Nancy Carlson has volunteered in every presidential election since John F. Kennedy defeated Richard Nixon in 1960. Now 81 and weakened by a blood disorder, Carlson is determined to do everything in her power to help get out the vote this fall.

Most afternoons, the former secretary roams the hallways and courtyards of Walker Methodist Plaza, a senior community in Anoka where she lives, seeking to engage fellow residents in conversations about voting. Gently and without mentioning any candidate by name, Carlson explains the absentee ballot process for those who may be unable to vote in person. Carlson estimates she has talked to at least 100 residents — some multiple times — in the past few months.

“This [election] may be my last go-round,” said Carlson, who has angioectasia, an unusual dilation of blood vessels that can lead to fatigue. “I am on a mission.”

That mission has never been more important — or more fraught.

This fall, Minnesota seniors who live in residential care communities face unprecedented challenges voting in an election upended by the coronavirus pandemic. Many are afraid to cast their ballots in person, worried about a virus that is resurging nationwide and has killed 2,301 Minnesotans — about 7 in 10 of whom lived in eldercare settings — and has infected nearly 130,000 statewide.

Family members and volunteers who would normally visit with seniors and do voter education are barred from entering many senior homes. And to protect older voters from the virus, dozens of polling locations across the state have been moved out of nursing homes and other senior care facilities — further limiting access to the ballot box.

The changes have senior advocacy groups and election experts worried that many of the 85,000 older Minnesotans who live in senior living communities will be unable to vote. The federal Centers for Medicare and Medicaid Services, which oversees nursing homes, recently notified state regulators they must “ensure a resident’s right to vote is not impeded” during the pandemic. But about 70% of the state’s 364 nursing homes have active outbreaks of COVID-19; and many do not have extra staff to help seniors with the logistics of voting, say nonprofit outreach groups.

To help fill this void, many senior residents are taking matters in their own hands. They are knocking on doors of fellow residents, handing out fliers and circulating absentee ballot applications. They are being supported by voter rights groups that have been contacting senior care facilities across the state, urging them to help older residents with the logistics of voting, including instructions on how to cast absentee or mail-in ballots.

But these get-out-the-vote efforts have been hampered by the spread of the coronavirus.

In past elections, the League of Women Voters, a nonpartisan political organization, would send teams of volunteers into nursing homes to educate seniors on the voting process. Now, these facilities are on lockdown, and volunteers with the league have had to redirect their efforts toward calling and e-mailing senior home administrators. Often, staff are too busy to respond, which has volunteers concerned that many isolated seniors are being deprived of their right to vote.

“We have to be especially proactive this year, and not let people assume that just because they live in a senior facility that they can’t vote,” said Michelle Witte, executive director of the League of Women Voters Minnesota.

A fall blizzard would not keep Kilray Beaumont from getting out the vote at his assisted-living complex near downtown Minneapolis. Early this week, he stepped out into a biting wind and several inches of fresh snow. Tucked inside his backpack, Beaumont carried several absentee voter applications and a completed ballot that he had collected from fellow residents. He planned to hand-deliver them to a county elections office several miles away.

“There’s too much at stake for us in this election to sit on the sidelines,” said Beaumont, 59, as he trudged through the snow.

A former marketing consultant, Beaumont is not timid about talking to his fellow residents about the election. He walks the halls of the building and slips voter information fliers under doorways. Many evenings, he will drop by the facility’s dining room and chat with people after dinner. He carries a bag of absentee voter applications and a flashlight to help people read.

Over the past few months, Beaumont said he has encountered several residents who were too frail or too sick to fill out a ballot or absentee application on their own. One lost his sight in the Vietnam War. Another was an elderly woman with severe arthritis who was unable to grasp a pen, he said. “A lot of people here really want to vote ... but they’re isolated and forgotten,” said Beaumont.

Beaumont said recent disruptions in the voting process spurred him to action. In the past, people who lived in his complex could walk across the street and vote. But that option is not possible this year: The polling site was among dozens that were relocated to protect older Minnesotans from the coronavirus. Now residents at Beaumont’s senior home have to travel farther to vote in person, but many lack cars or family members who can take them, he said.

The Minnesota Secretary of State’s Office estimates that at least three dozen polling places statewide have been moved out of senior facilities to sites less vulnerable to the virus. The former polling sites were in nursing homes, senior apartment buildings and other facilities, from Winona to Duluth, where many older Minnesotans had once cast their ballots. The moves are consistent with federal health guidance.

As in years past, nursing homes and other senior facilities can bring in election judges to conduct in-person voting. But with the election just 12 days away, there is still confusion over whether facilities should allow these visiting judges if they have COVID-19 cases in their buildings, said Erin Parrish, Minnesota AARP’s associate state director of advocacy and outreach.

Early this week, Carlson had to suspend her get-out-the-vote efforts because of a new outbreak of the virus in her facility.

Yet Carlson plans to persist in her “gentle persuasion,” as she calls it, until Election Day. “All most folks need is just a few uplifting words and a gentle reminder that their vote truly does matter.”