Older Firearm Owners and Advance Planning: Results of a National Survey

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Older Firearm Owners and Advance Planning: Results of a National Survey

Category: Behavior|Journal: Annals of Internal Medicine (full text)|Author: C Grogan, C Knoepke, D Matlock, G Wintemute, H Lum, K Suresh, M Betz, M Miller, M Ranney, R Johnson|Year: 2021

Background:

Approximately one third of older adults (aged ≥65 years) in the United States own a gun (1); some of them will develop dementia or other impairments that limit their capacity to handle firearms safely (23). Little is known about the extent to which older gun owners have considered future firearm transfers.

 

Objective:

To use a nationally representative survey to describe the frequency of advance planning by older gun owners to transfer their firearms to someone else if they can no longer handle them safely or if they die.

 

Methods:

Data were obtained from the second National Firearms Survey, conducted online from 30 July to 11 August 2019 by the research firm Ipsos (4). The survey was conducted among a sample of participants in the Ipsos KnowledgePanel, a probability-based web panel of approximately 55 000 noninstitutionalized, English-speaking adults (aged ≥18 years) designed to represent the U.S. population, excluding persons in active military service. The survey sample comprised adults living in a home with firearms, regardless of whether they were gun owners themselves; however, we restricted our analysis to older adults who owned firearms. Participants received points for an Ipsos incentive program, and the Harvard University Institutional Review Board approved the study.

Questions assessed whether respondents had a plan for transferring their firearms to someone else in the event of death or their inability to handle guns safely. Participant characteristics included demographics, caregiving for someone with dementia, and firearm-related measures (such as type and number of guns owned, reasons for ownership, training, and frequency of handling). Using the weight variable provided by Ipsos and weighting commands in Stata (version 16.1; StataCorp), we summarized the responses with descriptive statistics. We used study-specific poststratification weights to adjust for nonresponse and under- or overcoverage from the study-specific sample design, demographic distributions (from the U.S. Census Current Population Survey or American Community Survey), and such characteristics as gun ownership (from weighted KnowledgePanel data, for characteristics not available from the national surveys).

 

Findings:

The National Firearms Survey included 1001 respondents aged 65 years and older who were living in homes with firearms and were firearm owners themselves (completion rate, 71%; Table 1). These respondents had a median age of 71.0 years and owned a median of 3 firearms. Most were married (74.6%), White (81.4%), and male (73.7%). Although nearly half had handled a firearm once or less in the past year, 18.0% reported carrying a loaded handgun in the past month.

About one fifth of older firearm owners had a plan for securing, removing, or transferring firearms if they became unable to handle them safely, either written (5.6%) or unwritten (16.1%) (Tables 1 and 2). Nearly half had a plan for transferring firearms to someone upon death, either written (22.5%) or unwritten (25.4%) (Tables 1 and 2). Of participants who had a plan for transfer if they became unable to handle their firearms safely, almost all (87.2%) also had a plan for transfer upon death.

Discussion:

In this nationally representative survey, one fifth of older firearm owners had a plan for transferring firearms if they became unable to handle them safely, and half had a plan for transferring them upon death. To our knowledge, this is the first report to address the frequency and mode of contingency plans for firearm transfers due to cognitive or physical decline.

Multimodal outreach through various venues might foster more frequent and informed planning about future firearm safety. Some older gun owners may prefer information disseminated through firearm outlets or similar “trusted messengers”; others may prefer education via health care providers (5), aging or dementia organizations, or other community sources. Including firearm-related issues in medical, financial, or legal advance planning also might be useful. Future questions include the utility of an “advance firearm agreement” (2) and the concept of “firearm retirement planning” as part of firearm ownership, as well as how this process parallels discussions about “driving retirement.” Recent work suggests that few dementia caregivers have been counseled about firearm safety (4). This, combined with our study findings, highlights opportunities for improved engagement with older adults and dementia caregivers.

Our survey included only English-speaking older adults living in homes with guns, so our results may not be generalizable. We did not explore reasons for having (or not having) plans, the sample size limited subgroup analyses, and acceptability bias may have resulted in overreporting of planning.

Despite these limitations, this study highlights opportunities for enhanced future planning related to firearms. Informed by this work, trusted messengers—whether from the medical, legal, firearm, or other communities—can help prevent firearm injury by assisting in contingency planning for firearm retirement.

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