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Should Aging Parents With Dementia Lose the Right to Vote?

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My parents, products of the Depression and World War II, had very strong opinions about the right to vote. It was considered nearly sacred, a right that was not to be ignored. They weren’t political people, just people who deeply appreciated the right to vote and realized the importance of doing so.

Some of my memories of my vibrant mother in action were during the years when the League of Women Voters was really getting a foothold in my home area. Again, Mom wasn’t a political person, but the “League,” as she called it, was just there to get people out to vote. They are still active in holding debate forums all over the country.

In those days, we’d have a garage full of modest-sized, plain white signs that said in large black letters, VOTE. Mom and her colleagues spent hours hauling these signs around town, asking people to please put them in their yards, then going back and collecting them prior to Election Day.

Years passed, and Mom was no longer active in the League. However, she and Dad always considered their right to vote just that, a right to be exercised. Their civic duty.

By the time my uncle became a resident at Rosewood on Broadway, a nursing home close to my own home, Rosewood was a precinct voting location. It was handy, as my parents voted close to their apartment, and I could easily guide Uncle Wilkes, an opinionated, retired military officer, down to the poll site, via the elevator, and we’d vote at Rosewood. Then came Dad’s brain surgery, his subsequent dementia, and his move to Rosewood.

Dad still had lucid moments and, while he couldn’t make his hands do what his brain wanted them to do, we were well aware of his voting preferences. I ordered him an absentee ballot, and Mom and I helped him vote by reading and discussing each choice. We felt comfortable that he was voting as he chose. He had dementia but dementia doesn’t mean stupid.  He had many very bad days, but he had not changed his views on who should be in major offices.

Eventually, Mom moved to Rosewood, as her arthritis grew so bad that she fell regularly and she was afraid to be alone. My daily time with was not enough to make her feel secure. Even the personal alarm she wore, where she could call me at the push of a button, didn’t help. She made the decision to go to Rosewood with Dad.

At the time, her dementia had not gotten passed the “some forgetfulness” stage. By that time, we’d decided that Dad likely wasn’t aware enough at election time to vote, and so we felt he wouldn’t feel diminished by not exercising his right. We also knew he could no longer make an informed decision. Together, we decided it was time he skipped voting, and he didn’t seem to notice, and he was better off not talking about political things, as he could longer separate reality from the voice in his head.

However, Mom was determined to vote and I felt she was competent enough to make her own decisions. I took her to the voting booth and helped her in, then waited for her to finish. We’d then go back to her room to complete our daily routine.

I’ll back up a bit to say that I was used to helping elders vote. My neighbor Joe, the first elder I consistently cared for, was totally deaf and had limited vision. Joe and I had very different political views. We debated them daily, just for fun, with Joe talking and me writing my silly answers back.

I would take Joe to the poll, sit with him and help him mark his ballot, as I read each office and the choices to him. We’d joke about the process, and I’d bring a magnifying glass along just to prove I was showing him the right ones to mark. We had fun with the process, but we took voting seriously. Therefore, helping elders vote was natural for me. It would never have occurred to me to deny Joe help in voting 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? Where did her rights stop? I’d felt guilty when we stopped Dad’s voting, but there wasn’t as much gray area. He really had gotten past the point of awareness and decision making. With Mom, it was different.

I found that she was very aware it was election time, even if she couldn’t remember if my sister had come to visit or not, the Sunday before. I was also aware of how steadily dementia was eating into her dignity as a person and devouring of her decision making rights. I agonized over voting rights and whether she should do it.

However, until the last couple of years of her life, I kept helping her vote. Was I right? I knew her preferences. In hindsight, I probably should have had a third person help, but who but 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? I’m not sure, but maybe I should have. What is done is done.

It’s the “why” that mattered to me. She and I didn’t necessarily agree on all things political. But one thing we both knew was that she believed in her right to vote. This was a right that she held dear. I felt that as long as she was aware of the campaigns and that it was time to vote, it was her right to vote as she chose.

This is one of those issues, much like what I wrote about in “Elders and Sex: Who gets to Decide What is Proper?,” that is going to take on a much larger social presence as we move forward. Maybe some states have laws already in place about people with dementia and voting. But where would they draw the line? Should someone who was just diagnosed be denied the right to vote? How about someone who has been diagnosed, but is taking medication and still drives? Should that person be deprived of this very American right?

