Dec202025
Guardianship Q&A Series

What kind of medical or other proof do we need to show that an adult needs a guardian? – North Carolina

Short Answer

In North Carolina, the court process starts by asking the clerk of superior court to decide whether the adult is an “incompetent adult,” meaning the person lacks enough capacity to manage personal or financial affairs or to make or communicate important decisions. Proof often includes medical records and provider statements, but the clerk can also rely on testimony and other documents showing how the condition affects day-to-day decision-making. In many cases, the clerk may order (or consider) a “multidisciplinary evaluation,” which can include medical, psychological, and social work information and must be “current” to be used at the hearing.

Understanding the Problem

In North Carolina, when a family asks for guardianship for an adult relative, the key decision is whether the clerk of superior court will find the adult lacks sufficient capacity to manage affairs or to make or communicate important decisions, so that a guardian is needed. The question focuses on what proof is typically used to show that the adult meets the legal definition for guardianship, and what the clerk may require to make that decision. The timing matters because proof may need to be “current,” and some evaluation requests must be made soon after the case is served on the adult.

Apply the Law

North Carolina uses a specific court procedure to decide whether an adult is legally incompetent and therefore needs a guardian. The hearing is held before the clerk of superior court (or a jury if requested), and the decision must be supported by a high level of proof. Medical evidence is important, but the law also allows broader evidence about functional limitations—what the adult can and cannot do safely and consistently. If more information is needed, the clerk may order a multidisciplinary evaluation through a designated agency, and the evaluation can be used at the hearing if it is current.

Key Requirements

  • Legal incapacity (not just a diagnosis): The proof must show the adult lacks sufficient capacity to manage affairs or to make or communicate important decisions about person, family, or property.
  • Cause and impact: The proof should connect the limitations to a condition (such as illness, injury, dementia-type conditions, mental illness, or similar causes) and explain how it affects real-world functioning.
  • Less restrictive alternatives: The clerk may consider whether a less restrictive option (like supported decision-making, an appropriate power of attorney, or a representative payee) would allow the adult to function without a guardianship.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Based on the facts provided, the family’s goal is to show the clerk that the adult relative cannot reliably manage personal or financial matters or make/communicate important decisions, and that a guardianship is necessary. The proof should therefore focus on functional problems (missed medications, inability to understand financial obligations, unsafe decisions, inability to communicate choices), supported by medical information linking those problems to a condition. If the available records are incomplete or disputed, a multidisciplinary evaluation can provide a structured, current summary for the clerk to consider.

Process & Timing

  1. Who files: Any person may file. Where: The Clerk of Superior Court (as a special proceeding) in the proper North Carolina county. What: A verified petition to adjudicate the adult incompetent (and then, if incompetence is found, a request to appoint a guardian). When: Early case deadlines can matter; for example, a written request for a multidisciplinary evaluation must be filed within 10 days after service of the petition on the respondent if a party wants the clerk to consider ordering one.
  2. Gather and organize proof for the hearing: Common evidence includes recent medical records, discharge summaries, neurocognitive testing if available, letters or affidavits from treating providers, care facility notes, medication management records, and testimony from people who observe day-to-day functioning. The most helpful proof usually explains specific limitations (memory, judgment, safety awareness, ability to understand consequences), not just a diagnosis.
  3. Hearing and decision: At the incompetency hearing, the clerk (or jury) decides whether the standard of proof is met. If the clerk needs more information to understand the disability or to plan the guardianship, the clerk can order a multidisciplinary evaluation through a designated agency, which is filed with the clerk and is not a public record except by court order.

Exceptions & Pitfalls

  • Diagnosis-only proof: A label (for example, “dementia” or “mental illness”) is usually not enough by itself; the proof must show how the condition prevents managing affairs or making/communicating important decisions.
  • Outdated records: North Carolina treats a multidisciplinary evaluation as “current” only if made within one year of when it is presented/considered. Old records can still be helpful background, but they may not carry the case without more recent information.
  • Less restrictive alternatives: If a workable power of attorney, supported decision-making setup, or other less restrictive arrangement exists, the clerk may view a full guardianship as unnecessary or may consider a more limited approach.
  • Privacy and access issues: Medical providers may refuse to release records without proper authorization or a court process. Planning early for releases, subpoenas, or a clerk-ordered evaluation can prevent delays.
  • Missed early deadlines: Waiting too long to request an evaluation can lead to proceeding to hearing with incomplete proof, or to needing a continuance.

Conclusion

In North Carolina, proof that an adult needs a guardian focuses on capacity: whether the adult lacks enough ability to manage affairs or to make or communicate important decisions, and whether a less restrictive alternative could work instead. Useful proof often includes recent medical records and provider input, plus testimony and documents showing real-life decision-making problems. If more information is needed, a party can ask the clerk for a multidisciplinary evaluation, and that request must generally be filed within 10 days after service of the petition.

Talk to a Guardianship Attorney

If a family is dealing with a possible adult guardianship and needs help identifying what medical records, provider statements, and functional evidence will matter most in a North Carolina clerk of superior court proceeding, our firm has experienced attorneys who can help explain 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.

Category: Guardianship Q&A Series

Author: jpierce

Attorney Jared Pierce is the founder of Pierce Law Group in Raleigh, North Carolina, a firm he established with a dedicated focus on probate administration and estate planning across North Carolina. Born and raised in the Republic of South Africa, Jared moved to Durham with his family in 2001, bringing with him a rich cultural background and a distinctive accent that often serves as a conversation starter.