BACKGROUND
Approximately one third of U.S. older adults (≥65 years) own a gun (1); some of them will develop dementia or other impairments that limit their capacity to handle firearms safely (2,3). Little is known about the extent to which older gun owners have considered future firearm transfers.
OBJECTIVE
We used a nationally representative survey to describe the frequency of advance planning for firearms transfer among older gun owners if they become unsafe to handle them or at death.
METHODS
Data came from the second National Firearm Survey (NFS), conducted online July 30 to August 11, 2019 by the survey research firm Ipsos(4). Participants were sampled from Ipsos’ KnowledgePanel® (KP), a probability-based web panel of approximately 55,000 non-institutionalized, English-speaking adults (≥18 years) designed to be representative of the U.S., excluding active military service. Eligible participants were adults living in homes with firearms (as firearm owner or not); we restricted this 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 firearms to someone if they died or became unsafe to handle them. Participant characteristics included demographics, caregiving for someone with dementia, and firearm-related measures (e.g., type/number owned, reasons for ownership, training, frequency of handling). Using the weight variable provided by Ipsos and weighting commands in Stata (version 16.1), responses were summarized with descriptive statistics. Study-specific poststratification weights adjusted for: nonresponse and under- or over-coverage from the study-specific sample design; demographic distributions (from U.S. Census Current Population Survey or the American Community Survey); and characteristics like gun ownership (from weighted KP data, for characteristics not available from the national surveys).
FINDINGS
The NFS included 1,001 respondents aged ≥65 years living in homes with firearms who were firearm owners themselves (completion rate 71%; Table 1). These respondents had a median age of 71.0 years and owned a median 3 firearms. Most were married (74.6%), white (81.4%), and male (73.7%). While nearly half had handled a firearm once or less in the past year, 18.0% reported carrying a loaded handgun in the past month.
Table 1.
Demographic and firearm-related characteristics of older firearm owners (≥65 years; N=1,001).
| Total (n = 1,001) |
|
|---|---|
| Weighted % (95%CI) | |
| Age (years) | |
| 65-74 | 70.5 (67.1, 73.6) |
| 75+ | 29.5 (26.4, 32.9) |
| Median, IQR | 71.0 (68.0, 76.0) |
| Gender | |
| Male | 73.7 (70.2, 77.0) |
| Female | 26.3 (23.0, 29.8) |
| Race/ethnicity | |
| White/non-Hispanic | 81.4 (78.0, 84.4) |
| Black/non-Hispanic | 8.3 (6.2, 10.9) |
| Other/non-Hispanic | 3.2 (2.0, 5.0) |
| Hispanic | 7.1 (5.1, 9.8) |
| Veteran | 37.5 (34.2, 41.0) |
| Education | |
| High school degree or less | 39.3 (35.6, 43.2) |
| At least some college | 60.7 (56.8, 64.3) |
| Household size, mean (95%CI) | 2.1 (2.0, 2.2) |
| Household income | |
| <$50,000 | 29.9 (26.7, 33.3) |
| $50,000-<$85,000 | 26.1 (23.1, 29.4) |
| $85,000-<$150,000 | 23.2 (20.4, 26.2) |
| $150,000+ | 20.8 (17.9, 24.0) |
| Married | 74.6 (71.4, 77.5) |
| Currently working | 25.5 (22.6, 28.7) |
| Current caregiver for someone with dementia | 4.0 (2.9, 5.6) |
| Lives in a metropolitan statistical area | 78.7 (75.6, 81.6) |
| Region of residence | |
| Northeast | 9.9 (8.0, 12.1) |
| Midwest | 21.1 (18.4, 24.0) |
| South | 46.3 (42.8, 50.0) |
| West | 22.7 (19.8, 25.8) |
| Total number firearms owned (median, IQR) | 3 (1, 5) |
| Types of firearms owned | |
| Handgun | 82.2 (79.3, 84.7) |
| Long gun | 66.9 (63.3, 70.3) |
| Has had formal firearms training | 64.0 (60.5, 67.5) |
