But other states offer little more than absentee ballot applications and some have tried to make that process more difficult, says Michelle Bishop, manager of voter access and engagement at the National Disability Rights Network. For example, in 2023, Ohio passed a law that included a restriction on who can help a voter with a disability cast an absentee ballot — though a U.S. district court overturned that provision in July. In Louisiana, people risk criminal charges if they help more than one non-family member with an absentee ballot. A lawsuit is challenging those Louisiana laws.
Restrictions like those violate the federal Voting Rights Act, which permits voters with disabilities, including some residents of nursing homes, to get help when voting as long as they aren’t being assisted by their employer or union representative, Bishop says. Polling places also must be accessible to those with disabilities.
But limitations have a chilling effect.
"That's going to have a disparate impact on people for whom it’s going to be more difficult to get out and get to that polling place, including people who live in nursing homes,” she says.
In some places, it’s not state law or voting procedures that present a barrier. Instead, it may come down to nursing home staff, says Nina Kohn, a law professor at Syracuse University and a distinguished scholar in elder law at Yale Law School. Without that support, it may be difficult for residents to get information about voting deadlines and requirements, get absentee ballots or a van ride to the polls, Kohn says.
“If staff don’t see voting as something that is important for residents — whether that’s because they don’t think residents are the type of people who can or should vote, or whether because they themselves are not politically active,” Kohn says, “then they may simply not place priority on voting.”
Maurice Miller at his nursing home in Takoma Park, Maryland.
Greg Kahn
The right to cast ballots
People in long-term care and nursing homes are there for many reasons: they may have physical disabilities and need help with daily activities or require specialized care. They may have cognitive challenges or Alzheimer’s disease. So should they vote?
Yes, say advocacy organizations and legal experts. Questioning that right reflects society's unrealistic view of what nursing home residents, or even people with dementia are capable of, Mollot says.
“They’re not in a vegetative state, but that’s the implication, is that these people just don’t have value and that their voice doesn’t have value,” Mollot says. “That’s wrong, whether you have weeks to live or months to live or years to live.”
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Generally, most people who are 18 or older can vote unless they have been deemed incompetent by a court or, depending on the state, convicted of a felony.
“As long as a person can express a voting preference, they have capacity to vote. And of course, that is effectively the standard that we hold people without a diagnosis of dementia to,” Kohn says.
Mary Kohanek, 67, volunteers as an election judge and lives in Minneapolis. She helps her 93-year-old mother, who has dementia and lives in a nursing home, to vote using an absentee ballot, which is mailed to her. Kohanek says her mother considers voting her civic duty.
“She’s always done it, and still really, really wants to do it. I just help her fill out the ballots,” Kohanek says. “She can still read reasonably well. She can still see pretty well, and she can still write pretty well.”
If Kohanek’s mother has trouble reading the candidates’ names, Kohanek will read them aloud and her mother will show her where to mark the ballot. Kohanek then signs the ballot to say she helped her mother. A time may come when her mother no longer understands the voting process and Kohanek says her family will decide what to do then, but for now, her mother plans to vote.
“To me, it seems logical that if a person still understands what voting is, knows the candidates, and can make choices regarding the candidates, they are still connected enough with their surroundings to be able to participate in voting,” Kohanek says.
