Dementia poses a problem in voting



Who is competent to vote? There are no clear rules.
KNIGHT RIDDER NEWSPAPERS
PHILADELPHIA -- As the population of people with Alzheimer's disease grows, election officials need to tackle a problem that is growing with it: how to regulate voting among people with dementia.
In an article published Wednesday, a multidisciplinary research team said it saw evidence of two potentially big problems among the 4 million Americans with Alzheimer's disease: Some are still capable of voting but aren't allowed to. Others who shouldn't be voting still do and are vulnerable to fraud.
No clear rules
The country has no clear rules on deciding who is competent to vote, the group said in an article that appears in Wednesday's Journal of the American Medical Association.
"It's clear the states have paid woefully inadequate attention to this issue," said Paul S. Appelbaum, chair of psychiatry at the University of Massachusetts Medical School and one of the authors.
"Everybody with dementia at some point will cross the line from being able to do lots of tasks, including voting, to not being able to do that," he added. "There is a need to define the line."
Although they had no numbers, researchers said there was anecdotal evidence that voting problems were common and would only grow as the population of people with Alzheimer's disease ballooned to 15 million by 2050.
They say people with dementia should be encouraged -- and helped -- to vote as long as they understand the process. That includes thinking about how people with dementia or other mental problems react to something as confusing as Florida's notorious butterfly ballot. Simpler ballots with larger type and possibly even pictures might make them better voters.
"We need to think about cognitive accessibility, not just physical accessibility," said Jason Karlawish, an assistant professor of medicine at the University of Pennsylvania who is one of the research group's leaders.
Some laws
New Jersey's constitution, for example, excludes "idiots" and the insane from voting. Another law suggests that courts decide on voting when legal guardians are appointed, but offers no guidance on how to decide, Karlawish said. He could find no discussion of mental capacity and voting in Pennsylvania law.
Karlawish became interested in the issue after the 2000 election, when he read an Internet discussion by Alzheimer's caregivers. One wrote: "Since we have been married, he has always voted a straight Democratic ticket, so I did the same for him. ... I do not feel guilty."
Voting rights cannot be transferred from one person to another, Karlawish said, but many caregivers don't know that.
Questionable examples
He has also come across a handful of examples of questionable voting from nursing homes. Leonard Kiczek, a lawyer in Bayonne, N.J., discovered one of them during the Democratic primary in June. A bloc of absentee votes from a single nursing home swung a local election to candidates promoted by a rival Democratic faction. One of the candidates worked for the nursing home. Kiczek filed suit after he learned that party loyalists had been involved in helping people with dementia fill out their ballots.
Kiczek, a former Bayonne mayor who later dropped the suit, said the incident convinced him that lawmakers needed to pay attention to this issue. "People took advantage of these residents," he said.

By using this site, you agree to our privacy policy and terms of use.

» Accept
» Learn More