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Best Handgun Defensive Caliber for Old Arthritic Granny?

20 gauge double barrel coach gun, loaded with the heaviest shot you can find.
Dead simple, makes large holes, makes big boom. She'll only get off two rounds in a fight anyway.

If you just HAVE to have a pistol, I would suggest a Charter Arms or Smith and Wesson revolver in 38 special. No slide to rack, just pull the trigger over and over again until it clicks.
 
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can Granny say:
"Repent, the End is Near!"
 
I'd give a hard look at the beretta cheeta in 380. Tilt barrel for first round in chamber. No racking of the slide to worry about.

I'd steer clear of any rimfire unless that's as much recoil as she can handle. By nature, rimfire is simply too finicky to trust my life to.
 
Have her test drive a S&W EZ 380 and a Ruger Security 380 and the new Walther PD380.
No direct blowbacks like the Cheetah.

No rimfire pistols. Only rimfire I’d consider is a youth 10/22 with high quality ammo, but that still makes me nervous.

S&W 5.7 pistol
Ruger LC Charger in 5.7 or 9mm
Smallest & Simplest 9mm PCC (“pistol”)

410 youth shotgun

Big ass dog with a loud bark.
 
If it is for home defense would she be open to a carbine? I’m thinking the Ruger LC charger in 5.7 with a pistol brace. Light weight and maneuverable like a handgun. More stable since it has a brace. Recoil of a rimfire with reliability of a centerfire. She likely won’t be shooting it much so ammo cost doesn’t matter. Also higher capacity at ~20 rounds.
 
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