Identifying the barriers and challenges to voting by residents in nursing homes and assisted living settings

Jason Karlawish, Richard J. Bonnie, Paul Appelbaum, Rosalie A. Kane, Constantine Lyketsos, Pamela S. Karlan, Bryan M. James, Charles Sabatino, Thomas Lawrence, David Knopman

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


To ascertain the need for and to inform development of guidelines for voting in long-term care settings, we conducted a telephone survey of Philadelphia nursing (n = 31) and assisted living (n = 20) settings following the 2003 election. Substantial variability existed in procedures used for registration and voting, in staff attitudes, and in the estimated proportion of residents who voted (29% ± 28, range 0-100%). Residents who wanted to vote were unable to do so at nearly one-third of sites, largely due to procedural problems. Nearly two-thirds of facilities indicated they assessed residents' voting capacity before the election. However, methods differed and may have disenfranchised residents who were actually competent to vote. Current procedures in many facilities fail to protect voting rights. These data suggest that rights might be better protected if election officials took charge of registration, filing absentee ballot requests, ballot completion, and trained LTC facility staff on voters' rights and reasonable accommodations.

Original languageEnglish (US)
Pages (from-to)65-79
Number of pages15
JournalJournal of Aging and Social Policy
Issue number1
StatePublished - 2008

Bibliographical note

Funding Information:
This paper was produced as part of “Developing Practical Guidelines for Voting by Persons with Dementia,” a project supported by a grant from the Greenwall Foundation and the Virginia Brown Fellowship for Aging and Stroke Research. For more information about the Dementia Voting Project, visit


  • Assisted living
  • Long-term care
  • Voting rights


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