Ilene Warner-Maron, a nurse who specializes in geriatric cases, opened a discussion on gun-owning elders with dementia, depression or other serious infirmities by showing a picture of an 87-year-old woman gripping a gun in both of her outstretched hands.

The woman, Warner-Maron told a group at Philadelphia Corporation for Aging, is her mother. She weighs 105 pounds and lives in a gated community in Boca Raton, Fla.

“I cannot get my mother to give up her gun,” she said. The panel of experts with her, which included two police officers, did not have easy answers. It can be even harder to get elderly parents to give up their weapons than their car keys, they said. When possible, subterfuge may be the best option.

“It’s tough to get somebody who cares about their firearms to give them up,” said Rick Brehant, a Philadelphia police officer.

Warner-Maron led a panel during the corporation’s annual regional conference on aging, which drew nearly 550 professionals recently.

The subject of guns is important, she said, because advanced age raises the risk for both dementia and depression. Dementia can sometimes make people paranoid or unable to recognize caregivers or even close family members. Several years ago, a caregiver in the area was shot by a longtime patient with dementia.

A Pew Research Center report last year found that one-third of Americans age 65 or older own a gun, meaning that older adults have the highest rate of gun ownership.

They also have the highest rate of suicide, with older white men especially likely to complete suicide. More than 70 percent of older adults who kill themselves use guns to do it, according to the U.S. Centers for Disease Control and Prevention. Among people with dementia, firearms were used in 91 percent of suicide deaths. The FBI reported people older than 65 were responsible for 238 homicides by gun in 238.

Yet adult children and doctors are often more worried about whether the elderly can safely drive.

“If we’re that concerned about driving,” Warner-Maron said, “shouldn’t we be equally concerned about issues involving guns?”

She thinks doctors should routinely ask patients with dementia or depression and their caregivers whether there are guns in their home and whether the guns and their ammunition are stored safely.

Warner-Maron’s mother does not have dementia and lives independently. She thinks the gun could protect her, but also enjoys target practice with her friends. “All my friends have guns,” she tells her daughter.

Warner-Maron is worried that the recoil from the gun could knock her mother down, or a bad guy who could easily steal the weapon from her.

There’s little she can do to wrest the gun from her cognitively- intact mother other than reason with her, perhaps pointing out that statistics show that people are more likely to be shot by their own weapon than they are to use it for protection. But, even if a parent has dementia, even if she is losing her sight, a family can’t get much help from law enforcement if they want to get a gun out of the house, with few exceptions.

It is possible to take away an impaired person’s right to carry the gun in public, but the bar is much higher for removing it from the home. Someone who is forcibly admitted for psychiatric treatment, which can only occur when they are a danger to themselves or others, cannot have a gun, Brehant said. Guns can be removed from the home in some domestic violence situations and when the older person has a court-appointed guardian, said Jennifer Spoeri, director of older adult protective services at PCA. To qualify for that, the person must be at imminent risk and incapacitated by something, plus lack a responsible caregiver.

Brehant said a doctor can report a medical condition that could interfere with safe gun use to the permit issuing authority. They can revoke the license to carry, but won’t remove the gun from a home because of dementia.

Tracy Lewis, a victim advocate with the police department, said officers can only take guns away if they were used in a crime, someone held a gun while threatening to use it or the gun is believed to have been used in a crime in the past. “It really has to be a physical threat,” she said.

Warner-Maron said families may have to be a little devious with people who have dementia. If someone won’t give up a gun voluntarily, they may let a relative “borrow” it or take it for cleaning. A professional can disable the trigger.

Lewis said a neighbor in her 80s knocked on her door one day holding a brown paper bag. “I have something for you,” she said. The bag held a loaded revolver. She said her husband couldn’t handle it anymore and she didn’t know how to unload it. Lewis took it.

Brehant said his family worried about his Uncle Harry, who, in his 80s, had Parkinson’s, “medication fog” and Alzheimer’s. He wouldn’t give up his guns, but his wife convinced him to get a safe. Brehant and other relatives went for a visit. Uncle Harry took them to the 10 guns he could remember. They found another five. They put them in the safe and showed him the combination. Then, they changed the combination. Uncle Harry, who has since died, never discovered what they had done.

WHAT TO DO

When a loved one gets dementia, many families get no guidance on what to do about that person’s guns. Here are legal and practical steps to stay safe.

Question: What can families do ahead of time?

Answer: Talk to your loved one about how to safely transfer ownership of their guns if they should become incapacitated. Consider writing a “gun trust,” a legal document outlining that process.

Doctors are legally allowed to inquire about access to firearms when a person is diagnosed with dementia. But, experts say, they often don’t. If the health provider doesn’t bring it up, families should ask about gun safety along with other concerns, such as driving and use of kitchen appliances and power tools.

Q: What if family members don’t want to accept guns?

A: Some law enforcement agencies will temporarily store guns if there’s a potential threat. In some cases, distressed families have dropped off firearms at gun shops or shooting ranges for safekeeping, though that is not ideal, noted Jacquelyn Clark, owner of Bristlecone Shooting, Training and Retail Center in Lakewood, Colo. Dealers may be able to buy or consign the guns.

Q: What if the gun owner doesn’t want to give them up?

A: By federal law, a person loses the right to buy or own a gun if a judge deems them mentally incompetent to make decisions. Family members usually have to go to probate court for this kind of ruling, where they can be appointed as a guardian and take control of the guns.

Q: What about veterans?

A: Veterans who have been deemed mentally incompetent to manage their finances also lose their right, under federal law, to buy or own guns. As of March, nearly 109,000 veterans were barred from gun ownership because of their enrollment in the Veterans Affairs fiduciary program.

Q: What if they’re making threats?

A: In any state, police can take guns away from someone who threatens a specific crime.

Q: What if families want to keep the guns at home?

A: Store the guns unloaded in a locked cabinet or safe, with the ammunition stored separately. You can also disable the guns, replace bullets with blanks or replace the guns with decoys, but that raises the risk of them being mistaken for a functioning weapon in an emergency.

Sources: Giffords Law Center to Prevent Gun Violence; state legislatures; Texas Alzheimer’s and Memory Disorders program at Texas Health; Bristlecone Shooting, Training and Retail Center

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Kaiser Health News