Dementia Patients: Voting Rights And Competency Laws

Dementia patients' right to vote is a topic that raises ethical and legal questions. While a dementia diagnosis does not legally bar someone from voting, some states in the US forbid people who have been assigned a legal guardian from voting. The Mental Capacity Act, which provides a framework for making decisions on behalf of people who lack capacity, does not apply to voting. This means that a lack of mental capacity does not stop someone from being able to vote. However, the question of whether or not a person with dementia has the capacity to vote is a complex one, and there is no consensus on which abilities a person with dementia should retain to express a reliable choice.

The American Bar Association's Commission on Law and Aging and the Penn Memory Center have put together a guide on helping people with cognitive impairments to vote. They explain that a medical diagnosis, such as Alzheimer's Disease, does not disqualify someone from voting. Rather, we must ask if people wish to vote and, if they do, we must assist them.

The Bazelon Center for Mental Health Law, a disability rights group, has published resources on state laws related to voting and dementia. They emphasize that it is up to caregivers and family members to determine whether a person with dementia can formulate a voting decision. The Alzheimer's Association suggests considering factors such as past political activity, the importance of voting to the individual, their ability to explain their opinions, and whether they have expressed a desire to vote.

Ultimately, the right of dementia patients to vote is a complex issue that involves ethical, legal, and medical considerations.

Voting rights of people with dementia

People with dementia have the same right to vote as everyone else. No one can be prevented from voting because they have dementia. However, people with dementia may face additional barriers when they go to the polls. For example, they may need to be reminded of the date or need support getting to the polling station.

The law

In most places, a diagnosis of dementia alone does not legally preclude someone from voting. The Mental Capacity Act provides a framework for making decisions on behalf of people who lack capacity to make a decision, but this does not apply to voting. It is up to the individual to decide if they want to vote.

However, in some places, a person who has been legally declared incompetent or incapacitated may be barred from voting. Laws vary from place to place.

Assisted voting

Voters with dementia can bring someone to assist them at the polling place. This person can be a close relative (spouse, civil partner, son or daughter), a trusted friend, or another individual of the voter's choosing. Election officials can also provide assistance if needed.

Absentee voting

Voters with dementia can also use mail-in or absentee voting options. They can receive help in filling out their ballots, but they must follow specific rules to ensure the integrity of the vote.

Other options

Some jurisdictions offer curbside voting, where election officials bring a ballot to the voter's vehicle. Voting centres and drop boxes provide additional options for voters who may have difficulty accessing traditional polling places.

Voting assistance for people with dementia

People with dementia have the same right to vote as everyone else. No one can be prevented from voting because they have dementia. However, people with dementia may face additional barriers when it comes to voting. For example, they may need to be reminded of the date or need support getting to the polling station. Here are some ways to help people with dementia exercise their right to vote.

Voting in person

Local authorities have a responsibility to ensure polling stations are accessible. If a person with dementia needs assistance, they can contact their local council in advance or speak to the staff at their polling station. A person with dementia can also have a companion to assist them at the polling station. The companion must be a close relative (spouse, civil partner, son or daughter). The Presiding Officer at the polling station can provide more information.

Voting by post

For those who have impaired hearing or vision, or who might have difficulty reading a ballot, a postal ballot is a good option. A postal ballot allows time to enlist assistance to ensure the ballot is correctly understood and completed. If a person with dementia has applied to vote by post, they will receive a postal ballot pack. Once the postal voting pack arrives, they can complete their ballot paper and, once ready, take it to the post box themselves. If they are unable to post it themselves, they can ask someone they trust to post it for them or contact their local council to see if the elections team can collect it from them.

Voting by proxy

Anyone can appoint someone else to vote on their behalf. This is called voting by proxy. The proxy must fulfil the voter's wishes and vote the way they have been instructed to. Although a person with dementia does not need mental capacity to vote, they do need mental capacity to appoint and maintain a proxy. If a person with dementia has already applied to vote by proxy, the person they have appointed will need to go to the polling station to cast their vote.

Additional resources

The Alzheimer's Society provides further information on how people with dementia can vote. The Judge David L. Bazelon Center for Mental Health Law also offers a newly-updated online booklet, *Vote: It's Your Right*, and other resources.

Ethical considerations of voting with dementia

The question of whether people with dementia should be allowed to vote raises a number of ethical considerations. On the one hand, it is important to respect the autonomy of individuals with dementia and ensure that they have the same voting rights as everyone else. On the other hand, there are concerns about the potential for fraud or abuse, as well as questions about the integrity of the electoral process.

One key ethical issue is the potential for fraud or abuse when individuals with dementia cast their votes. This could occur, for example, if a person with power of attorney (POA) were to vote on behalf of someone with dementia without following their wishes. While this would constitute electoral fraud, it may be difficult to detect or prevent, particularly if the person with dementia is unable to communicate their intentions or preferences.

