Short Answer

In North Carolina, a guardian’s authority depends on the type of guardianship. A guardian of the person makes medical and personal-care decisions; a guardian of the estate manages money and property; and a general guardian does both. Courts must tailor guardianship to the least restrictive alternative, so powers can be limited. The Clerk of Superior Court issues Letters that hospitals, banks, and agencies rely on to recognize the guardian’s authority.

Understanding the Problem

You’re asking, in North Carolina, what decisions you (or another adult) can make for an adult child if the court appoints a guardian. You want clear authority for medical providers and banks, and you’re weighing one guardian versus co-guardians, plus whether a power of attorney is still possible. Your adult child recently turned 18 and providers now require a court order before accepting your direction.

Apply the Law

North Carolina separates guardianship into three roles: guardian of the person (medical and personal decisions), guardian of the estate (financial decisions), and general guardian (both). The Clerk of Superior Court is the primary forum for incompetency and guardianship, and must use the least restrictive option that meets the adult’s needs. If financial powers are granted, the guardian must file an inventory after qualification and periodic accounts thereafter; the clerk monitors compliance.

Key Requirements

• Type matches need: Choose guardian of the person for health and placement decisions; guardian of the estate for money and property; general guardian if both are needed.
• Least-restrictive powers: The court can limit or split duties so the adult keeps rights they can still exercise.
• Medical consent authority: A guardian of the person may consent to routine medical treatment and services; some procedures still require separate court orders or special statutes.
• Financial control with oversight: A guardian of the estate controls accounts, income, and bills, often with a bond; must file an inventory (typically within 90 days) and annual accounts.
• Clerk of Superior Court forum: Petitions and hearings occur before the clerk in the adult’s county; Letters of Guardianship evidence authority to third parties.
• Limited or successor arrangements: The court can appoint a single guardian and name a standby/successor; co-guardians are possible but can complicate signatures and filings.

What the Statutes Say

• N.C. Gen. Stat. § 35A-1251 (Guardian of the person: powers and duties) – Health care, residential, and personal decision-making authority.
• N.C. Gen. Stat. § 35A-1241 (Guardian of the estate: powers and duties) – Asset control, bill payment, claims, and related financial powers.
• N.C. Gen. Stat. § 35A-1221 (Limited guardianship) – Tailors authority so the ward retains as many rights as possible.
• N.C. Gen. Stat. § 90-21.13 (Consent to medical treatment) – Identifies who may consent to adult medical care, including a court‑appointed guardian.

Analysis

Apply the Rule to the Facts: Because providers and banks will not accept your direction now that your child is 18, a court order is the right tool. If your priority is medical decisions and daily care, a guardian of the person can consent to treatment and coordinate services. If you also need banking and benefits control beyond what you informally manage, a guardian of the estate (or a general guardian) provides recognized financial authority, with inventory and annual accounting to the clerk.

Process & Timing

1. Who files: Any interested person (often a parent). Where: Clerk of Superior Court in the adult child’s county. What: AOC‑SP‑200 (Petition for Adjudication of Incompetence and Application for Appointment of Guardian). When: After filing, the court serves the respondent, appoints a guardian ad litem and counsel as needed, and sets a hearing; local timing varies by county.
2. The clerk holds a hearing and decides incompetency and the least‑restrictive guardianship. If granted, the clerk issues an order and Letters of Guardianship that you can present to hospitals, banks, and agencies.
3. If estate powers are granted, expect to post bond (if required), open a guardian estate account, file an inventory within 90 days, and submit annual accounts. A guardian of the person follows court guidance and may be asked to provide periodic status updates.

Exceptions & Pitfalls

• Existing health care documents: A valid health care power of attorney can guide or limit a guardian’s medical role unless the court orders otherwise.
• Capacity for a power of attorney: Your child can sign a durable financial or health care power of attorney only if they understand the nature and effect of the document; if not, guardianship is the proper route.
• Limited guardianship: Ask the court to preserve rights your child can still exercise; overbroad authority can be avoided.
• Co‑guardianship friction: Two guardians can slow medical consents or banking because both signatures or coordination may be needed; a single guardian with a named standby/successor is often simpler.
• Financial transactions: Some actions (for example, selling real estate or certain investments) may require separate court approval even with estate authority.
• Notice and service: The respondent must be properly served and represented; defects can delay or undo the case.

Talk to a Guardianship Attorney

If you’re dealing with medical and financial decision-making for an adult child and need clear court authority, our firm has experienced attorneys who can help you understand your options and timelines. 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.