As baby boomers age, and more and more are diagnosed with dementia, this could become a political and social hot potato. Should a person lose his or her voting rights when they can no longer drive safely? Should they lose the right to vote when they no longer can recite the alphabet? Just where do we, as caregivers, draw the line? Will we have to prove people who have been diagnosed with dementia legally competent in order for them to exercise their right to vote?

For me it was a decision about the dignity of my elders. I made the decisions I made with my heart, and with the information I had at the time. As times change, this situation will likely become scrutinized more closely. Add the right to vote to the list of issues the tsunami of aging boomers will be shining a light on. Where do dignity and rights stop and the ability to make an informed decision end?


For over 20 years author, columnist and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Because of this experience, Carol created a portable support group – the book “Minding Our Elders: Caregivers Share Their Personal Stories.” Her sites, www.mindingourelders.com and www.mindingoureldersblogs.com  include helpful links and agencies. Carol’s newspaper column, “Minding Our Elders,” runs weekly, she speaks at many caregiver workshops and conferences and has been interviewed by national radio, newspapers and magazines. She is the moderator of the AgingCare.com forum.

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care4rparents said
Oct 29, 2008

Good article! I think it boils down to what you think is best for your own parents and how they feel as well. I also wanted to make a suggestion for others who are facing the same dilemma: For my own father (who is a stroke survivor and suffers from aphasia and osteoarthritis), I put us both on permanent mail in ballot. My mother is mid-level Dementia, so I don't think it would be beneficial for her to vote. Even if she still wanted to, this is how I'd let her "participate." I would then decide whether to send it in or not.

Rose Broyles

Lucylou said
Oct 31, 2008

My thoughts: Voting is a civic privilege and responsibility. It is not self-esteem therapy. Whether it's "beneficial" for the person with dementia, or whether it enhances feelings of independence, is irrelevant.

The point is whether the individual is able to comprehend issues of the day and make an informed decision. If not, then they shouldn't be voting. Period.

By definition, I do not believe that people with moderate to severe cognitive impairment (for example, Stage 4/5 and beyond in Alz) have that cognitive ability.

Guiding them to vote for certain parties or issues because "I know them, and that's what they would want" usurps their judgement and replaces it with the caregiver's. In fact, people do change how they vote from one election to the next, and their candidate preferences and positions on issues can shift as well.

If you're having to help them based on your prior knowledge of their voting history, to me that answers the question right there of whether they're truly capable of making this incredibly important decision themselves.

It shocks and appalls me that we caregivers generally wouldn't dream of letting people with dementia decide not to take their cognitive meds - but we're perfectly happy to let those same folks vote, an act which will affect far more people in their community.

PS I'm the caregiver for my 80-y/o mother, who will not be voting this year.

winkpc said
Oct 31, 2008

I wholehaeartedly agree with Lucylou. My wife hasn't voted in the last 2 presidential elections nd she wo't vote in this one. I feel that if I went into the booth with her and voted, it would be the same as me having 2 votes. I see tht as voter fraud.
Maybe people should stop voting around the time they can no longer handle driving a car.
I am aware that there are people who go to nursing homes to try to assist patients in exercising their voting rights. I hope that they exercise ethical standards (that is, only vote if the individual is capable of making such a decision).

cbhillman said
Oct 31, 2008

RE: I hope that they exercise ethical standards (that is, only vote if the individual is capable of making such a decision).

Alternatively, ir is completely ethical if the helper knows what the person he is helping would want or for whom that person would want to vote. My mother is in late-stage Alzheimer's Disease but she has never ever not voted in an election. If I asked her, "Are you for John McCain or Barack Obama?" she would be clueless. However, if I ask her if she is voting for the Democrats or the Republicans, she has a ready answer!!! So I do feel that helping my mother vote is completely ethical!

carol

delawton said
Nov 1, 2008

I agree that if an AD sufferer cannot comprehend the issues and the choices, they should not vote. I also think that if ANY person cannot or does not comprehend, they should not vote. You can see where I'm going here...

The only fair course would be to set a single, common, non-partisan standard for qualification to vote (similar to the idea of a drivers test for getting a license), and applying it to everyone.

I think that if new voters (mostly young) can be inspired into voting a specific way, they should be accountable for knowing what the issues are and what the choices are (in an inquiring way).

To try to set a standard solely for AD victims would probably be an unfortunate skewing of the electorate...but I'm sure this has already been strategized.

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