How do I change an adult guardianship so I can be involved in my relative’s medical decisions and care? – North Carolina

Short Answer

In North Carolina, changing an adult guardianship usually happens by filing a “motion in the cause” in the existing guardianship file with the Clerk of Superior Court in the county where the guardianship is docketed. A family member can ask the clerk to modify the guardianship order (for example, appoint a guardian of the person or adjust what decisions the current guardian controls) or, in serious situations, to remove and replace a guardian. If the goal is only access to medical information or permission for short visits, the request can be tailored to those specific issues rather than trying to change everything at once.

Understanding the Problem

In North Carolina adult guardianship cases, the key question is often: can a family member change the current guardianship arrangement so the family member can participate in medical decisions and day-to-day care when a facility is following the current guardian’s instructions and limits? The decision point is whether the existing guardianship order needs to be modified to add or change authority over medical decisions, information sharing, and short outings, or whether the situation calls for a change in who serves as guardian of the person.

Apply the Law

North Carolina places adult guardianship matters under the supervision of the Clerk of Superior Court in the county where the guardianship is docketed. When circumstances change or the current arrangement is not working, North Carolina law allows an “interested person” (often including a close family member) to ask the clerk to address issues in the case by filing a motion in the cause in the existing guardianship file. Depending on what is requested, the clerk can modify the guardianship order, resolve disputes about the guardianship, and (when legally justified) remove a guardian and appoint a successor.

Key Requirements

Standing as an “interested person”: The request generally must come from someone with a real connection to the ward or the guardianship (such as a close family member) and a concrete reason the clerk should act.
A specific change requested: The motion should clearly state what relief is needed (for example, appointment of a guardian of the person, clarification of who can receive medical updates, or an order allowing supervised/limited outings) and why that change helps protect the ward’s welfare.
Proper notice and a hearing: The clerk typically sets a hearing date, and the moving party must serve the motion and notice of hearing on the required parties in the guardianship case, following the clerk’s instructions and the applicable civil rules.

What the Statutes Say

N.C. Gen. Stat. § 35A-1203 (Clerk jurisdiction and authority) – Gives the clerk original jurisdiction over adult guardianships and authority to remove a guardian for cause and appoint a successor.
N.C. Gen. Stat. § 35A-1207 (Motions in the cause) – Allows any interested person to file a motion in the cause to request modification of the guardianship order or other relief related to the guardianship.
N.C. Gen. Stat. § 35A-1290 (Removal of guardian) – Lists reasons the clerk may remove a guardian and take steps to protect the ward’s interests.

Analysis

Apply the Rule to the Facts: Here, the adult is under guardianship and living in a care facility, and the facility is deferring to the current guardianship restrictions. If a family member wants to become (or be recognized as) guardian of the person so the family member can participate in medical decisions and care, the most direct path is usually a motion in the cause asking the clerk to modify the existing guardianship order to appoint a guardian of the person (or adjust the scope of authority among existing guardians). If the immediate need is narrower—such as permission to receive medical information and take the adult out for short visits—the motion can request a focused order addressing those points so the facility has clear direction.

Because there are already public entities involved, the clerk will usually want a clear explanation of (1) what decisions are currently assigned to which guardian, (2) what is not working in practice at the facility, and (3) why the requested change better protects the ward’s welfare and day-to-day needs. If the request is to replace a guardian, the motion should address why removal is justified under the statutory “cause” standards and why the proposed successor is suitable.

For additional background on how North Carolina typically divides authority between a guardian of the person and a guardian of the estate, see what powers a guardian has over medical and financial decisions.

Process & Timing

Who files: A family member or other “interested person.” Where: The Clerk of Superior Court (Estates/Guardianship) in the county where the guardianship is docketed. What: A verified motion in the cause requesting a specific modification (for example, appointment of a guardian of the person, clarification of medical-information access, or an order addressing short visits/outings). When: Any time a change is needed; the clerk sets a hearing date after filing.
Serve notice and prepare evidence: The moving party must serve the motion and notice of hearing on the parties in the guardianship case and anyone else the clerk directs. Evidence often includes facility communications, care-plan issues, and information showing the proposed change improves coordination and protects the ward.
Hearing and order: The clerk holds a hearing and can enter an order modifying the guardianship arrangement, resolving a dispute about authority, or (if legally supported) removing and replacing a guardian. The facility typically relies on the written order and updated letters of appointment.

Exceptions & Pitfalls

Asking for the wrong fix: If the real issue is access to information and coordination with the facility, a narrowly tailored modification may work better than trying to remove an existing guardian.
Not matching the request to the current order: Facilities usually follow the guardianship order and letters of appointment. If the paperwork does not clearly grant authority to receive medical information or approve outings, the facility may refuse even if everyone agrees informally.
Removal requires “cause”: Replacing a guardian is not automatic. The motion should address the statutory reasons for removal and focus on the ward’s welfare, not family conflict.
Notice/service problems: Motions in the cause require proper service on the parties in the guardianship case (and others the clerk directs). Improper service is a common reason hearings get continued.

Conclusion

In North Carolina, a family member can seek involvement in an adult ward’s medical decisions and care by filing a motion in the cause with the Clerk of Superior Court in the county where the guardianship is docketed, asking to modify the guardianship order (including appointing a guardian of the person or clarifying authority for medical information and short visits). The clerk can also remove and replace a guardian for legally recognized cause. The next step is to file a motion in the cause and serve all required parties so the clerk can schedule a hearing and enter a clear written order the facility can follow.

Talk to a Guardianship Attorney

If a care facility is deferring to a current guardianship order and a family member needs a change to participate in medical decisions, receive updates, or arrange short visits, our firm has experienced attorneys who can help explain options and timelines in North Carolina. 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.