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Wandering has become a concern

When staying home stops being viable, and what a secured memory care unit actually requires in your state.

Quick answer

When staying home stops being viable, and what a secured memory care unit actually requires in your state.

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Home›By Situation›Wandering has become a concern

Exit-seeking changes the calculation more than almost any other symptom, because it converts a supervision problem into a safety one.

Short answer

When staying home stops being viable, and what a secured memory care unit actually requires in your state.

What to do, in order

  1. Recognise what has changed. Exit-seeking converts a supervision problem into a safety one.
  2. Take practical steps immediately. Door alarms, secured exits, and enrolment in a wandering-response program.
  3. Understand North Carolina's requirement. The state requires a Special Care Unit disclosure statement under G.S. 131D-8, describing staffing, training and exit security for the secured unit specifically.
  4. Ask specific questions on tours. How are exits secured, what happens when a resident tries a door, what is the overnight staffing ratio inside the secured unit specifically.

Questions families ask

Is CAP/DA the same thing as Medicaid paying for assisted living in Wake County?

No. CAP/DA is a home- and community-based waiver that serves people living in their own home, not in a licensed adult care home or assisted living facility, so it does not pay for assisted living room and board or services. North Carolina has no Medicaid waiver dedicated to assisted living; room and board there is instead covered through the non-Medicaid State/County Special Assistance program.

What is State/County Special Assistance, and is it a Medicaid waiver?

State/County Special Assistance (SA) is a state- and county-funded cash supplement that helps pay the room-and-board cost for eligible low-income residents of licensed adult care homes and family care homes — it is explicitly not a Medicaid waiver or Medicaid program itself. SA recipients do become automatically eligible for Medicaid, which then covers separate medical and personal-care costs, but the SA cash payment for room and board comes from state and county funds, not the Medicaid program.

Did North Carolina's 2023 Medicaid expansion change anything about nursing home coverage for my father in Durham?

No — North Carolina's ACA Medicaid expansion, effective December 1, 2023, created a separate eligibility pathway covering low-income adults ages 19–64 generally, and it did not change the eligibility rules, income limits, or asset limits for long-term-care Medicaid (the aged/blind/disabled category covering nursing facility and waiver services). Nursing facility Medicaid eligibility continues to run through its own, generally lower, income and asset tests.

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