On a Friday morning last month, a San Jose substitute teacher headed off to work at Mt. Pleasant High School with two things that raised a red flag with police — he has dementia, and had a gun tucked under the driver seat of his car.

The teacher’s wife reported him missing that evening when he didn’t return home after work, and early the next morning he was stopped and arrested after swerving the wrong way down Interstate 280 near Portola Valley and officers found the unregistered gun in his car. San Jose police this month obtained a temporary court order to seize three handguns from him under the state’s “red flag” law.

Though elderly people with dementia don’t figure highly in gun crimes, they were the subject of several gun violence restraining orders police in Santa Clara County obtained in recent years. The issue highlights a growing concern among health officials in a country with a growing aging population and a right to bear arms.

“We do know that among older adults the main firearm risk is suicide as opposed to harming others,” said Dr. Marian “Emmy” Betz, associate professor at the University of Colorado School of Medicine and a leading researcher on driving, firearm and suicide risks to the elderly. “But certainly the harm to others is also something to worry about. Some people say it isn’t that big of a deal. But for families who have a loved one with dementia and firearms, this is a really big deal because it’s hard to talk about it.”

According to a Kaiser Health News study last year, 45 percent of Americans 65 and older own guns and 9 percent of those in that age group suffer from dementia — a term that describes a number of diseases or conditions that are characterized by memory loss, deterioration of cognitive abilities, or personality change, among other symptoms. The study found 15 homicides and 95 suicides since 2012 involving people with dementia.

The 71-year-old substitute teacher from San Jose has been released from custody since his Nov. 23 arrest and hasn’t been criminally charged, though the incident potentially violated California laws against driving with a concealed unregistered gun and bringing a firearm on school property.

His wife declined to comment and would not let him speak to a reporter. This news organization isn’t naming him because he hasn’t been criminally charged and is believed to suffer from mental illness.

John Rubio, associate superintendent of human resources at East Side Union High School District, said the teacher no longer works for the district. A family member, Rubio said, told the district last week that the teacher is no longer able to work due to a medical condition. Rubio wouldn’t say how long the teacher had worked for the district or whether others had raised concerns about his mental state or whether they knew he had a gun and were concerned.

San Jose police obtained a civil gun violence restraining order Dec. 3 allowing them to temporarily confiscate the teacher’s firearms for up to three weeks on grounds that the subject poses a significant threat of harming himself or others. A hearing on whether to extend the order up to a year is set for Dec. 23.

According to the gun seizure order, the teacher’s wife told officers he has early-onset dementia but is in denial about his condition and refuses to take medication prescribed to treat it. She said she hadn’t reported him missing before but that he tends to get lost and confused.

The gun violence restraining order said the teacher had unregistered guns in his home as well as in his car, and police used the law to seize a Sig Sauer .45 pistol, a .44 Ruger revolver and a .22 Ruger revolver. The court records did not indicate which gun was in the car or whether it was found loaded or secured.

California law requires residents to register gun ownership with the state Department of Justice, and that handguns in vehicles be unloaded and transported either in the trunk or a locked container. Carrying a concealed, unregistered handgun in a vehicle can raise the violation to a felony.

Of the 30 gun violence restraining orders Santa Clara County police obtained this year, the teacher’s was among four involving older residents suffering apparent dementia, depression or other mental health issues. One of the five gun orders last year also involved an elderly man neighbors described as unstable.

Law enforcement agencies in Santa Clara County have used the restraining orders more often than those in other Bay Area counties. Of nine cases in Alameda County since 2016, when California’s gun violence restraining order law became effective, none involved elderly residents.

Among other Santa Clara County cases, prosecutors in April 2018 obtained a restraining order to seize handguns from an 80-year-old San Jose man who kept a gun by his side while tracking the speed of passing cars in his neighborhood with a radar gun and haranguing the drivers for going too fast. The man, who wasn’t criminally charged, denied having mental health issues, but he had previously had his weapons seized after police detained him for psychiatric evaluation and neighbors told officers he was unstable and feared he would shoot someone, court records said.

In January, Mountain View police obtained an order to seize guns from a 71-year-old man who had armed himself with a handgun believing backyard planter boxes were prowlers. He was taken to a hospital for psychiatric evaluation, and his sisters and niece told police he suffers hallucinations and they worried about his access to guns.

In February, Mountain View police obtained an order to seize four rifles and a revolver from an 83-year-old man after his wife told police he suffers some sort of mental affliction and had left the home with a loaded rifle. Police found him and detained him for psychiatric evaluation after he told them he was going to meet unspecified people.

In July, San Jose police obtained an order to seize two shotguns and a .22 pistol from a 63-year-old man after he reported that he had fired a gun in his house believing someone was trying to break into his home and was tapping on his window. The man, who was being treated for anxiety, lived alone and police found no signs of an intruder, nor had neighbors reported any prowlers.

And in October, San Jose police obtained an order to seize eight guns from a 74-year-old man whose family had reported him making suicidal remarks that his “life is over” and that he “didn’t need to live” because “there is no point.”

Dr. Garen Wintemute, an emergency physician at UC Davis Medical Center and director of the Firearm Violence Research Center who helped craft California’s gun violence restraining order law, said there are no good data on how often they are employed for those with dementia. But he said it’s a concern, as gun ownership among people who suffer from the condition is similar to that in the general population.

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Federal judge upholds California ban on carrying guns in public The Kaiser Health News study found gun victims from owners with dementia included not only their spouses and children but also police officers, mail carriers and care givers. A San Diego nonprofit serving victims of Alzheimer’s no longer sends volunteers to homes where there are guns out of fear for their safety.

Betz said that for families of people with dementia, taking their guns is as vexing an issue as taking the car keys. For many gun owners, like retired law enforcement officers or hunters, their firearm is part of their identity, while others feel more vulnerable in their old age. And it’s hard to say as mild dementia progresses when it’s time to talk about giving them up.

“I think everybody agrees that someone with significant dementia shouldn’t drive a car or own a gun,” Betz said. “Defining where that point is is more challenging.”