, 2014, 08:11 AM
Jul 2014

gun risks in a home. I even contributed -- what I believe, at any rate -- to be a legitimate addition to that conversation, i.e. that within the set of "gun owning households" the sub-sets of "alcohol use" and "prior criminal history" provide a substantially clearer indication of risk.

One would think this provides an opportunity for substantive discussion but perhaps discussion isn't the actual desire.

 

Duckhunter935

(16,974 posts)
11. I agree completely
Sun Jul 27, 2014, 08:24 AM
Jul 2014
that within the set of "gun owning households" the sub-sets of "alcohol use" and "prior criminal history" provide a substantially clearer indication of risk


Add problems with the mental health system and legal prescription drugs also.

Too bad the OP does not want any discussion on article that would follow the group SOP. It is sad that as a host he ignores the SOP here but so strenuously enforces the one for the group he, she or it hosts.
 

NYC_SKP

(68,644 posts)
17. That's right, your sole mission is to insult and bait and avoid discussion.
Sun Jul 27, 2014, 10:55 AM
Jul 2014

.

You represent your group very well.

Stay classy, all of you.

MH1

(17,600 posts)
13. Why would those be more accurate predictors?
Sun Jul 27, 2014, 09:59 AM
Jul 2014

The article is talking about the risk of suicide, in elderly people who tend towards dementia progressing over time.

Suicide by alcohol is highly unlikely, although in combo with a prescription drug it is possible. However, in my experience, when a doctor prescribes a drug that interacts with alcohol, they warn the patient. Most drugs that would be used in combo with alcohol to commit suicide, also would be effective for that purpose without alcohol, in a large enough dosage. Heck, isn't it true that enough aspirin or tylenol can kill someone too? So regarding suicide, absent the disease of alcoholism, I'm not sure of the relevance of alcohol in the home.

If a patient is an alcoholic, that's a whole new level of risk - and extremely relevant to medical care - but their primary care physician is probably aware of the fact; in any case they certainly should be. In fact a question asked during every annual physical I've had for years is whether or not I drink and how much. The presence of alcohol in my home is irrelevant to my health if I don't drink and only keep it for guests. On the other hand, if I frequently have grandkids over without supervision of other adults, it might be relevant to their pediatrician if I am absent-minded and don't keep the booze in a childproof cabinet out of the kids reach.

I think the article is also considering to the risk of children left in the care of elderly grandparents or great-grandparents who have guns but might not be taking appropriate steps to prevent injury to the children. (I don't know for sure since I don't feel like creating a Medscape account.) To the extent that pediatricians normally counsel parents about ways to child-proof their home or assess the safety of day-care options, I would expect that guns would be part of that discussion. (Unless some law is telling the doc they can't ask the question. Is that what this is all about?)

As to criminal history, outside of sexual predators I don't know why that would be relevant, but there is already a "list" for that.

Nuclear Unicorn

(19,497 posts)
14. Alcohol is a significant contributing factor to suicide regardless of whether or not the patient is
Sun Jul 27, 2014, 10:15 AM
Jul 2014

clinically diagnosed as an alcoholic.

I think the article is also considering to the risk of children left in the care of elderly grandparents or great-grandparents who have guns but might not be taking appropriate steps to prevent injury to the children. (I don't know for sure since I don't feel like creating a Medscape account.)

hmm

MH1

(17,600 posts)
15. Ok, do you have a link for that? But in any case, doctors DO ask if the patient uses alcohol.
Sun Jul 27, 2014, 10:28 AM
Jul 2014

As a sporadic drinker myself (3 drinks total one week, 3 drinks total one year), I can't imagine choosing alcohol to commit suicide. That would be a horrible, horrible way to go, and as far as I know, not even likely to be effective. A gun would be much quicker, simpler, and with a little forethought, less likely to be horribly painful. Hence, booze is safely parked on the top shelf of a cabinet, and I will not have a gun in my home. (But, since you don't know who you're talking to, I'm one of those moderate pro-gun ownership folks who just doesn't want to keep one in my own house but don't give a shit if you keep a dozen or more in your house, as long as a young child never gets a hold of one and shoots himself / herself, or someone else.)

Response to MH1 (Reply #15)

Response to MH1 (Reply #15)

loudsue

(14,087 posts)
12. By all means: Let's take MORE personal decisions OUT of the hands of individuals.
Sun Jul 27, 2014, 09:34 AM
Jul 2014

Let's collectively decide that NOBODY gets to put an end to their life if they so choose....especially if we can stick our own noses in their private and personal business, call them old and senseless, and act like they are objects to be dealt with.

I'm old. If I want to kill myself, that is my own friggin' decision. LEAVE MY BODY ALONE. LEAVE MY PERSONAL CHOICES ALONE. Abortion isn't murder. Suicide isn't murder. A person's body is their own decision. As long as they aren't taking someone else's personal decisions away, it's not hurting anyone else.

pablo_marmol

(2,375 posts)
20. Isn't it astonishing how the "pro-choice" crowd does a complete reversal
Wed Jul 30, 2014, 03:04 AM
Jul 2014

here.....without the slightest sense of their amazing hypocrisy?

loudsue

(14,087 posts)
22. It makes me dizzy how quickly they reverse themselves.
Wed Jul 30, 2014, 04:23 PM
Jul 2014

Authoritarianism is SO fashionable right now. Screw it.

 

Eleanors38

(18,318 posts)
16. "increasingly framed as public health?" When did it stop?
Sun Jul 27, 2014, 10:53 AM
Jul 2014

You can always tell when another pump-up of the "public health" frame is coming on by the number of editorial writers suddenly talking about public health as if it were unchartered territory.

No one likes to talk about it much, but maybe elderly people, esp. those with debilitating diseases, have a gun so that they may decide when they want to end their lives, and not leave the decision to some predatory hyenna circling for the kill. If a person loses the capacity to control their lives, then due process can play a role in meting out those responsibilities to others. Unfortunate as it may seem, an otherwise in-control but ill and depressed individual is probably within his/her rights to keep a gun. Or a full-house load of prescription narcotics.

I renew this proposal: A big mass-media and on-line campaign to get folks to lock up weapons when not in use; Super Bowl, Final Four, Jon Stewart, Rachel Maddow, NYT, etc. A limited camp. has been going on for years in many shooting sports publications, sites & shows, and may account for the already very low rates of childhood accidental deaths via guns.

Latest Discussions»Issue Forums»Gun Control & RKBA»"Is There a Gun in t...