In a democracy, voting is a most sacred right for adult citizens. It binds us together, not as partisans, but as Americans. In this upcoming presidential election, exercising this essential right will be more challenging than usual, especially for older adults.
COVID-19 has generated concerns about the health risks of in-person voting, and the process of mail-in voting – while common since the Civil War – has been politicized. The nearly 1.5 million older adults in long-term care facilities, and the 5 million older adults living with cognitive problems, are at particular risk of disenfranchisement. Older adults who are unable to physically visit a voting booth may need assistance in requesting and completing an absentee ballot. Meanwhile, with heightened concerns around voter fraud, some may think that older adults with cognitive problems should not be allowed to vote at all.
We must address these challenges. The votes of older adults count just as much as the votes of others, and limiting their right to vote diminishes their dignity and their legal standing as U.S. citizens. To ensure their voices are heard this November, older adults, election officials and care partners can follow three key recommendations.
Bring the polls to older adults. This may involve transportation to the polls, or bringing the vote to long-term care facilities. Several states have adopted mobile polling centers that allow in-person voting for select populations, like Los Angeles County has done to serve essential workers. Mobile polling has been used successfully to allow residents of long-term care facilities to vote in-person in the past and is allowed in nearly half of the states. By bringing election officials to older voters, mobile polling decreases concerns of voter fraud and manipulation.
Challenge misconceptions about older adults voting. A diagnosis of Alzheimer’s disease or similar cognitive problems does not disqualify people from voting. To vote lawfully in the U.S., you must be a U.S. Citizen, at least 18 years old on Election Day and registered to vote. Although some states limit voting for people who have been judged incompetent by a court, there is no legal requirement for a voter to have a “clean bill of health.”
People may disagree about whether older adults with cognitive problems have the necessary capacity to vote, arguing that they could be “unreasonable.” But this discrimination towards people with cognitive problems places a higher standard for voting on people with disabilities than is placed on people without — and is unethical and unlawful.
Healthy people often cast ballots in ways that most us would find strange or unreasonable. In the 2016 presidential election, many voters wrote in names for president such as Jesus, Mickey Mouse and even a grilled cheese sandwich rather than voting for the candidates on the ballot. We do not question the right of these voters to cast a ballot, so why should we question the right of older adults with cognitive problems?
Do not manipulate older adults’ views or ballots. This position has attracted bipartisan attention and support. The American Bar Association Commission on Law and Aging and the University of Pennsylvania Memory Center partnered to develop several non-partisan recommendations to avoid bias and enhance the voting process for older adults, their families and others who care for them. They guide the kinds of conversations a care partner should have with an older adult who asks for assistance in reading or marking the ballot.
Care partners should not pressure older adults to vote unless they proactively express a desire. Conversations on voting should focus only on the information printed on the ballot. If the voter asks for the care partner’s opinion, that person should say, “This is your vote and your decision. I cannot tell you how to vote.” The care partner should mark the candidates the voter chooses and no others.
The voices of all Americans deserve to be heard in this election, including older adults living in long-term care and those with cognitive problems. We must do all we can to allow them to exercise that right. Following these recommendations can enhance the voting process and the dignity of older adults in this election.
Andrew Peterson is an assistant professor at the George Mason University Institute for Philosophy and Public Policy. Jason Karlawish is a professor at the University of Pennsylvania Perelman School of Medicine, co-director of the Penn Memory Center and author of “The Problem of Alzheimer’s,” forthcoming in February 2021.” Emily Largent is an assistant professor at the University of Pennsylvania Perelman School of Medicine.