On Guns and Hospice: Is Everyone Safe?

“Is it safe?”

That was the riveting question repeatedly asked in the 1976 film Marathon Man. During a grim and crucial scene, Sir Laurence Olivier’s menacing character demanded—as he wielded dental equipment in the worst way—to know if what he planned to do could be safely accomplished.

“Is it safe?”

Dustin Hoffman’s “innocent man” paid an excruciating price for every hesitation, every uncertainty.

I sometimes think of that scene when one of our hospice’s social workers announces that a patient’s house is safe. When we talk about a new patient entering hospice care, the question about safety must be asked and answered.

Which is to say, are there are any guns in the home?

According to 2014 statistics, 59% of the almost 1,700,000 hospice patients in the United States were treated at their place of residence by hospice staff. A residence includes nursing homes, residential facilities, and the estimated 600,000 living at “home sweet home.” (Those not in private residences were served in a hospice-owned facility or acute care hospital.)

Based on a recent Pew Research study, 37% of American households have at least one person who owns a gun. Pew agrees with other studies that there are likely 300,000,000 guns in the United States, or the equivalent to “one firearm for every man, woman and child.” Pew’s report continues with, “But in point of fact, only a minority of Americans own guns.”

Obviously, many hospice staff will be welcomed into private homes. Equally obviously, the staff never knows by simply looking if this is a household with firearms.

The hospice where I work (and I suspect this is the case with all hospices) requests that either guns are removed from the home or that they are clearly locked and . . . safe.

We won’t care for a patient without this reassurance.

Since many don’t own guns, the hospice question will be easily addressed by them. For gun owners, the majority quickly comply. A daughter takes her father’s shooting range pistol to her place. The family already has the weapons in a secure cabinet or vault designed for firearms. The spouse purchases a simple locking mechanism for the hunting rifle and stores the ammunition in a separate location. Complying with hospice’s request is cheap and simple.

Only a very few hospice patients or families disagree when the gun question is asked.

The resistance is rarely a second amendment debate (the right to keep and bear arms), but more of a you-can’t-tell-me-what-to-do cry for independence. Along with the other emotions individuals and families experience when entering hospice, they don’t want to lose control of the significant, or insignificant, parts of their once normal life.

Why does hospice ask the question?

  • We want the patient to be safe and not have a gun to use for suicide or threats.
  • We want the family to be safe and not have to worry about any accident.
  • We want the visiting medical staff to be safe, not threatened by a frightened patient or a random bullet from an accident or suicide attempt.

Whether suicidal, homicidal, or accidental, guns represent a different threat than other weapons (scissors, knives, the Marathon Man’s dental tools, shovels, etc.) in the home. Once a bullet leaves the barrel, it can easily penetrate walls, windows, and flesh. Bullets can strike objects across the street or across town. A bullet from a .22 rifle travels upwards of a mile. A shot from a .38 pistol will traverse the length of two football fields in less than a second.

But nothing bad will ever happen!

The patient is bedbound and can’t go to the bathroom by herself. The patient is medicated and barely communicates. Cancer wrecked his body and the patient can’t even eat unless someone feeds him.

All true, and not true.

Back in the 1990s, I worked as a hospice chaplain. We had a bedbound patient. Each day revealed his slow, sad decline. One of our support staff—she helped families with housework—routinely arrived at the patient’s home when most of the family was resting. It was a time when the patient usually took an afternoon nap. Soon after she entered the house, a gun was fired. The patient had managed to crawl from bed, stumble to his closet, and find the gun that everyone claimed had been removed. Suicide. It was terrible, messy, horrific death. All suicides shatter more than one life; the patient’s family would struggle with anguished questions and a sense of failure for the remainder of their lives. I recall, in the late afternoon after the bullet was fired, sitting with my hospice colleague, comforting her, reassuring her that none of what had happened was her fault. She too was a victim of his suicide.

Is your house safe?

It’s an essential question asked by hospice. It’s not a political question. It’s not a gun control question. It’s not a second amendment debate. It is, like so much of what hospice tries to do as they enter into a home, an effort to make sure everyone is well cared for and that everyone is safe.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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  1. I helped with the care of a hospice patient (cleaned the house each week and made a few meals as needed) who was a member of my church and in the course of those weekly cleanings came across 3 guns in a closet. Not a gun fan so I asked my husband to come and give me assurances those guns were no threat. He came out of the room with all three guns under an arm, straight into the patient’s room and let her know that he was taking them home with him. She was fine with that. When I got home, he let me know that they were all loaded. When I asked her about the guns at my next visit, she said she knew they were there and loaded by her husband before his death to help her feel safe living alone. She said she’d been afraid of that closet since his death. We returned the guns to the estate, unloaded, after she passed.
    Not all hospice must do that gun check. I’ve known about guns in homes of dying patients and worried.

    • Thanks for responding!

      The “ideal” of what every hospice “should” do is predictably influenced by the human element. We forget. We overlook. There are families that say they don’t have guns and do. There are hospice staff that say they asked about guns, but really didn’t. I would guess, overall, that most hospices try to do a good job and make sure that everyone, gun-wise, is safe. Exceptions exist. Sadly, probably every established hospice will have its “horror stories” about the use of a gun.

      The question is critical. Safety matters.

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