Opinions vary on how and whether possession of firearms should be regulated for seniors displaying signs of dementia.

By Thomas Goldsmith

This year’s news of school shootings in Parkland, Fla., and elsewhere heightened a national debate over the ability of young people to buy and possess guns.

In North Carolina, a related discussion has proceeded – a mostly quieter one – about the level of access to firearms that should be available to people with incipient or full-blown dementia.

A graphic illustration of the danger possible in such situations emerged in the June 2016 death of Charlene Norris, 79, of Charlotte. Her husband, James Nelson Norris, 84, faces a July 19 court date on a charge of first degree murder in her death. According to a media account, Michael Greene, Norris’s attorney, claimed both Jim and Charlene had dementia at the time of the shooting. Greene declined a request for comment.

A bill in the General Assembly, as previously reported by NC Health News, is intended to restrict access to firearms by people found at risk of harming themselves or others. The measure, HB976, would allow a family member or law enforcement to ask a district court for an “extreme risk protection order,” or ERPO, to avert danger.

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There’s a larger question behind the gun issue: At what age or condition do people lose the right to make risky decisions? A middle-aged person who makes an unwise investment is likely out of luck, but an older person encouraged to buy a money-losing product may be the victim of an illegal scam. The issue of access to guns by older people has been compared to seniors’ ability to keep driving at advanced ages, a question that requires balancing an older person’s need for mobility against safety concerns for himself and others.

The right to decide

“It’s a dangerous situation for everyone,” ” said state Rep. Marcia Morey (D-Durham), a former district court judge and one of the ERPO bill’s lead sponsors. “We certainly don’t want to stigmatize dementia, but that (ERPO) would absolutely definitely apply. It could very important for a family’s safety.”

Under the proposed statute, sometimes referred to as a “red flag law,” a judge could grant an emergency protection order to take away firearms, ammunition and carry permits from a person judged to be at risk of harming himself or others. While brought to public attention as a means to forestall school shooters, the ERPO procedure could also be used in cases where a person with Alzheimer’s disease or dementia owns a weapon and causes concern to people near him.

Paul Valone, president of the gun rights group Grass Roots North Carolina, strongly opposes the use of risk-based protection orders to take away people’s guns. Nonetheless, he acknowledges that some people with dementia should not handle guns.

“The devil’s in the details,” Valone said. “The bottom line is that I want to see due process in a court of law. There needs to be a hearing and there needs to be judicial adjudication that the person is a danger to himself or others.”

“There are probably a lot of people in the early stages of dementia who can be responsible gun owners, and they have owned guns for years, particularly if they are a sportsman and have been a hunter,” said Mary Bethel, president of the state Coalition on Aging. “As with older adults and driving, it is an individualized issue.”

For those contemplating suicide, owning a firearm can guarantee “success.”

According to detailed reports by the Centers for Disease Control and Prevention, about 80 percent of North Carolina suicides of people 65 and older were committed with a firearm. Among men older than 85, the 296 suicides by firearm between 2000 and 2016 represented about 95 percent of the total. And between one-quarter and one-half of people older than 85 typically show signs of dementia.

“It’s a really interesting and important problem particularly given the increasing population of older people and the fact that there’s going to be more people in North Carolina with age-related diseases, that are progressive, who have access to firearms,” said Jeffrey Swanson, a medical sociologist and professor at Duke University.

“An effective tool”

In 2017, Swanson and several colleagues published research on a law passed by the state of Connecticut in 1999, in the wake of a mass shooting at the state’s lottery offices. The law “established the legal practice of preemptive gun removal as a civil court action based on a risk warrant, a process that neither requires nor generates a record of criminal or mental health adjudication as its predicate,” researchers said.

Relatives or caregivers of people in long-term care shouldn’t have to worry about gun possession by residents, according to Ken Burgess of Raleigh, a partner at the law firm Poyner Spruill. Burgess wrote a post on the issue for the National Law Review in 2010 and confirmed this week that its information remains current law. People who operate assisted living facilities or nursing homes can ban gun usage on their property, although the provision should be put into a written policy and supplied to relatives and families in advance, Burgess wrote. “The U.S. Constitution’s guarantee of the people’s right to bear arms is found in the Second Amendment to the Constitution,” Burgess wrote. “Its reach is limited in that it only prevents the Government from infringing on a citizen’s right to possess guns for legal purposes. It does not reach private action by private persons, including those who operate residential or health care facilities.”

Although the law was intended to prevent homicides, the research showed that the principal result has been to reduce gun-related suicides.

“Laws that authorize police to remove guns from persons at risk of violence or suicide appear to be a logical and complementary approach to background checks in preventing gun violence,” the authors wrote.

Said Swanson: “I do think ERPOs could be an effective tool to prevent suicide in adults with age-related cognitive decline or a diagnosis of a major progressive neurocognitive disorder.”

GOP leaders at the General Assembly sent Morey’s ERPO bill to the House rules committee, from which many bills never progress. But she’s not giving up.

“We have a lot of people very supportive of it and we will keep trying and trying,” Morey said.

Nationally, the debate continues. A May 8 editorial in the Annals of Internal Medicine promotes the Alzheimer’s Association’s use of safety checklists that include the presence of firearms in the home of a person with dementia.

“Delusions about home intruders or confusion about the identity of persons in their lives may lead persons with dementia to confront family members, health aides, or other visitors,” the editorial says. “Access to a firearm may increase the potential for injury or death in such a situation.”

And a recent review conducted for the national Kaiser Health News estimated that of the 6.7 million residents of Washington state, about 15,000 people older than 65 reported “both cognitive decline and that they stored their guns unlocked and loaded.”

Bethel, from the state Coalition on Aging, says discussions are in order by relatives concerned about the presence of firearms.

“This is an issue which families should have conversations about and if the decision is made to continue to have guns, then safety precautions such as removing the ammunition from the gun and storing the gun in a gun safe should be followed,” she said.

Any move to establish a red flag law in North Carolina will likely face intense scrutiny, if not outright opposition, by strong proponents of Second Amendment rights. Grass Roots North Carolina’s Valone said that older people should only have guns taken away by government under carefully designated conditions and only by a court of law.

“Driving is not a right,” he said. “The right to bear arms is enshrined in the Constitution.”