The 2020 Election and Dementia: Voting Rights and Cognitive Decline

This year has seen considerable discussion about the 2020 election and dementia. However, that conversation has not often focused on the right to vote.

Over the past two decades, there’s been some debate over whether individuals with dementia should be allowed to vote. Nearly six million adults in the United States have some form of dementia — that’s 2.5% of the population that’s eligible to vote. With a presidential election on the horizon and pandemic concerns complicating this year’s voting process, it could be difficult to ensure eligible voters with dementia get the attention and assistance they need.

Dementia and the Right to Vote

A 2004 article discussed whether caregivers and poll workers should have some sort of cognitive benchmark for assessing whether someone with dementia possessed the mental acuity to cast a vote. However, it determined that as a franchise given to all Americans who are eligible, the right to vote applies equally to individuals with dementia.

Nina Kohn, JD, an elder law specialist at Syracuse University College of Law, has stated that “short of a court determination that an individual lacks the capacity to vote, an individual has the right to vote.”

Voters with Dementia in Long-term Care Facilities

Challenges for empowering people with dementia to vote can start where they live. Most nursing and long-term care facilities lack a system for tracking which residents are interested in voting. Adding to the complexity of the situation, some states are increasing mail-in voting options to limit voters’ exposure to Covid-19, meaning there are more options for how to cast that vote. Although some states have designated election officials to assist at nursing homes, many care facilities are limiting visitation and still more have no set process for enabling their residents to vote.

While Kohn believes nursing homes that accept federal funds have a duty to assist their residents with dementia in voting, there is no oversight to ensure it happens. She believes that documenting the individual’s preference in physicians’ notes could be a helpful way to record their desire to vote and help ensure they make it to the polls. Naturally, not every resident or patient with dementia will want to vote even if they can, with the stress and limitations caused by cognitive decline.

The Memory and Context of Voting

The 2020 presidential election will likely prove even more difficult for voters with dementia. In addition to needing help remembering when Election Day is or how to get to a polling location, older voters are also facing increased confusion on how to cast their votes.

“People are being told they can’t trust one system or another,” says Kohn, who noted “misinformation campaigns” are disrupting an already challenging election year. 

Although people with advanced dementia may not fully comprehend the act of voting, it is still their right as eligible U.S. citizens. Kohn goes on to say that “the reality is, [people with dementia] can understand for a really long time, particularly people who have voted their whole lives. This is something they’ve done, something they can put context around. They might need a little bit of assistance, but there are voting laws to support that.”

Talk to Your Patients About Their Cognitive Concerns

Research has shown that early detection and intervention can often prolong independence. And in the U.S., there’s no greater demonstration of independence than participating in the electoral process.

Now’s the time for providers to talk to patients with cognitive concerns and caregivers about available support for voting. And anytime is a good time to talk to patients about their cognitive health.

BrainCheck supports physicians in assessing and addressing patients’ cognitive concerns. Our integrated cognitive care management tools can help preserve cognitive function. With help from BrainCheck to detect and treat cognitive impairment earlier, providers can help make sure patients can participate in elections to come.

Learn more about the BrainCheck platform »


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