Jan22026
Guardianship Q&A Series

What are my rights to get information and raise concerns about medication changes and medical decisions while my parent is under a court-appointed guardian? – North Carolina

Short Answer

In North Carolina, once a parent is adjudicated incompetent and a court-appointed guardian of the person (or general guardian) is in place, that guardian generally has the legal authority to make medical decisions and consent to treatment. A family member who is not the guardian usually does not control medical decisions, but can still raise concerns with the guardian, the facility, and—when appropriate—the Clerk of Superior Court overseeing the guardianship. Access to medical information often depends on whether the family member has legal authority (such as being the guardian, a valid health care agent whose authority has not been suspended, or another recognized representative) and on privacy rules.

Understanding the Problem

In North Carolina guardianship cases, a common question is: can an adult child get information and object to medication changes or medical decisions after the court has found a parent incompetent and appointed a guardian. The key decision point is whether the adult child has any legal decision-making role (such as being the appointed guardian or a still-authorized health care agent) versus being an involved family member without court authority. The timing often matters because medical decisions may be made quickly in a nursing facility setting, while court review usually happens through motions or petitions in the guardianship file before the Clerk of Superior Court.

Apply the Law

Under North Carolina law, the guardian of the person (or a general guardian) typically has custody authority and the power to consent to medical and other professional care for an incompetent adult, subject to the clerk’s orders and certain limits. If the parent previously signed a valid Health Care Power of Attorney, the health care agent generally keeps authority unless the Clerk of Superior Court suspends that authority after a petition by the guardian. When disagreements arise about care, placement, or decision-making, the guardianship is supervised through the Clerk of Superior Court, and the guardian can ask the clerk to concur in major consents or approvals.

Key Requirements

  • Who has legal authority to consent: The court-appointed guardian of the person (or general guardian) generally makes medical decisions for the ward, unless a valid health care agent still has authority that has not been suspended by the clerk.
  • How concerns get raised: Concerns usually start with communication to the guardian and the care team; if unresolved, they can be raised in the guardianship case to the Clerk of Superior Court that oversees the file.
  • What information can be obtained: Medical information access often turns on whether the requesting person is legally authorized to receive it (guardian, authorized health care agent, or another recognized representative) and whether the facility can share information under privacy rules.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, the parent has been found incompetent and is in a nursing facility under government custody, which strongly suggests a court-appointed guardian is currently responsible for medical consents and care decisions under North Carolina law. Because the adult child is not described as the appointed guardian or as a still-authorized health care agent, the adult child’s role is usually to communicate concerns and request review rather than to direct medication choices. If the adult child believes medication changes are harming the parent or that decisions are not in the parent’s best interests, the most direct legal path is typically to raise those concerns with the guardian and, if needed, through the guardianship file before the Clerk of Superior Court.

Process & Timing

  1. Who files: Usually an interested person (often a family member) or the guardian, depending on the relief requested. Where: The guardianship file with the Clerk of Superior Court in the county where the guardianship is administered in North Carolina. What: A written motion or petition in the guardianship matter asking the clerk to review the guardian’s actions, clarify authority, or order appropriate relief (the exact form and title can vary by county). When: As soon as a serious concern arises, especially if a medication change or medical decision is time-sensitive.
  2. Information-gathering: Request the current guardianship order(s) and letters of guardianship from the clerk’s file to confirm who the guardian is and what powers were granted or limited. Then request a care conference with the facility and ask the guardian to participate so concerns about medications, side effects, and goals of care are documented and addressed.
  3. Court involvement if unresolved: If the guardian will not address the concern, or if there is a dispute about who has authority (for example, whether a health care agent’s authority was suspended), file for clerk review in the guardianship case and ask for a hearing or other appropriate direction. The clerk can also be asked to concur in or review significant consents when the guardian petitions for that concurrence.

Exceptions & Pitfalls

  • Existing Health Care Power of Attorney: If the parent signed a valid Health Care Power of Attorney and named a health care agent, that agent may still have authority unless the Clerk of Superior Court suspended it after a petition by the guardian. Confusion about whether the agent’s authority is active is a common source of conflict.
  • Guardianship order limits: Some guardianships are limited. The order may reserve certain rights to the ward or restrict the guardian’s powers. Relying on assumptions instead of reading the actual order can lead to avoidable delays.
  • Privacy and access problems: Facilities often will not share detailed medical information with family members who lack legal authority. A common mistake is demanding records from the facility instead of first confirming who has authority (guardian or authorized agent) and routing requests through that person.
  • Focusing only on removal allegations: Disputes about why placement happened can be separate from the immediate question of current medical decision-making authority. Mixing the issues can slow down urgent care-related requests.
  • Not using the guardianship forum: When the guardian is not responsive, the practical enforcement tool is usually the guardianship case overseen by the Clerk of Superior Court, not informal complaints alone.

Conclusion

In North Carolina, a court-appointed guardian of the person (or general guardian) usually has the authority to consent to medical treatment and medication decisions for an incompetent parent, unless a valid health care agent still has authority that has not been suspended by the Clerk of Superior Court. A family member who is not the guardian typically cannot direct care, but can raise concerns with the guardian and the facility and can ask the Clerk of Superior Court to review issues in the guardianship file. The next step is to file a written motion or petition in the guardianship case with the Clerk of Superior Court as soon as the concern becomes serious or time-sensitive.

Talk to a Guardianship Attorney

If a parent is under a court-appointed guardian and there are concerns about medication changes, medical decisions, or access to information, an attorney can help clarify who has authority and what options exist in the guardianship file. Call 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: jpierce

Attorney Jared Pierce is the founder of Pierce Law Group in Raleigh, North Carolina, a firm he established with a dedicated focus on probate administration and estate planning across North Carolina. Born and raised in the Republic of South Africa, Jared moved to Durham with his family in 2001, bringing with him a rich cultural background and a distinctive accent that often serves as a conversation starter.