| Frequency of handling firearms for any reason over past year | |
| Daily | 5.2 (3.6, 7.0) |
| Weekly | 7.8 (6.1, 9.8) |
| Monthly | 9.4 (7.5, 11.8) |
| A few times a year | 30.9 (27.6, 34.3) |
| Once in the past year | 16.0 (13.6, 18.7) |
| Not in the past year | 30.8 (27.6, 34.2) |
| Has carried a loaded handgun in the past 30 days | 18.0 (15.3, 21.0) |
| Have ever stored a gun for a friend/family member because concerned wasn't safe to have access to a gun | 8.5 (6.5, 11.0) |
| Has written advance directive for medical decision-making in event are unable to make medical decisions for themselves | 64.1 (60.5, 67.5) |
| Plan for securing, removing, or transferring firearms if they became unsafe to handle them | |
| Has written plan | 5.6 (3.9, 8.0) |
| Has plan, but not written | 16.1 (13.7, 18.8) |
| Thought about, but no plan | 15.1 (12.7, 18.0) |
| Haven’t thought about | 63.1 (59.6, 66.7) |
| Plan for transferring firearms to someone else upon death | |
| Has written plan | 22.5 (19.6, 25.7) |
| Has plan, but not written | 25.4 (22.3, 28.7) |
| Thought about, but no plan | 17.2 (14.7, 20.1) |
| Haven’t thought about | 34.9 (31.6, 38.3) |
About one-fifth of older firearm owners had a plan for securing, removing, or transferring firearms if they became unsafe to handle them, either written (5.6%) or unwritten (16.1%; Tables 1 & 2). Nearly half had a plan for transferring firearms to someone upon death, either written (22.5%) or unwritten (25.4%, Tables 1 & 2). Among participants who had a plan for transfer if unsafe, almost all (87.2%) also had a plan upon death.
Table 2.
Demographic and firearm-related characteristics of older firearm owners (≥65 years), by presence of a plan (written or not) for (a) securing, removing, or transferring firearms if they became unsafe to handle them or (b) transferring firearms to someone else upon death.
| Plan (written or unwritten): | ||
|---|---|---|
| if unsafe to handle (n=215) |
upon death (n=471) |
|
| Weighted %* (95%CI) |
Weighted %* (95%CI) |
|
| Age (years) | ||
| 65-74 | 22.3 (18.8, 26.3) | 47.7 (43.4, 52.0) |
| 75+ | 20.2 (15.6, 25.9) | 48.6 (42.1, 55.1) |
| Gender | ||
| Male | 20.3 (17.2, 23.7) | 48.0 (44.0, 52.1) |
| Female | 25.8 (19.3, 33.5) | 47.6 (40.0, 55.4) |
| Race/ethnicity | ||
| White/non-Hispanic | 20.2 (17.4, 23.3) | 48.0 (44.3, 51.8) |
| Black/non-Hispanic | 21.2 (10.7, 38.1) | 32.2 (19.5, 48.2) |
| Other/non-Hispanic | 39.3 (19.6, 63.2) | 58.7 (35.8, 78.4) |
| Hispanic | 32.0 (18.2, 50.0) | 60.4 (43.7, 75.0) |
| Veteran | 20.5 (16.4, 25.2) | 48.8 (43.3, 54.4) |
| Education | ||
| High school degree or less | 21.7 (16.4, 28.2) | 48.6 (41.8, 55.5) |
| At least some college | 21.7 (18.6, 25.2) | 52.5 (48.6, 56.4) |
| Household size, mean (95%CI) | 2.31 (2.06, 2.55) | 2.12 (2.01, 2.23) |
| Household income | ||
| <$50,000 | 23.9 (18.7, 30.1) | 46.1 (39.7, 52.7) |
| $50,000-<$85,000 | 23.5 (17.9, 30.2) | 50.5 (43.5, 57.6) |
| $85,000-<$150,000 | 18.3 (13.5, 23.9) | 46.9 (40.1, 53.8) |
| $150,000+ | 20.1 (13.8, 28.4) | 48.4 (40.1, 56.8) |
| Married | 20.4 (17.1, 24.1) | 46.8 (42.6, 51.0) |
| Currently working | 24.2 (18.5, 31.0) | 48.9 (42.1, 55.8) |
| Current caregiver for someone with dementia | 34.2 (19.7, 52.4) | 57.0 (39.7, 72.8) |
| Lives in a metropolitan statistical area | 21.5 (18.3, 25.2) | 47.8 (43.8, 41.8) |
| Region of residence | ||
| Northeast | 24.9 (16.9, 35.2) | 45.4 (35.0, 56.3) |
| Midwest | 19.1 (13.4, 26.6) | 43.9 (36.7, 51.5) |
| South | 22.7 (18.4, 27.6) | 49.6 (44.1, 55.1) |
| West | 20.9 (15.3, 27.7) | 49.4 (42.1, 56.8) |
| Total number firearms owned (median, IQR) | 3 (1, 7) | 4 (1.05, 7) |
| Types of firearms owned | ||
| Handgun | 24.0 (20.7, 27.7) | 51.3 (47.3, 55.3) |
