Feb52026
Guardianship Q&A Series

How do I get emergency guardianship for an adult relative who is in the hospital and can’t make decisions? – North Carolina

Short Answer

In North Carolina, what many people call “emergency guardianship” for an adult is usually handled by asking the Clerk of Superior Court to appoint an interim guardian in an incompetency case. The process typically starts by filing an incompetency petition and a verified motion explaining why immediate authority is needed to prevent an imminent or foreseeable risk of harm to the person or the person’s estate. The clerk must set a prompt hearing, and if the legal requirements are met, the clerk can enter an order appointing an interim guardian with limited powers for a short period while the permanent guardianship case moves forward.

Understanding the Problem

In North Carolina guardianship law, the key question is: can a family member get court authority quickly to make decisions for a hospitalized adult who cannot make or communicate informed decisions? The decision-maker is the Clerk of Superior Court, and the relief requested is a short-term court appointment that allows someone to act right away while the longer process for a permanent guardianship continues. The trigger is a situation where waiting for the full incompetency hearing could create a serious, time-sensitive risk to the adult’s health or finances.

Apply the Law

North Carolina places adult guardianship cases under the Clerk of Superior Court. For urgent situations, the law allows the clerk to appoint an interim guardian when there is reasonable cause to believe the adult is incompetent and there is an imminent or foreseeable risk of harm that requires immediate intervention. The interim guardian’s authority must be tailored to the emergency and lasts only long enough to address the immediate need while the court schedules and completes the incompetency (and then guardianship) process.

Key Requirements

  • Reasonable cause of incompetence: Facts must support that the hospitalized adult likely cannot manage personal or financial affairs or make/communicate important decisions.
  • Immediate risk that cannot wait: The motion must show an imminent or foreseeable risk of harm to physical well-being (often medical-consent related) and/or a risk of harm to the person’s estate that requires immediate action.
  • Need for a limited, temporary appointment: The request must explain why an interim guardian is needed before the full adjudication hearing, and the requested powers should match the emergency (for example, medical-consent authority only, or limited financial authority).

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, a sibling is hospitalized and has been deemed unable to make decisions. That supports the first requirement (reasonable cause to believe incompetence). The emergency piece usually turns on what decision must be made now (for example, consent to a procedure, discharge planning, access to records, or stopping a financial loss) and why waiting for the regular incompetency hearing would create an imminent or foreseeable risk of harm. If the situation is primarily medical, the motion should focus on immediate risk to physical well-being and request person-focused powers; if finances are also at risk, the motion should explain the specific estate risk and request only the financial powers needed to address it.

Process & Timing

  1. Who files: Typically an interested family member (or, in some cases, the respondent’s guardian ad litem) files. Where: The Clerk of Superior Court in the appropriate North Carolina county. What: An incompetency petition plus a verified motion requesting appointment of an interim guardian and describing the emergency facts. When: The interim-guardian request can be filed at the time the petition is filed or after; the hearing must be held as soon as possible and generally no later than 15 days after the motion is served on the respondent.
  2. Hearing on interim guardianship: The clerk holds a short, fast-tracked hearing focused on whether there is reasonable cause of incompetence and an imminent/foreseeable risk requiring immediate intervention. If granted, the clerk signs an order that spells out the interim guardian’s limited powers and issues letters of appointment.
  3. Next steps toward permanent guardianship: The case continues to the full incompetency adjudication and then the appointment of a guardian (if the clerk finds the adult is incompetent and needs a guardian). The clerk may also require additional information to decide what type of guardianship is needed and who is suitable to serve.

Exceptions & Pitfalls

  • Asking for powers that are too broad: Interim guardianship is designed to address the emergency. Overbroad requests can slow things down or lead to a narrower order than expected.
  • Not tying the emergency to a specific risk: “The hospital needs someone to decide” is often not enough by itself. The motion should connect the facts to an imminent or foreseeable risk of harm to health and/or the estate and explain why immediate authority is necessary.
  • Service and notice problems: The statute requires prompt service of the motion and notice of hearing. Delays or mistakes in service can push the hearing date and defeat the purpose of an emergency request.
  • Bond and accounting issues for estate powers: If the interim guardian is given authority over finances, the clerk can require a bond and later accounting. Planning for that up front can avoid delays in getting usable letters of appointment.
  • Facility employee restrictions: North Carolina law restricts certain treatment-facility employees from serving as guardian for an inpatient/resident of that facility, which can affect who is eligible to be appointed.

Conclusion

In North Carolina, “emergency guardianship” for a hospitalized adult is usually handled by filing an incompetency case and asking the Clerk of Superior Court to appoint an interim guardian based on reasonable cause of incompetence plus an imminent or foreseeable risk of harm that requires immediate intervention. The clerk must set a prompt hearing, and any interim authority must be limited to what is necessary and is temporary. The practical next step is to file the petition and a verified interim-guardian motion with the Clerk of Superior Court as soon as possible, because the hearing timeline runs from service.

Talk to a Guardianship Attorney

If a hospitalized adult family member cannot make decisions and immediate court authority is needed to address medical consent or urgent safety and financial issues, our firm has experienced attorneys who can help explain the interim guardianship process and the timelines in North Carolina. Call us today at [CONTACT NUMBER].

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.