Feb62026
Guardianship Q&A Series

If the hospital is planning to discharge my family member soon, what can we do to keep them from going home alone if we think they’re a danger to themself? – North Carolina

Short Answer

In North Carolina, the two fastest legal paths are usually (1) seeking an interim (emergency) guardian through the Clerk of Superior Court so someone has authority to make safe discharge and placement decisions, and/or (2) starting the involuntary commitment process if the person is mentally ill and dangerous to self under the mental health statutes. Which option fits depends on whether the immediate problem is decision-making capacity, safety risk, or both. Time matters, so families often act the same day the discharge plan becomes clear.

Understanding the Problem

In North Carolina, when a hospital plans to discharge an adult who may not be safe living alone, the key question is: can a family take a legal step quickly enough to prevent an unsafe discharge when the adult cannot make or communicate safe decisions? The main decision point is whether the situation calls for someone to be legally appointed to make decisions (guardianship) or whether the situation meets the legal standard for court-ordered evaluation/treatment because the person is a danger to themself (involuntary commitment). The timing trigger is the hospital’s discharge timeline and whether the person can safely return home without supervision.

Apply the Law

North Carolina law provides tools for urgent safety situations involving adults with cognitive decline or serious mental health symptoms. If the immediate need is authority to consent to care, arrange placement, and coordinate a safe discharge, families often look to an interim guardian appointment through the Clerk of Superior Court. If the immediate need is to prevent harm because the person meets the legal criteria for being dangerous to self due to mental illness, the involuntary commitment process can lead to temporary custody for evaluation and a prompt district court hearing.

Key Requirements

  • Urgent risk: Facts must show an imminent or foreseeable risk of harm to physical well-being (or, in some cases, to the person’s property) that requires immediate intervention.
  • Likely incapacity: There must be reasonable cause to believe the adult is incompetent (meaning they cannot manage important personal or financial decisions in a way that keeps them safe).
  • Right tool for the problem: Guardianship addresses decision-making and safe placement; involuntary commitment addresses mental illness plus danger to self/others and can result in evaluation and treatment orders.

What the Statutes Say

Analysis

Apply the Rule to the Facts: The facts described involve severe medical issues plus significant memory/cognitive decline, with the family being told the adult cannot make decisions, cannot live independently, and may be a danger to themself if discharged home. Those facts commonly support the two core interim-guardian requirements: (1) reasonable cause to believe incompetency and (2) an imminent or foreseeable risk of harm to physical well-being if discharge occurs without supervision. If the danger is tied to mental illness symptoms (for example, suicidal behavior, severe psychosis, or inability to care for basic needs due to mental illness), the involuntary commitment process may also fit because it focuses on mental illness plus danger to self/others rather than decision-making authority for discharge planning.

Process & Timing

  1. Who files: A family member or other interested person typically files, and the guardian ad litem can also request interim relief once appointed. Where: The Clerk of Superior Court in the county where the guardianship is filed. What: A petition to adjudicate incompetence plus a verified motion requesting an interim guardian with specific facts showing urgent risk. When: As soon as discharge planning indicates the person may be sent home alone; the clerk must set a hearing promptly, and the hearing must be held as soon as possible and within the statutory timeframe after service on the respondent.
  2. Parallel safety step (if criteria are met): If the person is mentally ill and dangerous to themself, the involuntary commitment process can be initiated for evaluation and possible inpatient commitment, which then proceeds to a district court hearing on a tight statutory schedule.
  3. Discharge planning coordination: Once an interim guardian is appointed (or a health care agent’s authority is activated under a valid health care power of attorney), that decision-maker can work with the hospital team on a safer discharge plan, such as a supervised setting, rehabilitation placement, or other structured care plan consistent with medical recommendations.

Exceptions & Pitfalls

  • Guardianship is not the same as involuntary commitment: An interim guardian can often make placement and consent decisions, but guardianship does not automatically create authority to hold someone in a hospital against applicable discharge rules if commitment criteria are not met.
  • Capacity and paperwork gaps: Families sometimes assume a hospital statement that someone “can’t make decisions” automatically gives the family authority. Without an activated health care power of attorney or a court order, the legal authority may be unclear.
  • Not enough detail in the emergency request: Clerks typically need concrete, recent facts showing why harm is imminent or foreseeable (for example, wandering, inability to manage medications, repeated unsafe choices, or inability to meet basic needs), not just general concerns.
  • Overbroad requests: Interim guardianship powers should be narrowly tailored to the urgent problem (often consent/placement/discharge decisions). Asking for more than necessary can slow things down.
  • Local timing differences: Scheduling and procedures can vary by county, so filing early and following local clerk practices can matter.

For additional background on urgent hospital situations, see our posts on emergency guardianship for an adult relative in the hospital and options to require inpatient treatment when an adult is not safe.

Conclusion

In North Carolina, when a hospital plans to discharge an adult who cannot live independently and may be a danger to themself, the fastest legal options are usually an interim guardian request through the Clerk of Superior Court and, if the legal criteria are met, the involuntary commitment process for evaluation and possible treatment. The practical next step is to file a guardianship petition and a verified motion for interim guardianship with the Clerk of Superior Court immediately once an unsafe discharge becomes likely.

Talk to a Guardianship Attorney

If a hospital discharge is approaching and an adult family member may not be safe going home alone, our firm has experienced attorneys who can help explain the emergency options, prepare the filings, and move quickly on the right timeline. 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: Pierce Law

Pierce Law Group is a North Carolina law firm focused on probate administration, real estate partition matters, and surplus funds claims across North Carolina. We know these situations often come with stress, family dynamics, and time-sensitive decisions—so we prioritize clear communication, steady guidance, and a practical plan from day one. Our goal is to make a complicated process feel manageable, while protecting what matters most to you.