Civic Engagement in Nursing Homes: Helping Residents Find Ways To Cast Their Votes

For elderly people receiving care in skilled nursing facilities, in assisted living residences, and in their homes, voting can have its challenges. The coronavirus pandemic has added even more hurdles, as it has imposed limitations on traditional means of registering voters.

In-person registration drives have been hindered by social distancing and fears of contracting COVID-19. In many states, Department of Motor Vehicles offices have had limited hours because of COVID-19 stay at home orders and may still have restricted hours during phased reopening.

Although voter registration forms are available online in many states, seniors may have trouble completing online registration or printing the forms, filling them out, and mailing them. With family visits off limits until recently in skilled nursing facilities, many healthcare workers have been feeling a call to action to assist residents with registering and voting.

Encouraging Voter Registration

One way you can empower your residents to overcome these challenges is by having a voter registration drive. Voter registration volunteers must follow all guidelines in the state and locality where they are registering voters. Each state has different instructions and deadlines for registering to vote, so you will need to check your state’s requirements.

Some healthcare professionals are mobilizing to support their patients’ civic engagement by facilitating voter registration and sharing information about deadlines and voting options, as Modern Healthcare notes. Physicians and even medical students are organizing efforts to ensure their patients can help shape healthcare policy by voting.

To hold a drive, check the website of your city or county government’s Board of Elections. The forms and requirements should be available there. Another resource is vote.gov, a U.S. government website that can point you to your state’s registration requirements.

Let the residents who are registering know that if they mail in their registration and are registering for the first time in their jurisdiction, federal law requires the voter to show proof of identification the first time they vote. Proof of identification includes one of the following:

• A current and valid photo identification.
• A current utility bill, bank statement, government check, paycheck, or government document that shows the voter’s name and address.

Voting Aids for People With Disabilities

Once they are registered, the greater challenge becomes how to ensure your residents can cast their ballots. Going to a public polling place while COVID-19 is circulating is out of the question for most seniors in long-term care facilities.

A nonpartisan group called Democracy Works provides tools designed to assist with voting in all circumstances and all states via its TurboVote website. TurboVote links those who sign up for the service to voter registration, absentee, and vote-by-mail rules in all 50 states, and it also will send election reminders.

The U.S. Election Assistance Commission provides information on provisions initiated under the Help America Vote Act of 2002 that are designed to ensure voting accessibility for people with disabilities, including those needing skilled nursing care. The commission estimates that 35 million Americans with disabilities, or about one-sixth of the electorate, are eligible to vote. The Voting Accessibility for the Elderly and Handicapped Act of 1984 has provisions that require states to provide registration and voting aids and ensure that polling places used for federal elections maintain physical access for people with disabilities.

These laws have existed for years. However, COVID-19 has added new layers to the voting challenges for individuals in long-term care.

Although mail-in ballots are an option in some states, controversy continues to surround the U.S. Postal Service’s ability to deliver massive numbers of these ballots. Postmaster General Louis DeJoy assured election officials recently that the agency can handle the increased mail volume during this election season.

Assistance Filling Out the Ballot

Beyond the laws and federal efforts to support voting in the time of COVID-19, long-term care facilities are faced with practical concerns. What happens when a skilled nursing patient or assisted living resident needs help filling out their ballot?

On September 17, the Centers for Medicare and Medicaid Services (CMS) eased visitation restrictions for nursing homes and even threatened citations and enforcement actions if facilities do not facilitate social distancing visitation when appropriate. The guidance says, “facilities may not restrict visitation without a reasonable clinical or safety cause.”

However, family members themselves may still want to stay away to avoid subjecting their elderly relative to potential infection with COVID-19. The lack of support from family for filling out a ballot may still be an issue for many residents.

Follow State and Local Laws

As a doctor, nurse, or nursing assistant who has formed relationships with your residents, you naturally want to help. You are caregivers, and that is what you do. Yet some healthcare workers who want to help residents fill out their ballots may find their hands tied.

In Louisiana, nursing home staff members can help residents register to vote, but the staff cannot provide voting assistance. Nursing home residents in the state can apply for absentee ballots, and the registrar of voters will come to the facility for early voting.

North Carolina also prohibits skilled nursing facility employees from helping residents with absentee ballots. When requested, the local Board of Elections will send a multipartisan team to the facility to assist residents with absentee voting.

Whatever the rules are in your state, you can still inform your residents of their voting options, facilitate requests for assistance from the local Board of Elections, and be a voice for your residents. In this time when isolation rules the day, you can help empower your residents by connecting them with resources and assistance so they can exercise their rights and cast their votes.