Safe removal of guns key to getting help at home

Guns, mental health and elder safety are top concerns in home health care.  Discussing proper storage or removal of guns are important parts of elder safety and creating a plan of care that supports the client and protects the caregiver. 

As an example, during a recent home care shift,  a caregiver was helping a elderly client organize a kitchen cupboard. On a higher shelf, she found a .22 caliber handgun, with a box of bullets next to it. The client had forgotten about the gun, which may have been there for years.

Previously, storing a gun on a shelf, out of the reach of children, would be meeting the legal standard of “securing the firearm”. But as of July 2020, the client was unknowingly violating local laws.

In 2019, to address guns, mental health and elder safety in home health care and public safety in general,  the San Diego City Council voted on an ordinance that specifically requires guns to be stored in a locked container/lock box or fitted with an approved trigger lock when not in use. The Los Angeles City Council crafted a similar law. In February of 2023, the Los Angeles County Board of supervisors passed even stricter gun restrictions based on guns, mental health, and elder safety.

The California Department of Justice recommends using both a trigger lock and lock box and storing the ammunition separately. They have six basic tips that any gun owner should follow.

This particular client had no need for a gun and decided to get rid of it, but sometimes, the situation is not so clear cut.

Home care clients, just like most adult Americans under the 2nd Amendment, have the right to bear arms within legally defined boundaries. But there are exceptions for people with compromised mental health status. For example, most home health and home care agencies will require that clients with dementia have all firearms removed from the home, regardless of how they are stored. The local Alzheimer’s association won’t send volunteers into homes where firearms are kept.

Years ago we had an in home care client with dementia whose family had no idea she kept a gun in her closet. We all found out about the hidden gun the day the client threatened to shoot caregiver with it. Truth be told, the client was bed bound and really couldn’t make it to the closet to get the gun without help, but the caregiver was terrified.

San Diego police ended up removing the firearm. 

When At Home Nursing Care signs up new clients for service, a home care nurse will ask about any “unsecured firearms” in the home to deal with guns, mental illness and elder safety in home health care. Homecare nurses will educate clients about proper storage and the various laws if need be. If a client has a history of violence, dementia or mental health issues, the RN will initiate a discussion about gun removal. Each case is evaluated based on its own issues and we work with families to find solutions that promote safety.

One of the easiest solutions, especially if the firearm is valuable or has sentimental value, is to have a responsible party, like an adult son or daughter, take the gun. It can also be kept in a bank lock box.

If a client has advanced dementia, and will be distressed by the conversation, At Home Nursing Care recommends the responsible party make the decision without involving the client, to spare them grief or stress. Confronting someone with diminished capacity or “convincing” them that removal is best often creates useless confrontation.

Another way the daughter of a man who has mild cognitive impairment dealt with the issue of guns, mental illness and elder safety in home health care was to have the gun disabled. The daughter took the gun to Duncan’s Gunworks in San Marcos. It was changed into a non-functional gun. Her father, who believes he needs the gun for safety whenver he is alone, has no idea the gun won’t fire. He keeps his sense of safety and independence, while the daughter is complying with the law and keeping the caregivers safe.

One downside of disabling a gun is that law enforcement won’t know it’s disabled if they are ever called to the home and it’s out in the open, since the gun looks functional. But his particular senior has no history of making threats or pointing the gun at anyone. He also has in home care most of the time and the caregivers are aware of the situation and can diffuse any confusion. But this compromise is much better than doing nothing at all and letting the father keep a functional weapon.

Getting rid of unwanted guns can be done pretty easily. People can call their local police department and ask about gun surrender programs. Most departments have some sort of “buy back” program once a year. When surrendering a gun to the police department, be sure to secure it in the trunk of the car, and walk up to the police station without it to explain you are turning in an unwanted gun. 

As a policy, we don’t allow our caregivers to handle guns, but we will facilitate removal by a trained professional or law enforcement if family is unable to help. 

(Article originally published in 2020, updated May 10, 2023)