Guns and Dementia: A Caregiver’s Guide

Why Firearms and Dementia Are a Concern

A family member’s dementia diagnosis changes everything—including how safe their home is. Firearms come with built-in risks, even in the safest hands. But when dementia enters the picture, those risks can escalate sharply, turning a once-secure situation into a dangerous one. Families find ways to manage and prevent driving accidents, kitchen mishaps and falls, but what about firearms?

The statistics on this issue speak volumes:

60% of older adults with dementia live in homes with firearms, according to research published in 2023 by the Journal of the American Medical Association (JAMA Network).
Firearm suicides among people with dementia have increased by 44% over the past decade, according to the Harvard School of Public Health.
Over 90% of firearm deaths among adults aged 65 and older are suicides, according to the Centers for Disease Control and Prevention (CDC) (2024).

Without proper precautions, a gun in the home can lead to tragedy. But there are steps caregivers can take to ensure safety without unnecessary conflict.

Why Acting Early Matters

As dementia progresses, a person’s judgment, awareness, and impulse control can change in ways that increase the risk of an accident or violent encounter.

Waiting too long can mean trying to address this issue after confusion, paranoia, or mood changes have already taken hold. That makes the discussion much harder for everyone involved.

Acting early helps avoid conflict, gives your family member a voice in the plan and sets you both up for fewer safety risks later.

What to Watch For

Certain behaviors may help you determine when it’s time to act:

Trouble recognizing familiar people or regular visitors. This can indicate disorientation or confusion about who belongs in the home.
More suspicious, fearful, or quick to anger. Mood changes, mistrust, or delusions can escalate into impulsive or unsafe behavior.
Frequently misplacing important or potentially dangerous items, including keys, medications, household tools or cleaning products.

The Conversation: When and How to Have It

Firearm safety is a difficult but necessary discussion. Dementia brings changes that impact judgment, perception and impulse control. Having a plan in place before an emergency arises can prevent dangerous situations.

Some families recognize the need for this conversation early, while others may not realize there’s a problem until a crisis forces the issue. Even if the conversation happens later than ideal, it’s still possible to act.

Knowing When to Talk About Guns

These conversations don’t all start the same way. Sometimes there’s a clear incident that signals it’s time to talk. Other times, it’s just a quiet sense that something has changed. Emotions, beliefs, and family dynamics can make the topic feel overwhelming, but you’re not alone. Many families have navigated this path.

Jonathan’s Story: Jonathan’s father was diagnosed with Alzheimer’s. At first, he simply forgot small things. But one day, Jonathan found a loaded gun under his father’s mattress. When he brought it up, his father resisted, feeling like his independence was being threatened.

Marisol’s Story: A woman noticed her father, a retired veteran, becoming increasingly paranoid. He insisted on keeping a loaded firearm near his bed and had mistaken his own son for an intruder once before. She struggled to convince him to secure his gun safely.

Tasha’s Story: One caregiver removed ammunition from the house, only to find that her brother had purchased more to replace it, believing their father still had the right to access his firearm. The family’s disagreement delayed acting, increasing the risk.

What matters most is recognizing the moment when it’s time to speak up—and trusting that it’s okay to start, even if it’s uncomfortable.

How to Approach the Conversation

How you approach a person with dementia about firearms in the house will depend on the individual’s level of cognitive functioning, mood and behavioral disorders, and the person’s attachment to the firearm. The subject may have to be broached more than once with a few days in between conversations.

Approach the subject with care and respect. It can help to frame the discussion in a way that focuses on safety rather than restriction.

“I know how important your guns are to you. Let’s make a plan to keep everyone safe.”

“Many people set up a firearm plan, just like they do with driving. Can we talk about what that might look like for you?”

“I’d feel safer if we could find a secure way to store the gun while we work through all of this together.”

Some individuals may respond better when close family members or friends help with the conversation. A longtime hunting partner, a trusted sibling or a close friend may be able to make the discussion feel more supportive rather than restrictive.

Handling Resistance and Bringing in Reinforcements

Gun ownership is deeply personal, and not everyone will agree to changes right away. If your family member resists:

Pause and revisit the conversation later. Timing matters.
Frame the issue around your comfort and safety, rather than focusing solely on their abilities.
Consider enlisting a more neutral authority figure, such as:
A physician or healthcare provider.
A clergy member or faith leader.
Local law enforcement (some departments offer safe storage programs).
A legal or elder care expert who can explain state laws.
A longtime friend or hunting buddy who can help ease the transition.

These reinforcements can sometimes carry more weight than a family member’s concerns, helping guide the conversation toward a safer resolution.

Managing a Heated Conversation

If a person gets agitated, hostile, or aggressive, stop the conversation immediately. Don’t try to continue explaining the issue or offering solutions in that moment.

Wait a few days and revisit the conversation when they are calm and alert. If a caregiving spouse or partner isn’t successful, an adult child or grandchild may have more influence. For instance, a teenage grandchild might say, “I want to visit, but I’m nervous about the gun under the mattress. Can we put it somewhere else while I’m here?”

Not everyone will agree right away. Many emotions are often tied to owning a gun, especially when linked to identity or protection. When someone is already feeling scared of losing control due to dementia, this is a subject that can be very emotional. Be patient and try different approaches:

Respect the person’s concerns and reluctance to make this change.
Acknowledge their fears and how hard it is to think about giving up control.
Let them share their thoughts without immediately offering counter-arguments.
Drop the subject and return to it later with a new approach.

Making a Firearm Plan

One option that experts recommend, especially in the early stages of cognitive change, is creating a simple, written agreement about how firearms will be handled over time. It can be as straightforward as writing down when the person is willing to stop using or accessing firearms, and who they trust to help with that decision.

