Should Someone With Dementia Be Able to Vote?
As products of the Great Depression and World War II, my parents had very strong opinions about their rights as American citizens. Voting was considered nearly sacred—a right that was not to be ignored. My parents were not political people, just people who deeply appreciated the right to vote and realized the importance of doing so.
I have many memories of my vibrant mother in action during the years when the League of Women Voters was really gaining traction in the area around my hometown. Again, Mom was not a political person, but “the League” was just there to encourage people to get out and participate.
During election season back in those days, we would have a garage full of modest-sized white signs that said “VOTE” in large black letters. Mom and her colleagues spent hours hauling these signs around town, asking people to display them in their yards and then diligently collecting them after Election Day.
Years passed and eventually Mom stopped participating in the League. However, she and Dad still considered voting to be their civic duty.
My uncle moved into a nearby nursing home, which had also coincidentally become a precinct-polling place. It was convenient since my parents lived nearby, and I could easily guide my uncle, an opinionated retired military officer, down to the poll site on the first floor of the facility to cast his ballot. Shortly after my uncle’s move, my father underwent brain surgery. This procedure led to his subsequent dementia, and he joined my uncle at the same facility.
Dad still had lucid moments and, while he could not make his hands do what his brain wanted them to do, we were well aware of his voting preferences. At election times, I ordered him an absentee ballot, and Mom and I helped him vote by reading and discussing each of the choices on the sheet. We felt comfortable that he was voting as he chose. He had dementia, but dementia does not indicate stupidity. He had many very bad days mentally and physically, but he had not changed his views on who should be holding major governmental offices. If there was an item on the ballot that he just could not understand or that we were unsure of how he would vote on it, we skipped it.
Eventually, my mom’s arthritis worsened, leading to regular falls and a fear of being alone. My daily visits with her were not enough to make her feel secure, so she made the difficult decision to move to the same skilled nursing facility to be with Dad.
Meanwhile, we had decided that Dad was not aware enough to participate at election time, and we knew he could no longer make an informed decision. Together, we decided it was time he skipped voting. Fortunately, he did not seem to notice. He was better off not talking about politics, as he had increasing difficulty separating reality from his dementia-related delusions.
However, Mom was still determined to vote, and I felt she was competent enough to make her own decisions. At the time, her dementia had not progressed past mild forgetfulness. I would take her downstairs to the voting booth, help her in and wait for her to finish. Afterward, we would go back to her room to resume our daily routine.
I will back up a bit to say that I had plenty of previous experience helping elders vote. My neighbor Joe was the first elder I consistently cared for. He was mentally sound, yet he was totally deaf and had limited vision. Joe and I had very different political views, but we debated them daily, just for fun. Joe would talk and I would scribble my retorts on a large notepad.
I would take Joe to the polling station, sit with him and help him mark his ballot as I read off each office, all the candidates and the legislative propositions. We would joke about the process, and I would bring a magnifying glass along just to prove I was showing him the right choices to mark. We had fun, but we still took voting seriously. It would never have occurred to me to deny Joe help in voting to support his views.
As Mom’s dementia grew worse, I started to wonder a bit. Could I just let the election slip past? Would she notice? When and where did her rights stop? I had felt guilty when we stopped Dad’s voting, but it was not as black and white with Mom. He really had gotten past the point of awareness and lost the ability to make informed decisions. This situation was different.
I found that Mom was very aware it was election time, even though she could not remember if my sister had come to visit her the Sunday before. I was also painfully aware of how steadily this disease was undermining her dignity and stealing her decision-making abilities. I agonized over voting rights and whether she should continue to do it.
Ultimately, I kept helping her vote until the last couple of years of her life. Was I right to do this? In hindsight, I probably should have had a third person help, but who else aside from family would have known her past preferences and her political beliefs? How would it have helped to have someone sit there as we discussed it?
It is the “why” that mattered most to me. She and I did not necessarily agree on all things political. But one thing we both knew was that she believed in her right to vote. This was a privilege that she held dear. I felt that as long as she was aware of the campaigns and that Election Day was approaching, it was her right to vote as she chose.
This is one of those controversial topics that is going to receive far more attention as the country ages and the population of seniors with dementia increases. Maybe some states already have laws in place regarding competency and voting. But where would they draw the line? Should someone who was just diagnosed with Alzheimer’s disease be denied the right to vote? How about someone who has been diagnosed but is taking medication and still able to drive? Should that person be deprived of this right as an American citizen? Will those with a diagnosis have to prove their cognitive abilities to cast a ballot? How would we be able to determine if a dementia patient is show timing? This could become a political and social hot potato.
I do not have a black and white answer to this difficult dilemma. For me, this issue was about preserving my elders’ dignity. I made the decisions I did with my heart and with the information I had at the time. As times change, this situation will likely be scrutinized more closely. Simply add the right to vote to the pressing list of issues that the growing tsunami of aging baby boomers will force us to deal with as a nation and as caregivers.