Feb92026
Estate Planning Q&A Series

Do adult children automatically have the right to make medical or financial decisions for a parent, or is a power of attorney required? – North Carolina

Short Answer

No. In North Carolina, an adult child does not automatically have legal authority to make medical or financial decisions for a parent just because of the family relationship. A parent usually must sign a health care power of attorney for medical decisions and a durable financial power of attorney for financial decisions while the parent still has capacity. If the parent can no longer make decisions and no valid documents are in place, a court guardianship through the Clerk of Superior Court is often the legal path.

Understanding the Problem

In North Carolina estate planning, a common question is whether an adult child can step in and make medical or financial decisions when a parent becomes seriously ill or starts to lose decision-making ability. The decision point is simple: can an adult child act as the parent’s legal decision-maker without written authority, or is a power of attorney required to give that authority. This question often comes up alongside other planning goals, such as preparing a will and naming a preferred guardian for a minor child the parent has adopted.

Apply the Law

Under North Carolina law, decision-making authority for an adult generally comes from (1) the adult’s own ability to decide, (2) a valid power of attorney naming an agent, or (3) a court-appointed guardian if the adult is found incompetent. For health care, North Carolina recognizes a “health care power of attorney,” which is a written document signed with specific formalities that appoints a health care agent to act when the principal lacks capacity. For finances, a durable financial power of attorney is typically used so an agent can handle banking, bills, and property matters without a court case. If no document exists and the parent cannot make or communicate decisions, a guardianship case is filed and handled by the Clerk of Superior Court in the county with jurisdiction.

Key Requirements

  • No automatic authority based on being a child: Being an adult child (even the closest, most involved child) does not automatically create legal power to sign contracts, access accounts, consent to treatment, or direct care on a parent’s behalf.
  • Valid written authority for the type of decision: Medical authority usually comes from a properly executed health care power of attorney naming a health care agent. Financial authority usually comes from a durable financial power of attorney that grants the needed powers.
  • If capacity is gone and no POA exists, court involvement is often required: When a parent cannot make decisions and did not sign valid documents beforehand, the usual solution is a guardianship proceeding, with appointment of a guardian of the person (medical/personal decisions), guardian of the estate (financial decisions), or a general guardian (both).

What the Statutes Say

Analysis

Apply the Rule to the Facts: The facts describe a parent doing estate planning after adopting a minor child (a grandchild) and wanting a will that names a preferred guardian if the parent dies. That planning is a good time to address adult-decision-making documents too, because a will controls what happens at death, but it does not give an adult child authority to manage the parent’s finances or make medical decisions while the parent is alive. If the parent wants an adult child (or another trusted person) to be able to act during incapacity, the parent typically needs to sign a health care power of attorney and a durable financial power of attorney while capacity is still present.

Process & Timing

  1. Who signs: The parent (the “principal”), while the parent still has capacity. Where: Typically in an attorney’s office or another setting where proper witnessing and notarization can be done. What: A health care power of attorney (to name a health care agent) and a durable financial power of attorney (to name an agent for finances). When: Before a crisis, because once capacity is lost, a new power of attorney may not be valid.
  2. If a crisis happens first: If the parent cannot make or communicate decisions and no valid documents exist, an interested person may need to start an incompetency/guardianship proceeding. In North Carolina, these cases are handled through the Clerk of Superior Court, and timing can vary by county and the urgency of the situation.
  3. After appointment: If the clerk appoints a guardian, the guardian’s authority is defined by the order (person, estate, or general). The guardian then uses the court appointment to deal with medical providers and financial institutions, subject to court oversight and required reporting in many cases.

Exceptions & Pitfalls

  • Confusing a will with decision-making authority: A will can name an executor and express a preferred guardian for a minor child after death, but it does not authorize an adult child to manage the parent’s money or make medical decisions during the parent’s lifetime.
  • Assuming “next of kin” status is enough: Hospitals and banks often require formal legal authority. Without a valid power of attorney (or guardianship), an adult child may be limited to helping informally, not signing or directing.
  • Documents that are signed but not usable in practice: Medical documents must meet North Carolina execution rules, and financial powers of attorney sometimes need to be accepted by third parties. For real estate transactions, recording may be required before an agent can transfer real property under a power of attorney.
  • Waiting until a parent is already impaired: If the parent cannot understand what is being signed, a power of attorney may be challenged or rejected, leaving guardianship as the practical option.

For more background on timing and capacity issues when a power of attorney is needed quickly, see set up a power of attorney if someone is in the hospital right now.

Conclusion

In North Carolina, adult children do not automatically have the legal right to make medical or financial decisions for a parent. That authority usually comes from a properly signed health care power of attorney and durable financial power of attorney, created while the parent still has capacity. If capacity is already gone and no documents exist, a guardianship case through the Clerk of Superior Court is often required. Next step: sign the appropriate powers of attorney now, before capacity becomes a problem.

Talk to a Estate Planning Attorney

If you’re dealing with a parent’s planning needs and questions about who can make medical or financial decisions, our firm has experienced attorneys who can help explain options and timelines, including powers of attorney and (when necessary) guardianship. 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: Estate Planning 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.