Another ethical consideration is the integrity of the electoral process. Allowing individuals with dementia to vote raises questions about the role of informed and intelligent voting in a democracy. As noted by Jennifer Mathis, a Washington lawyer at the Judge David L. Bazelon Center for Mental Health Law, "our voting system does not require intelligent voting or informed voting... [but] the idea of informed voting is too susceptible to abuse." This statement highlights the potential tension between the ideal of an informed electorate and the reality of cognitive impairment in a significant portion of the population.

A third ethical issue is the potential impact of voting by individuals with dementia on election results. As the population ages and the number of people living with dementia increases, the impact of this group on election outcomes may become more significant. This raises questions about the representation of the interests of individuals with dementia in policy-making and the potential for their votes to be influenced or manipulated by others.

In addition to these ethical considerations, there are also practical challenges to consider, such as the development of methods to assess the capacity to vote and the identification of appropriate assistance for individuals with cognitive impairments to cast their ballots. Overall, the question of voting rights for individuals with dementia is a complex and multifaceted issue that requires careful consideration of ethical, legal, and social factors.

Legal considerations of voting with dementia

In many countries, people with dementia retain the legal right to vote. However, there are some legal considerations surrounding this topic that are important to understand.

Firstly, it is essential to distinguish between capacity and competency. Capacity refers to an individual's ability to make a specific decision at a particular time or situation, while competency is a legal determination made by a judge regarding an individual's ability to retain decision-making power. In the context of voting, capacity evaluation for a person with dementia involves assessing their understanding, communication skills, appreciation, and reasoning abilities. It is a functional assessment typically made by a clinician, and it does not assume that patients with dementia are incapable of making decisions.

In some jurisdictions, a person who has been legally declared incompetent or incapacitated may be barred from voting. However, this varies from state to state or country to country, and a diagnosis of dementia alone does not necessarily preclude someone from voting. The Mental Capacity Act, for example, provides a framework for making decisions on behalf of individuals lacking capacity, but this does not apply to voting.

To ensure that individuals with dementia can exercise their right to vote, certain laws have been enacted. These include the Americans with Disabilities Act, the Voting Rights Act, the Voting Accessibility for the Elderly and Handicapped Act, the National Voter Registration Act, and the Help America Vote Act. These laws require accessible voting systems, polling places, and assistance for individuals with disabilities, including cognitive impairments.

When assisting a person with dementia in voting, it is crucial to follow specific guidelines and rules to ensure the integrity of the vote. This may include bringing an assistant to the polling place, utilising mail-in or absentee voting options, or taking advantage of curbside voting or voting centres with drop boxes.

In conclusion, while people with dementia generally retain the legal right to vote, there are important legal considerations to bear in mind. These include understanding the distinction between capacity and competency, being aware of varying laws and regulations across jurisdictions, and ensuring that appropriate assistance is provided to facilitate the voting process while maintaining the integrity of the vote.

Voting accessibility for people with disabilities

In the United States, the Help America Vote Act (HAVA) of 2002 was passed by Congress to reform the nation's voting process and improve voting systems and voter access. HAVA ensures that voters with disabilities have equal opportunities for access and participation as other voters. The Americans with Disabilities Act (ADA) also protects the right of people with disabilities to vote by ensuring access to an accessible route to and within voting areas.

Voting Accessibility Features

• Accessible Absentee Ballot Requests: People with disabilities can request absentee ballots and vote by mail.
• Accessible Polling Locations: All voting locations must be accessible for people with disabilities, with features like ramps, wide doors, and accessible parking.
• Accessible Voting Machines: Each polling location is required to have at least one voting machine that is accessible for people with disabilities, including audio ballots, Braille touch pads, large print/zoom features, and height and tilt adjustments.
• Assistance at Polling Places: Voters with disabilities can bring someone to help them vote or request assistance from poll workers.
• Accessible Voter Registration: Efforts are made to ensure voters with disabilities have equal access to the voter registration process.
• Language Accessibility: The EAC's Language Accessibility Program provides translated voting materials to help election officials better serve voters with limited English proficiency.

Voting for People with Dementia

People with dementia generally have the same right to vote as everyone else. However, the specific laws and procedures may vary depending on the jurisdiction. In some states, a person legally declared incompetent or incapacitated may be barred from voting. The decision to vote on behalf of someone with dementia is both legal and ethical. While a diagnosis of dementia alone does not legally prevent someone from voting, it is up to caregivers or family members to determine if the person can formulate a voting decision.

Factors to Consider When Voting for Someone with Dementia

• Does the person understand the voting process, such as choosing between candidates?
• Does the person understand that the candidate with the most votes wins and takes office?
• Was the person politically active or interested in voting in the past?
• Can the person explain their opinions and voting preferences clearly?

Frequently asked questions