| Long gun | 23.1 (19.7, 27.0) | 52.3 (48.1, 56.5) |
| Has had formal firearms training | 22.7 (19.2, 26.5) | 52.8 (48.4, 57.2) |
| Frequency of handling firearms for any reason over past year | ||
| Daily | 14.2 (5.4, 32.3) | 57.2 (38.0, 74.4) |
| Weekly | 34.9 (24.5, 47.0) | 75.1 (63.2, 84.1) |
| Monthly | 25.0 (16.7, 35.9) | 66.2 (54.0, 76.6) |
| A few times a year | 26.0 (20.4, 32.6) | 55.1 (48.6, 61.4) |
| Once in the past year | 17.4 (11.7, 25.1) | 35.3 (27.7, 43.8) |
| Not in the past year | 16.4 (11.9, 22.3) | 33.0 (26.9, 39.8) |
| Has carried a loaded handgun in the past 30 days | 29.7 (22.3, 37.6) | 73.0 (64.8, 80.0) |
| Have ever stored a gun for a friend/family member because concerned wasn't safe to have access to a gun | 35.3 (22.3, 50.1) | 65.2 (51.9, 76.4) |
| Has written advance directive for medical decision-making in event are unable to make medical decisions for themselves | 23.6 (19.7, 27.4) | 51.2 (46.8, 55.6) |
| Plan for securing, removing, or transferring firearms if they became unsafe to handle them | ||
| Has written plan | - | 92.3 (71.5, 98.3) |
| Has plan, but not written | - | 85.4 (78.0, 90.6) |
| Thought about, but no plan | - | 52.2 (42.8, 61.5) |
| Haven’t thought about | - | 33.2 (29.1, 37.6) |
| Plan for transferring firearms to someone else upon death | ||
| Has written plan | 37.7 (30.3, 45.6) | - |
| Has plan, but not written | 41.4 (34.3, 48.8) | - |
| Thought about, but no plan | 7.3 (3.6, 14.0) | - |
| Haven’t thought about | 4.4 (2.5, 7.7) | - |
All percentages (95% CIs) are row percentages (95% CIs); for example, of the older firearm owners aged 65-75, 22.3% (95% CI: 18.8%, 26.3%) have a plan for securing, removing, or transferring their firearms in the event that they became unsafe to handle them.
DISCUSSION
In this nationally representative survey, one-fifth of older firearm owners had a plan for transferring firearms if they became unsafe to handle them, and half had a plan for what would happen upon death. This is the first report to address the frequency and mode of contingency plans for firearm transfers due to cognitive or physical decline.
Multi-modal outreach through varied 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 healthcare providers (5), aging or dementia organizations, or other community sources. Inclusion of firearm-related issues in medical, financial, or legal advance planning might also be useful. Future questions include the utility of an “Advance Firearm Agreement” (2), the concept of “firearm retirement planning” as a part of firearm ownership, and 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 with dementia caregivers.
Our survey included only English-speaking older adults living in homes with guns, so our results may not generalize. We did not explore reasons for having (or not having) plans, sample size limited subgroup analyses, and acceptability bias may have resulted in over-report of planning.
Despite these limitations, this study highlights opportunities for enhanced future planning related to firearms. Informed by this work, trusted messengers – be they from the medical, legal, firearms, or other communities – can help prevent firearm injury by assisting in contingency planning for “firearm retirement”.
ACKNOWLEDGEMENTS
This project was supported by NIH/NIMH/NIA R34MH113539-01 and by the New Venture Fund (NVF-FFSF-Northeastern University-007811-2018-12-04). Dr. Knoepke was supported by a career development award from the American Heart Association. The contents of this work are the authors’ sole responsibility and do not necessarily represent official funder views or the views of the Department of Veterans Affairs.
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