This kind of plan helps take pressure off family members later and allows the person to participate in choices while they’re still able. It doesn’t require an attorney or complicated legal steps, just a thoughtful conversation and a record everyone can refer to later if needed.

Some people find it helpful to think of this like a driving retirement plan. It’s not about taking something away immediately, rather having a plan in place when the time comes.

Key questions to discuss include:

When should firearms be locked away or removed?
Who will be responsible for them?
Should a doctor give guidance?

Some doctors are willing to write a brief, informal “prescription” recommending that firearms be stored or removed for safety reasons—similar to how they might suggest a person stop driving. This written note can help caregivers frame the decision as a medical recommendation, rather than a personal judgment.

Firearm plans can also be included in a living trust or in powers of attorney. An individual can sign an agreement with a “firearm retirement date” when they agree to give up the gun(s). (See Firearm Agreement Form below.)

Know Your Legal Options

In some situations, especially when safety becomes an urgent concern, you may need outside help to remove or secure a firearm. While these steps can feel difficult or even extreme, they’re sometimes necessary to protect your family member and everyone around them.

Gun laws vary by state. Some legal options may include:

Extreme Risk Protection Orders (ERPOs): Allow temporary firearm removal if someone is a danger to themselves or others.
State Firearm Transfer Laws: Some states require legal procedures to transfer a firearm from one individual to another, while others allow private transfers without a background check.
Federal Law: There is no federal law that prohibits a person with dementia from owning a firearm unless they have been legally declared incompetent or involuntarily committed for mental health reasons (Gun Control Act, 18 U.S.C. § 922(g)(4)).
Local Law Enforcement: Contact your neighborhood police or sheriff’s department if you are unsure about the legal steps available to you.

When There Is Immediate Risk

If there is an imminent danger of the person using the weapon, it may be necessary to act immediately against the individual’s wishes. If this is the case, having someone else with you when you do so can help you be more successful and ensure everyone’s safety. Contact local law enforcement for help or enlist a trusted individual.

Practical Tips and Tools

If there are guns in the house, teach and practice good gun sense.

Always store firearms and ammunition separately. Hiding ammunition can sometimes be easier than hiding a gun.
Store guns and ammunition in a locked cabinet, especially if the key is hidden in a hard-to-find place. If the person with dementia forgets where it is, it may make the “hiding place” even safer
Move the firearm or ammunition to another place or out of the house if the person with dementia forgets about it.
Use a gun safe or a gun lock (trigger lock) to help someone feel they still have their guns, but they are being kept safe from others—such as grandchildren.

Checklist: Addressing Firearms and Dementia

Use this checklist to help ensure safety and make informed decisions:

Is there a gun in the house?
Where is it stored?
Is it loaded?
Where is ammunition stored?
Is ammunition stored separately from the firearm?
Is ammunition in a locked container or place?
Is the key hidden?
Is there a gun safe in the house?
Are all firearms kept in the gun safe?
Does the person with dementia know the combination to the gun safe?
If there is not a gun safe, is the firearm in another place that can be locked?
Is the key hidden?
Does the firearm have a lock on it?
Is the key to the gun lock hidden?
Have you had a conversation with the person with dementia about firearm safety?
Does their physician know about the firearm?
Will the physician talk with the patient about firearm safety?
Will the physician help the patient to complete a firearm retirement agreement?
Will the physician write a “prescription” to take the gun out of the house or have it locked up or have the ammunition in a separate place?
Has the family had a conversation about firearms, and is there agreement among family members of what is to be done?
If not, can you enlist the help of a clergy person, physician, relative, or trusted friend to explain dementia and help create consensus?
Is legal action necessary, such as an Extreme Risk Protection Order?

Sample Firearm Retirement Agreement

(Adapted from a form by Emmy Betz, MD, PhD)

To My Family:

The time may come when I can no longer make the best decisions for the safety of myself and others. Therefore, to help my family make necessary decisions, this statement is an expression of my wishes and directions while I am still able to make these decisions.

I have discussed with my family my desire to control possession of my firearm(s), if it is safe for me to do so.

When it is no longer safe for me to have access to my firearm(s), I desire ___________________________to tell me.

I trust my family will take the necessary steps to protect me and those around me while still protecting my dignity and rights.

Name(s): _______________________________________________________

Signed: ___________________________________ Date: ________________

Witness: __________________________________ Date: ________________

Where Can I Get Help on This Topic?

A detailed, print-friendly firearm life plan toolkit (https://firearmlifeplan.org/firearm-life-plan/plan/) is available at no cost through the Firearm Injury Prevention Initiative at the University of Colorado Anschutz Medical Campus.

More resources:

Family Caregiver Alliance
www.caregiver.org
415-434-3388
800-445-8106 toll free

AARP
www.aarp.org
888-687-2277

Veteran’s Administration
www.va.gov
800-698-2411

Giffords Law Center to Prevent Gun Violence
www.giffords.org

National Shooting Sports Foundation (NSSF)
Firearm Storage Resources
www.nssf.org/safety

National Conference of State Legislatures
Extreme Risk Protection Order (ERPO) Laws by State
www.ncsl.org

Sources & Acknowledgments

This fact sheet was developed using information from the Journal of the American Medical Association (JAMA Network), Harvard School of Public Health, the American College of Physicians and the Annals of Internal Medicine, the Centers for Disease Control and Prevention (CDC), the Veterans Administration (VA.gov), AARP, Emmy Betz, MD, PhD, Giffords Law Center to Prevent Gun Violence (www.giffords.org), the National Conference of State Legislatures (NCSL), and National Public Radio (NPR.org). Edited by Trish Doherty.