Daryl Howard turns 65 in October. He has a Glock .45-caliber handgun stored in his desk at home, but hopes never to use it.
"It's not something that's taken lightly," Howard says on a weekday afternoon, in his second-floor Dallas apartment.
"For me, there was no second option. It was something I felt was really necessary for me to be safe."
Howard, who says he owns his gun for protection, is in good health. Getting a handgun license 15 years ago did not raise much of a fuss for his children, or son-in-law, Justin Allen.
"You were very educated about it," Allen says to Howard. "That's one reason why I feel so comfortable with him owning a handgun."
Millions of elderly Americans like Howard own guns, according to a 2017 survey by the Pew Research Center. An April 2019 University of Washington study found that about a third of older adults don't store their firearms in the safest way — locked up and unloaded.
The University of Washington study also found that 91% of firearm deaths from this population are a result of self-inflicted wounds.
Twenty-seven states and the District of Columbia have some version of a safe storage law, which requires guns to be locked up.
Elderly people are at a higher risk of developing cognitive issues and medical conditions such as dementia or depression. A gun can be a risk for its owner, as well as anyone who visits — caregivers, grandkids, friends.
Chiffon Kinney, a registered nurse at Parkland Hospital in Dallas, sometimes encounters grandkids when she visits elderly patients at home.
Eventually, the gun question comes up.
"This is Texas, they'll come right out and tell you," Kinney said. "They're never locked up.”
If Kinney thinks the gun needs to be removed, she'll usually speak to a family member about it. If need be, the family member or caregiver and the doctor work in tandem to address the safety concerns.
"It is not easy. Some people have been with their guns all their life and when we're asking them to stay away from them, it's not going to be an easy conservation," said Dr. Raja Paspula, the lead physician in the Geriatrics Center at Parkland.
Paspula says he can ask the state to take away an elderly patient's driver's license if they present a driving risk, but it doesn't work that way with guns. Police can only intervene if someone poses an immediate risk. Otherwise, the onus is on someone else, usually a family member.
Medical professionals like Kinney and Paspula say that doctors should talk with their elderly patients often about all kinds of safety risks, including guns.
As patients age, these conversations only become more important.
For Kinney, the gun question is part of her standard set of questions, alongside asking if the patient has fallen and whether or not they're taking their medicine.
Dr. Ali Rowhani-Rahbar, a researcher at the University of Washington and a co-author of the study on older adults and firearms, said the medical community needs to find more validated screening tools to recognize the relationship between firearm access and declining health as patients grow older.
"I think the majority of reasonable individuals would agree that if somebody has very mild, cognitive impairment, there would be some questions, such as, 'Is there access to firearms?'" Rowhani-Rahbar said. "And, are their plans, that if this gets worse — then the firearm could be stored with someone else, potentially."
KERA is part of Guns & America, a national reporting collaborative of 10 public media newsrooms focusing attention on the role of guns in American life. You can find more Guns & America coverage here, and learn more about the collaboration here.