DEMENTIA SERVICES FOR INDIVIDUALS AND ORGANISATIONS JULIE COLE OCCUPATIONAL THERAPIST

Firearms and Dementia: A UK Perspective

In the United Kingdom  firearms ownership is deemed a privilege rather than a right.   Possession in this country is highly regulated and has been particularly restrictive since the Dunblane school shooting of 2002.  Gun licensing is the responsibility of local police forces and a person has to have a very good reason to own this class of weapon.

As such, most health and social care professionals do not routinely come across people who have firearms stored in their homes.  They might therefore  lack knowledge about how to act appropriately and proportionately when they do so.   The most common reason for being granted a licence to possess a gun is  for  the purpose of vermin control.  So in rural areas, where people have responsibilities in agriculture, forestry and land management,  ownership, whilst not routine,  is reasonably common.  I’m therefore writing this article to increase the understanding of issues around firearms and how these might be particularly pertinent for people with dementia.

Firearms Licensing And The Interaction With The Healthcare System

Firearms certificates are issued by police forces rather than a central regulatory authority as local officers are more likely to have in-depth knowledge of the communities that they serve.   They allow  a person to acquire and keep certain types of firearms and ammunition.   Only certain types of guns are allowed in the United Kingdom.  For example, handguns and automatic weapons cannot be legally owned.   As part of the conditions of ownership guns must be kept securely although the exact way that weapons showed be stored is not stipulated in legislation.  Police can make unannounced visits to make sure that they are satisfied that these arrangements are adequate.  See the Home Office’s ‘Guide on Firearm Licensing Law’ for in-depth information.

Since 2016 there has been a requirement for the police to contact a person’s GP on a firearm certificate is applied for or renewed.   Certain medical conditions which include dementia and other mental health and neurological conditions are notifiable which may lead to a licence being refused or withdrawn.  The GP is also responsible for flagging on the person’s record that they are a gun owner and alerting the police if they have concerns after a gun licence is issued.

Issues to Consider

  • It is useful to remember that a GP might not be aware that the individual has a legal firearm if their licence was issued before April 2016.  Whilst the person themselves has a responsibility to report any changes in their medical condition that may impact on their ability to hold a gun licence they may not do so for a variety of reasons.  This may include a lack of appreciation of the need to do so or could be based on their own self evaluation of their ability to retain firearms.
  • Not all guns are held or stored legally.   Report immediately to the police if you have concerns.  This situation may arise if their is evidence that ammunition or the firearm is not always been kept locked away when not in use.
  • Due to the risks associated with loss of function, increased depression and a reduction in ability to control emotions it is important that ownership of a gun by a person with dementia is relinquished before this becomes an issue.
  • There is provision for obtaining detailed medical reports to  support a challenge to the decision to withdraw a person’s licence after a condition has been notified.   It seems likely that the police will take the view that someone is unfit to hold a licence after a diagnosis of dementia because in the vast majority of cases deterioration in performance of activity will already be evident.
  • Relinquishing a gun licence might be emotive for someone who has held one responsibly for legitimate purposes for a number of years.  There are parallels to giving up driving and therefore the issue must be tackled sensitively.
  • Remember ownership of weapons by other people might also impact on the person with dementia. Family members may hold guns legally or illegally.   In 2016 an elderly man with mental health issues shot his wife in a care home.   As well as risks of someone else causing harm to the individual risks around safe storage of firearms where a person with dementia might have potential access must also be considered and assessed.

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