“Safety in Dementia”: Development of an Online Caregiver Tool for Firearm, Driving, and Home Safety

Polzer, Evan R.; Nearing, Kathryn; Knoepke, Christopher E.; Matlock, Daniel D.; Azrael, Deborah; Siry-Bove, Bonnie; Meador, Lauren; Betz, Marian E.

doi:10.1111/jgs.16693

Cited by 15 publications

(21 citation statements)

References 10 publications

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“…SiD represents the first publicly available decision aid that addresses firearm access among people with dementia [ 6 ]. This trial demonstrated the feasibility of recruiting caregivers through MTurk and collecting efficacy outcome data.…”

Section: Discussionmentioning

confidence: 99%

“…We previously created the web-based Safety in Dementia (SiD) decision aid [ 6 , 7 ] to support care partners. SiD guides users through questions, such as those about preferences for in-home storage versus out-of-home storage or how a person with ADRD may react to no longer having access to firearms.…”

Section: Introductionmentioning

confidence: 99%

“…We sought to examine the feasibility of collecting outcome data and the acceptability of the tool in preparation for a future full-scale randomized trial. Although SiD situates firearm access within the context of other safety considerations (eg, driving and household safety) [ 6 ], we focused this evaluation on the firearm component of SiD.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and Acceptability of a Web-Based Caregiver Decision Aid (Safety in Dementia) for Firearm Access: Pilot Randomized Controlled Trial

Betz¹,

Polzer²,

Nearing³

et al. 2021

JMIR Form Res

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Background Firearms are common in the households of persons with Alzheimer disease and related dementias (ADRD). Safety in Dementia (SiD) is a free web-based decision aid that was developed to support ADRD caregivers in addressing firearm access. Objective We aimed to evaluate the feasibility and acceptability of SiD among a web-based sample of ADRD caregivers. Methods SiD was tested in 2 phases by using participants who were recruited from a web-based convenience sample (Amazon Mechanical Turk participants). In phase 1, caregivers were randomized to view either the intervention (SiD) or the control (Alzheimer’s Association materials), and the blinding of participants to the study arms was conducted. In phase 2, caregivers of individuals with ADRD and firearm access were recruited; all of these participants viewed the firearm section of SiD. In both phases, participants viewed SiD independently for as long as they wanted. Measures for evaluating decision-making and SiD acceptability were used, and these were assessed via a self-administered web-based questionnaire. Results Participants were recruited for phases 1 (n=203) and 2 (n=54). Although it was feasible to collect the study outcome data in a web-based format, in phase 1, there were no significant differences between SiD and the control in terms of decision-making and self-efficacy. The majority (137/203, 67.5%) of phase 1 participants spent between 5 and 10 minutes reviewing the resources. In phase 2, 61% (33/54) of participants spent 5 to 10 minutes viewing the firearm section, and 31% (17/54) spent 10 to 20 minutes viewing this section. Usability and acceptability were high across the phases. Conclusions SiD represents a new resource for promoting safety among people with dementia, and high acceptability was achieved in a pilot trial. In this sample, SiD performed similarly to Alzheimer’s Association materials in supporting decision-making and self-efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feasibility and Acceptability of a Web-Based Caregiver Decision Aid (Safety in Dementia) for Firearm Access: Pilot Randomized Controlled Trial

Betz¹,

Polzer²,

Nearing³

et al. 2021

JMIR Form Res

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“…Research has found that risk of suicide may be especially elevated in the period after an older adult receives a dementia or mild cognitive impairment diagnosis [43]. Talking with caregivers of patients with dementia about the risk of firearms remains rare [51], and experts suggest that conversations about firearms and dementia should parallel those about driving and dementia [52].…”

Section: Risk Factors For Firearm Suicidementioning

confidence: 99%

Clinical strategies for reducing firearm suicide

Pallin

Barnhorst

2021

Inj. Epidemiol.

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Suicide is complex, with psychiatric, cultural, and socioeconomic roots. Though mental illnesses like depression contribute to risk for suicide, access to lethal means such as firearms is considered a key risk factor for suicide, and half of suicides in the USA are by firearm. When a person at risk of suicide has access to firearms, clinicians have a range of options for intervention. Depending on the patient, the situation, and the access to firearms, counseling on storage practices, temporary transfer of firearms, or further intervention may be appropriate. In the USA, ownership of and access to firearms are common and discussing added risk of access to firearms for those at risk of suicide is not universally practiced. Given the burden of suicide (particularly by firearm) in the USA, the prevalence of firearm access, and the lethality of suicide attempts with firearms, we present the existing evidence on the burden of firearm suicide and what clinicians can do to reduce their patients’ risk. Specifically, we review firearm ownership in the USA, firearm injury epidemiology, risk factors for firearm-related harm, and available interventions to reduce patients’ risk of firearm injury and death.

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“…Data were collected as part of a parent project focused on engaging key stakeholders in developing “Safety in Dementia,” a decision support tool for ADRD caregivers 10 . For the parent study, we conducted one‐on‐one interviews with key informants from three key stakeholder groups: ADRD caregivers (professional, informal), medical professionals (geriatricians, neurologists), and firearm professionals (retailers, range employees, instructors).…”

Section: Methodsmentioning

confidence: 99%

Firearm access and dementia: A qualitative study of reported behavioral disturbances and responses

Polzer

Nearing

Knoepke

et al. 2021

J American Geriatrics Society

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Background Cognitive impairment and behavioral changes associated with Alzheimer's disease and related dementias (ADRDs) can impair safe firearm handling ability, an issue that can be challenging for ADRD caregivers to address. In this qualitative analysis, we sought to explore behavioral disruptions that raise concerns about firearm access in dementia and how caregivers react and respond. Methods Secondary qualitative analysis using data from semi‐structured, one‐on‐one interviews originally conducted as part of a study to develop firearm safety educational materials for ADRD caregivers. Interviewees were English‐speaking adults (≥18 years) from three stakeholder groups: ADRD caregivers (professional or informal), medical professionals (geriatricians, neurologists), and firearm professionals (retailers, range employees, instructors). For secondary analysis, transcripts of interviews were recoded and analyzed after an inductive‐deductive thematic analysis process. Results Among 24 participants, 17 (70%) were female and 20 (83%) white; 13 (54%) had personal or professional experience with ADRD caregiving; and 5 (21%) had a firearm affiliation. Major themes were: (1) behavioral disturbances that make caregivers concerned about firearm access; (2) caregiver emotional responses to and difficulties associated with these disturbances; and (3) caregiver actions (planned or actual) to limit firearms access. Conclusion Various behavioral disturbances and emotional burdens can trigger ADRD caregiver concern about firearms access, but strategies exist for restricting or safeguarding firearms in the home. Study findings suggest a need for caregiver support on this topic, including counseling by healthcare providers, advance planning for older firearm owners, and development of community resources.

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“Safety in Dementia”: Development of an Online Caregiver Tool for Firearm, Driving, and Home Safety

Cited by 15 publications

References 10 publications

Feasibility and Acceptability of a Web-Based Caregiver Decision Aid (Safety in Dementia) for Firearm Access: Pilot Randomized Controlled Trial

Feasibility and Acceptability of a Web-Based Caregiver Decision Aid (Safety in Dementia) for Firearm Access: Pilot Randomized Controlled Trial

Clinical strategies for reducing firearm suicide

Firearm access and dementia: A qualitative study of reported behavioral disturbances and responses

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