Jan282026
Guardianship Q&A Series

How do I get a healthcare and financial power of attorney for my adult child who is still in the hospital and can’t really speak? – North Carolina

Short Answer

In North Carolina, an adult can only give a healthcare power of attorney and a financial (durable) power of attorney if they still have enough capacity to understand what they are signing and can sign (or direct a signature) with the required formalities. A healthcare power of attorney must be signed with two qualified witnesses and a notary, and it only covers medical decisions—not banking. If the adult child cannot reliably communicate or understand the documents right now, the practical path is usually a court guardianship case, often with a request for an interim (emergency) guardian to get authority quickly.

Understanding the Problem

In North Carolina guardianship situations, the key question is whether an adult child who is hospitalized and has limited ability to communicate can still legally appoint someone to act for them. If the adult child can validly sign, a healthcare power of attorney can authorize medical decision-making, and a separate financial power of attorney can authorize help with banking and other money matters. If the adult child cannot validly sign, the question becomes whether a court process is needed to give a parent or another responsible person legal authority to act while the adult child recovers.

Apply the Law

North Carolina treats medical decision authority and financial decision authority as two different documents with different rules. A healthcare power of attorney appoints a health care agent to make health care decisions when the principal lacks capacity to make or communicate those decisions, but it does not give general authority over money or property. Financial authority generally comes from a durable power of attorney, and when a person cannot execute valid powers of attorney, a guardianship (often starting with an incompetency proceeding) may be required. In urgent hospital situations, North Carolina also allows an interim guardian in appropriate cases through the Clerk of Superior Court.

Key Requirements

  • Capacity at signing: The adult child must understand, at least in a basic way, what authority is being granted and to whom. If the adult child cannot understand or cannot communicate a consistent choice, signing a power of attorney may not be valid.
  • Correct document and scope: A healthcare power of attorney covers medical decisions; it generally does not solve banking access. A separate financial power of attorney is usually needed for banks and other financial institutions.
  • Proper execution formalities: A North Carolina healthcare power of attorney must be signed in the presence of two qualified witnesses and acknowledged before a notary, or it may not be accepted when it is needed most.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, the adult child is hospitalized long-term and has limited ability to communicate, and the parent needs authority for both healthcare decisions and financial matters like dealing with a bank. Under North Carolina law, a healthcare power of attorney could address medical decision-making only if the adult child can still validly execute it with two qualified witnesses and a notary. If the adult child cannot reliably understand and communicate consent to sign, a guardianship case (often with an interim guardian request) is typically the tool that creates legal authority for both medical and financial needs during recovery.

Because banks and many institutions are cautious, even a valid financial power of attorney can run into practical acceptance issues if it is incomplete, unclear, or appears to have been signed when the principal was not able to understand what was happening. In hospital cases, the most important early step is to determine whether the adult child has a “good day” window where they can understand and communicate enough to sign properly; if not, moving quickly toward interim guardianship can prevent gaps in decision-making and bill management.

For a related discussion, see can a power of attorney still be signed, or is something else needed.

Process & Timing

  1. Who files: Typically the parent or another interested person. Where: The Clerk of Superior Court in the county where the adult child resides (or is present, depending on the situation). What: If the adult child can sign, prepare (1) a North Carolina healthcare power of attorney with two qualified witnesses and a notary, and (2) a separate financial power of attorney for banking and other financial matters. If the adult child cannot sign, file a petition to have the adult child adjudicated incompetent and apply for appointment of a guardian; if urgent, include a verified motion for an interim guardian. When: An interim guardianship hearing must be held as soon as possible and no later than 15 days after the motion is served on the respondent under the interim guardian statute.
  2. Next step: If pursuing interim guardianship, gather medical information that supports the need for immediate intervention (health risk and/or risk to the estate) and be prepared for the court to limit powers to what is necessary right now. If pursuing powers of attorney, coordinate with hospital staff to arrange a notary and two qualified witnesses who meet the statutory disqualifications.
  3. Final step: For powers of attorney, provide copies to the hospital and any financial institutions and confirm their internal acceptance requirements. For guardianship, follow the clerk’s orders, post any required bond for estate authority, and use the guardianship letters/order to deal with healthcare providers and financial institutions.

Exceptions & Pitfalls

  • Healthcare POA does not equal banking authority: North Carolina law limits a healthcare power of attorney to healthcare decisions; it generally will not let an agent access accounts or negotiate with a bank for routine financial matters.
  • Witness problems in the hospital: A healthcare power of attorney requires two “qualified witnesses,” and the statute disqualifies several categories of people, including certain facility employees and providers involved in care. Planning who can serve as witnesses is often the practical hurdle in a hospital setting.
  • Capacity concerns can derail everything: If the adult child cannot understand the document or cannot communicate a consistent choice, a power of attorney may be challenged or refused. In that situation, delaying a guardianship filing can leave no one with clear authority when a decision or financial action is time-sensitive.
  • Interim guardianship is limited and temporary: The clerk can limit the interim guardian’s powers to what is necessary, and the authority can expire quickly if the case does not proceed. Planning for the longer-term guardianship track matters if incapacity continues.

Conclusion

In North Carolina, an adult child can only grant a healthcare and financial power of attorney if the child still has enough capacity to understand the appointment and can sign with the required formalities. A healthcare power of attorney must be signed with two qualified witnesses and a notary and does not cover banking. If the adult child cannot validly sign right now, the next step is usually to file an incompetency/guardianship case with the Clerk of Superior Court and, when urgent, request an interim guardian; the interim hearing must be held within 15 days after service.

Talk to a Guardianship Attorney

If you’re dealing with an adult child in the hospital who cannot communicate well and immediate medical and banking decisions still need to be made, our firm has experienced attorneys who can help explain the options, paperwork, and timelines under North Carolina law. 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.