For those with dementia, voting still a question

For those with dementia, voting still a question

Sunday, October 24, 2004

By Mackenzie Carpenter, Pittsburgh Post-Gazette

As the hunt for every last vote intensifies, one question is being quietly debated in medical circles that may have an impact on this year's election:
Should people with dementia be allowed to vote?

In California, Democratic activists have filed suit against a veterans' hospital whose officials, they say, prohibited them from talking to residents on the grounds that they have dementia and were therefore incompetent to vote.

In Mobile, Ala., the district attorney fielded complaints this summer that mentally incompetent residents of a nursing home were allowed to vote in a municipal election.

And in South Carolina, state Democrats held a new primary after a state senator complained of voting fraud with absentee ballots of people in nursing homes with dementia and Alzheimer's disease.

It's not known how many people with dementia actually vote, although recent studies in Pennsylvania and Rhode Island found that residents from dementia clinics voted in higher numbers than the population at large. Nationally, 4.5 million people are estimated to have dementia, while in Pennsylvania, those with Alzheimer's -- the most common form of dementia -- is estimated at 285,000.

Legally, states are all over the map on the issue, said Dr. Jason H. Karlawish, a geriatrician at the University of Pennsylvania's Institute on Aging, who directs the Dementia Voter Project. Pennsylvania, like 26 other states, has no guidelines on how election officials and judges should handle questions about voters who may or may not be capable of voting -- although it is possible that individual counties and boroughs have their own rules, he said. On the other hand, the 23 states that do have guidelines are mostly focused on the delivery of absentee ballots to nursing homes rather than on issues around assistance in voting.

Diane Balcom, regional director of the Alzheimer's Association of Greater Pittsburgh, noted that the problem splits two ways. Those with advanced dementia may be the victims of voter fraud when nursing home officials mark their ballots, while many people with an early diagnosis of dementia may be denied their right to vote even though they're capable of it.

"There are people with dementia who might not be able to drive, but who still have the ability to cast a vote and understand the process," she said.

---