During the 2016 Election, Dr. Jane Caldwell was living in Iowa, just a few doors down from her mother, who lived in a long term care facility. Dr. Caldwell’s mother suffered from severe dementia.
"She didn’t know my name, she didn’t know that I was her daughter, she couldn’t remember that her husband had died a few months before, and she couldn’t tell you anything about her day," said Caldwell.
Shortly before the election, the facilities manager of that home told Dr. Caldwell that some poll workers would be coming by to register people to vote. Caldwell had power of attorney for her mother.
"I requested that she not be registered to vote, because I didn’t feel that she could make a good decision," she said. "And furthermore, I didn’t want to help her to vote, because I felt like I would bias her to vote for the person I wanted.
"Two weeks later, I went to visit my mom, and she had an ‘I Voted’ sticker on her dress, and I asked her if she had voted and she said ‘I don’t know’ – because my mom had dementia, she didn’t remember. So I went to the facilities manager, and they said ‘oh, yes, they came by today, and they helped everyone to vote. And I said, ‘well, I asked you not to let my mom register or vote.’ They said, ‘well, you can’t do that.’ "A few weeks later I started getting mail from the Republican Party, and so I assumed my mom had voted Republican, which was something I don’t think she would have ever done."
Dr. Caldwell’s story raises a question that doesn’t get asked very often: can a cognitive impairment keep you from voting? And, if not, how does voting work?
The laws
A cognitive impairment doesn’t mean someone can’t vote. The American Bar Association likens the capacity to vote to the capacity to ride a bicycle: the only way to determine it accurately is to let a person do it. If someone can communicate a choice on the ballot, they can vote, even if someone else has power of attorney.
The exception, at least in Missouri and a handful of other states, is guardianship. Specific cases vary, and there are ways to reinstate a ward’s voting rights, but generally, anyone under a guardianship order is ineligible to vote.
The process
To learn more about how voting in long term care facilities works, at least in the state of Missouri, KSMU spoke to Greene County Clerk Shane Schoeller.
The process starts with requests to vote absentee, which according to state law can actually be filed by a relative of the voter on their behalf.
"Per the statute, if we receive 10 or more applications, we’re supposed to send a bipartisan team," Schoeller explained.
The "bipartisan" clause is pretty serious, in this case: the election judges have to be one registered Republican and one registered Democrat. In a case where the voter needs help filling out their ballot, they both have to be present the entire time.
"And I’ll give you an example," said Schoeller, "someone may end up reading the issues for the voter and another one might be filling in the ovals. So, regardless, you have two people with the voter and the ballot to make sure it’s fair."
While the election judges can read the ballot to the voter, they can’t, say, explain a ballot measure or a candidate’s positions. If the voter says they want to vote for someone, the judges have to mark that name down — even if it’s not on the ballot, or even if the person they name isn’t running in that election. These rules are the same if election judges assist someone with voting at an in-person voting location on Election Day.
Still, cognitively impaired voters can choose anyone to help them vote — barring some obvious exceptions like political candidates. In the case of a long term care facility with less than 10 applicants to vote absentee, they might not even have the option of being aided by poll workers. Inherently, one helper is going to be less accountable than a bipartisan team of two. And remember, all of this is just in Missouri – every state has its own procedures. But as America’s population continues to age, stories like Dr. Caldwell’s are going to become even more relevant.