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Older Americans suffer serious access limitations to exercise their right to vote

PHILADELPHIA The US Senate Special Committee on Aging held a hearing yesterday in Washington, DC, on older Americans and the significant barriers they face in exercising their right to vote. Jason Karlawish, MD, associate professor of Medicine and Medical Ethics at the University of Pennsylvania School of Medicine, testified before the Committee, citing results from a series of his studies examining voting rights for the elderly. Karlawish, a member of Penns Institute on Aging who specializes in older adult health care and related issues, recommends that to help break down the logistical and geographical voting barriers many older Americans face, the United States must develop a model for mobile polling.

Elderly voters especially elderly voters who live in long-term care settings are at the mercy of others when it comes to exercising their right to vote, said Karlawish. Due to geographical distances, the lack of transportation to polling sites, and the lack of assistance to absentee ballot applications, it is other people who decide whether or not older Americans with issues of mobility can vote.

Karlawish recommended that the US must develop a model for mobile polling to improve access to voting for older Americans. Mobile polling means election officials or equivalent groups visit long-term facilities in their district prior to registration deadlines to encourage and solicit registrations, said Karlawish. It also means directly distributing ballots to long-term facility residents, assisting with voting, collecting ballet and ensuring their return to a polling site.

Successful models of mobile polling currently exist in Australia and Canada, where it is the norm. Karlawish also proposed to the US Election Assistance Commission to conduct research to develop a set of best voting practices for long-term care facilities, training for election officials to implement them, and partner ships between the Commission and states to test their feasibility and refine them.

Neglecting the Voting Rights of Seniors

Election officials, said Karawish, have paid limited attention to two key issues: assuring that residents of long-term care facilities have access to the ballot, and preventing unscrupulous persons from exploiting their vote.

Karlawish reported on the results of studies of voting in long term care populations conducted by him and his colleagues. Twenty-nine states do not have voting guidelines to accommodate residents of long-term care facilities. According the Karlawish, the convergence of four trends underscores the need to address this issue:

  1. The 2000 US presidential election clearly demonstrated how very important elections can be won by remarkably small numbers of votes. These razor-thing margins of victory continue to foment concern about the accuracy and legitimacy of every vote cast, said Karlawish.

  2. Older Americans vote in larger numbers than any other age group.

  3. The older American population is growing at an unprecendented rate. It is estimated that between 2000 and 2030, the population over 65 will more than double from 35 to 71.5 million.

  4. An increasingly larger number of Americans with cognitive impairments ranging from mild to severe live in long-term care settings such as assisted living facilities and nursing homes. our surveys of Philadelphia and Virginia show that in states without guidelines for voting in long-term care, access to the polls is largely determined by the practices and attitudes of the long-term care staff, typically social workers or activities directors and those practices are inadequate and they are unacceptable.

Despite the current situation, Karlawish told the Special Senate Committee, You have the precedent of Congressional efforts to facilitate voting by people with disabilities and to promote greater uniformity in state electoral practices. You also have the federal reach into nursing homes through the regulations that govern nursing home inspections and the quality of care.

For more on information on the studies conducted by Karlawish and colleagues, please go to and click on Facilitating voting as people age: addressing the challenges of cognitive impairment.


Contact: Olivia Fermano
University of Pennsylvania School of Medicine

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