Short Answer

Yes. Under North Carolina law, a spouse can be held responsible for the other spouse’s “necessary” living and medical expenses, which can include assisted living when it is medically or functionally necessary. Providers may pursue the refusing spouse for payment, and families can also seek a court-appointed guardian to manage an incapacitated spouse’s assets so lawful obligations are paid. If the couple is separated, support orders may address contribution.

Understanding the Problem

You’re asking whether, in North Carolina, a husband who refuses care can be made to help pay for his wife’s assisted living. The adult child wants to know what tools exist to require a spouse to contribute. One key fact: the mother can no longer manage daily life and needs assisted living.

Apply the Law

North Carolina recognizes a spousal “necessaries” rule: third‑party providers can seek payment from one spouse for the other spouse’s necessary expenses (such as medically needed residential or assisted living care) if the receiving spouse cannot pay. Separately, if a spouse lacks capacity, the Clerk of Superior Court can appoint a guardian to manage that spouse’s money and property; the guardian pays the ward’s valid debts and care costs, and may, with appropriate approval and documentation, satisfy the ward’s lawful obligations arising from the necessaries rule. If spouses are living apart, the dependent spouse can ask the District Court for postseparation support or alimony.

Key Requirements

• Marital relationship: The parties were legally married when the assisted living services were provided.
• Necessary expense: The assisted living care is reasonably necessary for the spouse’s health, safety, or maintenance (often shown by cognitive or functional decline, physician recommendations, or inability to perform activities of daily living).
• Nonpaying spouse’s responsibility: The receiving spouse cannot cover the bill; the other spouse has the legal duty to contribute and may be pursued by the provider.
• Capacity and management: If the refusing spouse has dementia and cannot manage finances, a guardian of the estate can be appointed to marshal assets and pay lawful obligations; expenditures must be for the ward’s benefit and documented.
• Forum fit: Payment disputes by providers proceed in civil court; guardianship petitions are filed with the Clerk of Superior Court; support between separated spouses is sought in District Court.

What the Statutes Say

• North Carolina Gen. Stat. § 35A-1101 (Incompetent adult defined) – Sets who is “incompetent” and triggers guardianship jurisdiction with the Clerk of Superior Court.
• North Carolina Gen. Stat. § 50-16.2A (Postseparation support) – Allows a dependent spouse to seek temporary support after separation.
• North Carolina Gen. Stat. § 50-16.3A (Alimony) – Authorizes ongoing support after separation based on need and ability to pay.

Analysis

Apply the Rule to the Facts: The spouses are married, and the mother’s assisted living appears necessary because she can no longer manage daily life. If she cannot afford the facility, the provider can seek payment from her husband under North Carolina’s necessaries doctrine. Because the husband has dementia and refuses care or contribution, an interested person (such as the adult child) can petition for a guardian of his estate so his assets are managed properly and lawful obligations are paid, with expenditures documented and overseen by the Clerk.

Process & Timing

1. Who files: Any interested person (e.g., adult child). Where: Clerk of Superior Court in the county where the husband resides. What: Petition for Adjudication of Incompetence and Application for Appointment of Guardian (AOC‑SP‑200). When: As soon as ongoing bills exceed what the mother can cover; hearing timelines vary by county.
2. After filing, the court ensures notice and representation for the respondent; a hearing is held. If a guardian of the estate is appointed, the guardian collects the husband’s income/assets and pays his valid obligations, keeping receipts and using funds for his benefit as required by the court’s oversight.
3. If the couple separates, the dependent spouse may file in District Court for postseparation support or alimony; those orders can require contribution to necessary living or care costs.

Exceptions & Pitfalls

• Separated spouses: Once living apart, contribution typically shifts to court‑ordered support (postseparation support or alimony), not the informal household model.
• Reasonableness: Providers still must show the charges were reasonable and necessary; luxury or purely elective services usually do not qualify.
• Capacity issues: Contracts signed by someone lacking capacity can be challenged; use guardianship to avoid voidable agreements and to pay obligations properly.
• Real estate: Selling or mortgaging jointly owned homes when one spouse lacks capacity usually requires court approval; plan for added time.
• Do not personally guarantee: Family members should avoid signing admission papers as personal guarantors unless they intend to be liable.

Talk to a Family Law Attorney

If you’re dealing with a spouse refusing to contribute to necessary assisted living costs, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.