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Having Dementia Doesn’t Mean You Can’t Vote

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Edward Kozlowski usually informed his daughter how his father had walked throughout Siberia to return to America.

Born in Chicago 99 years in the past, Mr. Kozlowski grew up on Midwestern farms. He left West Point throughout World War II to enlist within the Army Air Corps and made 4 flights over Europe on D-Day. A mechanical engineer, he spent a lot of his profession at NASA and at Texas A&M.

And all through his grownup life, Mr. Kozlowski, a registered Republican, voted in just about each election. “In my family, voting was the highest honor of citizenship,” his daughter, Judith Kozlowski, mentioned. “You owed it to your country to vote; that was always the message.”

It stays necessary to Mr. Kozlowski, now a resident of an unbiased dwelling facility in Chevy Chase, Md. He didn’t wish to vote in particular person this 12 months, cautious of publicity to the coronavirus, so his daughter helped him request a mail-in poll — despite the fact that he has developed dementia.

“Some days he’s right on the mark, sometimes he’s not,” mentioned Ms. Kozlowski, 68. Her father can develop disoriented; susceptible to wandering, he requires round the clock caregivers. Yet he watches “The PBS NewsHour” and CNN “religiously,” his daughter mentioned, and tuned in for the presidential and vice-presidential debates.

He has macular degeneration, so Ms. Kozlowski learn him the poll throughout brief, kitchen-table classes over a number of days. It most likely helped that as a former federal prosecutor and elder justice marketing consultant, she knew the principles higher than most.

Her father might inform her which candidates he needed to vote for.

And that’s all it takes.

“There are many misperceptions of what ‘capacity to vote’ is,” mentioned Charles Sabatino, director of the American Bar Association Commission on Law and Aging. “Incapacity to follow a recipe and cook dinner doesn’t mean incapacity to vote. The inability to remember your grandchildren’s names doesn’t mean you can’t vote.”

What is required — as the fee and the Penn Memory Center level out in a brand new information — is the power to precise a desire.

“Can you pick among the choices?” mentioned Dr. Jason Karlawish, a geriatrician and co-director of the Penn Memory Center. “That’s it.”

The Census Bureau has reported that greater than 23 million American adults — near 10 p.c — have circumstances limiting psychological functioning, together with studying and mental disabilities and Alzheimer’s illness or different types of dementia.

Keep up with Election 2020

Some are younger or middle-aged, however many of the practically eight million individuals with dementia are older adults. Many will likely be successfully disenfranchised.

Voting can turn into difficult for a lot of older residents, who might battle to achieve polling locations, stand in traces, use computerized voting machines or learn ballots printed in small kind.

But misunderstandings about cognitive decline current nonetheless extra obstacles. Workers in nursing properties and assisted dwelling amenities, in addition to relations, might refuse to help impaired voters as a result of they imagine that dementia disqualifies them.

It doesn’t. A prognosis of cognitive impairment doesn’t bar somebody from voting. Voters want go no cognitive assessments. They don’t have to have the ability to title the candidates or clarify the problems. If they need assistance studying or bodily marking the poll, they are often assisted, both on the polls or with mail-in ballots. In some states, even individuals underneath court-appointed guardianship don’t lose their voting rights.

In any case, the proportion of people that have guardians is low. If you might be contemplating serving to somebody with dementia to take part in an election, and so they have registered to vote, generally there are solely two actual pointers to remember.

One: After reminding the person who Election Day is nearing, ask whether or not she or he wish to vote. A “no” stops the method, Mr. Sabatino mentioned, however “anyone who expresses an interest in voting should be assisted, within the limits of the law.”

Two: You might learn the voter the poll selections, if she or he can’t learn them, however can’t present extra info or interpretation, though discussions earlier than voting begins are permitted. “Ask them their choices and see if they answer,” Mr. Sabatino mentioned. “If they do, they vote.”

Voters needn’t full the poll; they will vote for president and ignore every little thing else. There isn’t any time restrict; a relative or paid caregiver may help the voter full a mail-in poll over a number of days. Write-ins are permitted. “If they tell you they want to vote for F.D.R., you write in F.D.R.,” Mr. Sabatino mentioned.

“You may find it disturbing to write in someone odd, but we let people do that,” Dr. Karlawish mentioned. Voters with regular cognition might write within the title of Mickey Mouse, choose the primary particular person on the poll, whoever that is perhaps, and in any other case behave lower than rationally. “We can’t hold certain people to standards that we don’t hold everyone else to, when it’s a matter of a fundamental right,” Dr. Karlawish mentioned.

With the continuing health disaster, nonetheless, “it’s going to be harder to participate for a lot of people this year,” mentioned Myrna Pérez of the Brennan Center for Justice.

For residents of nursing properties and assisted dwelling amenities, for instance, visiting restrictions will make it onerous for kin to assist with ballots.

Elaine and Charlie Fettig, married for 58 years, have seen one another in particular person simply twice since June, when Mr. Fettig, 82, moved right into a nursing home in suburban Philadelphia. He developed dementia after a stroke two years in the past.

“We always voted,” mentioned Ms. Fettig, 81. Permitted a distanced go to earlier this month, she stuffed out an software for a mail-in poll; a workers member helped her husband make the legally required mark.

Now, Ms. Fettig wonders whether or not she’s going to be capable of go to once more in time to assist him vote. “If I could go every day, I wouldn’t have to worry about who’s going to help him make an X,” she mentioned.

Earlier this month, a Medicare memorandum warned that nursing properties should be sure that residents can vote and supply help when wanted.

Well earlier than the pandemic, nonetheless, such amenities have been chronically understaffed. Family caregivers might should drop off ballots and pester directors to assist residents full and return them. (Ms. Pérez advises consulting no less than two trusted sources on state legal guidelines governing who might help with and return a poll.)

Most older individuals with dementia dwell at home, nonetheless, the place wider use of mailed ballots would possibly really make voting simpler. Twenty-two states and the District of Columbia are sending ballots or poll purposes to most or all lively registered voters this 12 months, the Brennan Center has mentioned.

Could unscrupulous caregivers benefit from impaired older voters by overriding their selections or discarding their ballots? It’s doable, but in addition unlawful. “Anyone who sees undue influence or coercion should report it” to native election boards, Mr. Sabatino mentioned.

A rustic dedicated to making sure that every one eligible residents can vote might make this course of less complicated. During the 2008 election, as an illustration, Vermont experimented with cellular polling that despatched educated election officers to chose nursing properties.

“Everyone said how much residents felt their dignity and sense of worth was enhanced,” Dr. Karlawish mentioned; he was a part of a analysis crew following the hassle.

But though some jurisdictions emphasize outreach to older voters, cellular polling stays uncommon, most likely as a result of election boards are underfunded.

So, as usually occurs, the accountability largely falls to households. On Oct. 8, after appreciable dialogue, Judith Kozlowski helped her father make his alternatives. He allowed her to reveal that, after a lifetime of voting Republican, this time he had voted for Joseph R. Biden Jr.

She drove him to the drop field outdoors a local people middle, the place different voters and relations have been additionally returning ballots. They spontaneously applauded as Mr. Kozlowski, utilizing a walker, approached and slid his poll by the slot.

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