When parents have always been passionate about exercising their right to vote, adult children don’t think twice about helping them get to the polls. But when advancing dementia diminishes mental capacity, should seniors continue to vote? Who decides if people with dementia have the capacity to vote? How is that assessment made? And where is the line drawn? If a person has just been diagnosed with Alzheimer’s disease and can still drive a car, should he or she be allowed to vote? Should a person lose voting rights when she can no longer drive a car? Tie his shoes? Where is the line? And what role should adult children play in the process?

At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be denied the right to vote or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud.

It’s a thorny issue, one that most states, including Connecticut, have managed to sidestep. Since the 1800s, a few states have attempted to withhold voting rights from “idiots, the insane, lunatics, imbeciles, and the weak-minded” but those terms were notoriously difficult to define and the laws didn’t hold up under scrutiny. (Actually, if those terms could be defined, entire swaths of the population today would likely would lose their franchise.)

About 30 states and the District of Columbia have laws in their constitutions that can limit people with mental disabilities from voting if they have been ruled “mentally incapacitated,” or incompetent, by a court. This means they have been determined unable to manage their own affairs or make specific life decisions, which, other than voting for candidates, can include managing their money, entering a contract, making medical decisions or caring for their children.

But in Connecticut, there’s no standard of capacity that people must meet in order to cast a vote. I’m not aware of anything that would prohibit someone with Alzheimer’s disease or dementia from voting. The truth is, anyone can vote. Even crazy people can vote. Why wouldn’t someone with dementia be allowed to vote?

Ultimately, the decision to help an elderly loved one with dementia exercise his or her voting rights falls to family caregivers. The best you can do is to make decisions from the heart using the information presented. When a parent is perfectly lucid one moment and can’t remember your name a few minutes later, there are no easy answers. But if you want to be thoughtful in assessing your parent’s capacity to vote in upcoming elections, consider the following points as a guide:

• Was your parent politically active in the past? Was voting important to him or her?
• Can your parent explain his or her opinion in a way that exhibits an understanding and comprehension of the question and decision?
• Has your parent expressed a desire to vote?

If you make the decision to assist your parent during the voting process:

• Request to have a mail-in ballot so your parent can take time with the ballot and fill it out in a comfortable, familiar place.
• Ask your parent one or two questions at a time, so as not to overwhelm him or her.
• Explain the questions and ask for your parent’s decision multiple times. For example, ask the same question several times in a week to see if you get the same answer. Some physicians who use this technique when asking about medical decisions find that the person almost always answers the question the same way even when they can’t remember their original answer or that they were ever asked that question.
• Be supportive but avoid helping out too much with filling out the ballot.

With a little thought and care, you can help your aging parents exercise this fundamental right for as long as possible. When it’s time for them to stop voting, you’ll know.