About two years ago, my colleagues at the Medical
University of South Carolina Memory Disorders Clinic came across a
gentleman with Alzheimer’s disease who believed that his neighbor’s
lawn was slowly creeping onto his own lawn. One night, in order to "make
it stop" he took the family shotgun out and fired several shots
into the neighbor’s yard.
To my colleagues and I, believing
that someone’s lawn might creep onto your lawn in the middle of the
night wasn’t the strange part. Delusions of time and space are
fairly common with Alzheimer’s disease. Deciding to shoot a lawn in
order to influence it to "change its mind" and creep back
to where it came from wasn’t the strange part either. Poor problem
solving is typical in all types of dementias. The part that was
strange to us was that this gentleman had access to the family gun.
We couldn’t get over that part of the story. Families with small
children tend to keep guns locked away or out of the house. Weren’t
families with an Alzheimer’s patient at home doing the same?
the next year, we began a study in which we asked all of our
patients diagnosed with Alzheimer’s disease whether guns were
present in their households (we also asked their family members to
confirm in case they had forgotten). Our results were disturbing.
Guns were present in over 60% of households, regardless of
the severity of memory/ thinking problems, aggressive symptoms, or
the presence of severe depression. Where guns were present, over 82%
of family members reported that the guns were kept loaded, or that
they were unsure whether the guns were kept loaded or not. In other
words, when guns were present in a household with an Alzheimer’s
patient, only 18% of families specifically took steps to make sure
it wasn’t loaded!
Our study presents disturbing data with
potentially significant consequences for public health and safety.
What we found contradicts the belief that families of individuals
with Alzheimer’s disease are necessarily aware of the safety risk of
firearms and take appropriate actions to remove the guns from
households or lock them away. Many family members cited "safety"
as the reason for allowing loaded firearms to be kept available.
Guns were still viewed as a means of protection for the Alzheimer’s
patient, rather than a dangerous weapon in the hands of an
individual who may no longer recognize his family members much less
be able to tell a door to door salesperson from a burglar.
the past few years, more attention has been drawn towards the
potential danger of firearm use among patients with Alzheimer’s
disease in the scientific literature. Case reports have been
published describing Alzheimer’s patients whose delusions led to the
use of a gun. Other studies indicate that physically aggressive
behavior has been found to occur in 30-50% of patients with
Alzheimer’s disease, assault by demented persons is a common reason
for psychiatric hospitalization, and about one fifth of geriatric
psychiatric admissions on a particular unit studied had just used
some form of a weapon during an assault.
In October of
1999 the study was published in the Journal of the American
Geriatrics Society. The article concludes with a recommendation that
health care clinicians, community members, and family members of
individuals with Alzheimer’s disease or other types of dementias
specifically ask about the presence of firearms and strongly
advocate for their removal.
Karen Spangenberg is a Neuropsychologist at
Northeast Rehabilitation Health Network and has offices in Lowell
and Salem. For more information on Alzheimer’s or other NRH Network
psychology services, please call (603) 893-2900 extension 728.