It won’t be the first thing hospice asks you, but it’s important.
“Is it safe?”
The above could be a query from hospice, but it was definitely the riveting question asked in the 1976 film Marathon Man. During a grim, crucial scene, Laurence Olivier’s menacing character demanded—as he wielded dental equipment in the worst way—to know if his scheme could be safely accomplished.
Dustin Hoffman’s “innocent man” paid an excruciating price for every hesitation, every uncertainty.
I sometimes thought of that cinematic confrontation when one of the hospice’s social workers announced a patient’s house was “safe.” During the discussion about a new patient entering hospice care, the “safe question” must be asked and answered. Which is to say . . .
Are there are any weapons in the home?
Research in the New England Journal of Medicine indicates a growing trend of people dying at home. While a home may be categorized as a nursing home or residential facilities, many hospice patients will die their “home sweet homes.”
According to a 2021 Pew Research study, four in ten of all American households have at least one person who owns a gun. Various studies have concluded there are likely 300,000,000 guns in the United States—which means there is nearly one firearm for every man, woman and child. A 2017 Pew report stated this modern truth about firearms: “Americans have a deep history and a complex relationship with guns. A point of pride for some and a source of fear for others, guns continue to ignite sharp debates in our society.”
Obviously, many hospice staff will be welcomed into private homes. Equally obviousl, the staff never knows by simply glancing around if a household has firearms. The hospice where I worked requested that either guns be removed from the home or they are clearly locked and . . . safe.
We might not care for a patient without this reassurance.
For gun owners, the majority quickly complied with the request. 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 locking mechanism for the hunting rifle and stores the bullets in a separate location. Complying with hospice’s request is cheap and uncomplicated.
Only a very few hospice patients or families disagreed when the gun question was asked.
The resistance is rarely a second amendment debate, but more of a personal declaration of 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 penetrate walls, windows, and flesh. Bullets strike objects across the street or many blocks away. 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! The patient is medicated and barely communicates! The patient hasn’t walked in months!
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.
Whatever position we take about guns, one that always troubles me when I see the statistics has to do with suicide. Of the thousands of annual deaths by a firearm, 60% were suicide. I have no idea how many of those bullets may have been fired during hospice care, but one would be too many.
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.
++++++++++
My book, A Companion for the Hospice Journey, is available at Amazon.
Photo: Sir Laurence Olivier in the 1976 film, Marathon Man.