I am a volunteer long term care ombudsman. As an ombudsman, I advocate for improving the quality of life in nursing homes and assisted living facilities.
When a person moves to a nursing home, their right to choose is
one of the first rights to go. Often, they cannot choose what to eat, when to
eat, when to bathe, or what television program to watch. They cannot even choose
to be alone.
In 2007, I began Project Old Faithful to make certain that in
2008, residents in long term care facilities could help choose the next president of the United States. What I found was a variety of barriers. People
assume that long term care residents have access to everything that we do. They
do not. When I called various government offices and asked “How do I……?”,
these are some of the responses I got:
“The information is on our web site” – Long term care residents don’t have access to the internet
unless they are wealthy enough to provide their own computer and Internet service provider.
Many facility staff members do not have access to the internet.
“Just call our local office” – Long term care residents usually do not have their own private phone. It is a phone located in an open area. They
may have difficulty in dialing because of arthritic hands and background noise can make it difficult for them to hear. Cell phones are discouraged, and often come up missing. When I tried calling the given number, I got continuous busy signals or no answer at all.
“The information is in the newspaper” – Not everyone in long term care can afford a subscription
to a newspaper. The facility may have a subscription, but the paper often ends
up in the staff lounge or trash. The print is small and can be hard to read if
your glasses are not correct.
“You can come by one of our convenient locations” or “You can vote curbside at any of the early voting
locations” – I love these responses. How does a long term care resident
get transportation to a tax office, library or any government office? Many facilities
don’t have vans. The ones that do, offer many excuses as to why they cannot
transport residents to the polls, such as “It is not covered by Medicare/Medicaide”, “We don’t have
a driver”, “They cannot travel alone.”
“Just show your driver’s license” – Each legislative session, bills are introduced to require
a photo id to vote and to register to vote. Long term care residents let their
license expire. Why pay for a renewal for something they can not use. Yes, they can get a state ID if they have transportation to go to the DPS office (See “Come by one of our convenient offices” and “Just call your local office” above). So, many long term care residents do not have a photo ID, but let us
assume, for now, they do. Where does someone keep this important information? Residents are told not to keep valuable items in their rooms because it could get
lost or stolen. Where can it be kept?
Discussions about voting in long term care seem to eventually
come back to the issue of capacity to vote, can this person make an informed choice?
The legal experts tell me that it takes a judge’s order to remove the right to vote. It must be specifically stated in a guardianship order that the person in not capable of voting. As for the issue of “informed choice”, every day I drive the streets and highways of Harris County and
can tell you first hand, that the ability to drive to the poll does not mean you can make an “informed choice”. Some drivers cannot commit to a lane change, so how can we expect them to commit to
a candidate or party.
There are people who will be unable to vote for a variety of reasons. They may be unresponsive, in a coma, or in late stages of Alzheimer’s. There may also be people who do not want to vote.
That is not a problem if it is their choice.
It is the people that want to vote, or the people that don’t know that they can still vote, that I am trying
Do people in nursing homes want to vote? On March 5th of this year, one of my fellow ombudsman went to 3 nursing homes and interviewed
10 residents in each one. She asked if they had voted in the primary election
and some of the responses were:
“This is the first time ever I missed voting.”
“I wanted to vote but messed up on the dates.”
“I’ve voted since I was 18 and missed this one because
I had no information.”
“I didn’t know there was a Republican running.”
“I didn’t know if I was registered.”
“I didn’t know were to go.”
“I didn’t have enough information.”
Of the 30 people questioned, 5 actually voted.
In the Parade Magazine article How to live to 100, Dr.
Mark Liponis states “Becoming disconnected, isolated or withdrawn can mark the beginning of deterioration and loss of
function. Staying connected and current keeps your brain working and increases
your sense of purpose.” Voting is an opportunity for long term care residents
to stay connected to their community and feel that they are still of value.
Make certain that long term care residents and the elderly are
represented during the House Committee Meeting on Mail in Ballots.
Experts recommend mobile polling.
It is a broad term and can be interpreted in many ways.
- Look for ways
to involve the community in assisting these voters by defining a position of a trained and certified Volunteer Voter Assistance
Clerk. Clerks could then go to the facilities and oversee the preparation of
mail in ballots to insure the integrity.
- Develop a recorded
script, DVD or other assistive technology that can be used by those people who assist voters with mail in ballots. A recording can be done in several languages so that the assistant does not have to speak multiple languages.
Look for ways to involve the facility in assisting these voters
by including specific requirements addressing voter registration and access to the ballot in Title 40 Social Services and
Assistance, Part 1 Department of Aging and Disability Services Chapter 19 and any other area regarding the licensure of long
term care facilities in the Texas Administrative Code.
Work with county elections offices to share information, such
as a list of state licensed facilities in electronic format.
Develop a smoother way to transition older drivers to a state
Provide a safe location in the facility where residents can store
important papers and documents such as photo id, voter registration card, social security card, etc.