Can an Alabama assisted living facility keep a resident who wanders?
Not a regular ALF: Alabama requires free and unhindered exit for every ALF resident and forbids admitting or retaining anyone who can live there safely only if exits are restricted, so a parent who wanders needs a SCALF or other secured setting.
ADPH tracks elopement closely. The SCALF rules require the RN to reassess and notify the physician and family after an elopement, and elopement incidents show up in statements of deficiencies.
What can we do at home when a parent starts wandering?
Add door alarms or chimes, keep keys and car keys out of sight, enroll in a location or ID program, tell neighbors, keep a recent photo ready, and structure the day so restlessness has an outlet, such as a walk at the same time each afternoon.
Call 911 immediately if your parent is missing; do not wait. Wandering often happens around the same time each day, which helps both prevention and searching.
What should we look for in a Birmingham memory care community?
Look for a SCALF license covering the unit, secured but pleasant outdoor space, a walking path that loops, staffing at or above Table A minimums, DETA-trained staff and clear policies on how they respond to exit-seeking.
ADPH lists 25 specialty care assisted living licenses in the seven Birmingham-area counties, with 898 licensed beds; 13 are in Jefferson County and 7 in Shelby. See the memory care roster.What if memory care says our parent's behavior is too much?
Alabama SCALFs may not keep residents whose behaviors are unmanageable or dangerous to themselves or others, so ask the RN for a behavior plan and physician review first, and involve the ombudsman if a discharge notice follows.
Sometimes a medical cause such as an infection or medication change drives sudden behavior; a hospital or geriatric psychiatry evaluation can help. Some nursing homes have secured units for advanced dementia when a SCALF is no longer allowed.
Does a nursing home ever make more sense than memory care for wandering?
Yes, when wandering comes with needs a SCALF may not meet, such as needing total help with feeding, inability to walk safely, or skilled nursing; at that point a nursing home with a secured unit is the setting the rules allow.
Ask nursing homes directly whether they have a secured unit and how many residents it holds. CMS data on our nursing home pages shows staffing hours and recent inspection results.
At a glance
| A regular ALF | A SCALF | |
|---|---|---|
| Exits | Must allow free egress | May secure exits |
| Wandering resident | Cannot admit or keep | Designed for |
| Staffing | No numeric minimum | Table A minimum by shift |
| After elopement | Discharge likely | RN reassessment and family notice |
Sources: Ala. Admin. Code chapters 420-5-4, 420-5-10 and 420-5-20; ADPH Bureau of Health Provider Standards; ADPH Health Care Facilities Directory and Deficiencies applications; Alabama DHR Adult Protective Services. See our editorial standards.
