“Is There a Gun in the Home?” Assessing the Risks of Gun Ownership in Older Adults

An important ethical and safety concern that geriatricians, primary care providers, and home health professionals need to address is gun ownership by elderly adults. Those aged 65 and older now have the highest rate of gun ownership in America, and they also have a high prevalence of depression and suicide. Dementia can add additional layers of risk. Even older gun owners who are otherwise intellectually intact may benefit from information about gun safety with the increasing numbers of children being cared for by grandparents. Health professionals should ask patients, “Is there a gun in the home?” in the clinic and during home visits. Healthcare professionals must have knowledge and skills to address safe gun ownership in elderly adults. The 5 L's (Locked, Loaded, Little children, feeling Low, Learned owner) will assist professionals in addressing all aspects of safe ownership.     

“Congenital” coronary arteriovenous malformations: Are they truly congenital?

We report a patient with ischemic chest pain due to obstructive coronary artery disease. The patient underwent a second cardiac catheterization 2 years later that revealed progression of the coronary disease and the appearance of a new arteriovenous malformation. Unless a prior angiogram was available, this malformation would have been classified as congenital. This case report raises the question of whether all congenital arteriovenous malformations are truly congenital. © 1996 Wiley-Liss, Inc.