Jan252026
Guardianship Q&A Series

What happens if my adult child can’t clearly communicate—can a power of attorney still be signed, or do we need something else? – North Carolina

Short Answer

In North Carolina, an adult can sign a power of attorney only if they still have enough understanding and capacity for that specific document. For a health care power of attorney, North Carolina law requires the adult to have the capacity to make and communicate health care decisions at the time of signing. If the adult child cannot reliably communicate or understand what is being signed, the usual solution is a court guardianship through the Clerk of Superior Court so someone can legally make health care and/or financial decisions during the recovery.

Understanding the Problem

Under North Carolina guardianship law, the key decision point is whether an adult child who is hospitalized long-term but has limited ability to communicate can still validly sign a power of attorney that gives a parent authority over health care decisions and financial matters. If the adult child cannot clearly communicate or does not have enough understanding to sign, the question becomes what legal process is used instead to give someone authority to act.

Apply the Law

North Carolina treats a power of attorney as a document that must be signed by the adult who is giving someone else authority (the “principal”). If the principal lacks the required capacity at the time of signing, the document can be ineffective and third parties (like hospitals and banks) may refuse to honor it. When an adult cannot sign a valid power of attorney, a guardianship case is typically filed with the Clerk of Superior Court so the clerk can appoint a guardian with court-ordered authority.

Key Requirements

  • Capacity at the time of signing: The adult child must have enough understanding for the type of power of attorney being signed. For health care powers of attorney, North Carolina requires “understanding and capacity to make and communicate health care decisions” when the document is made.
  • Proper execution formalities: Powers of attorney must be signed with the required formalities (commonly including notarization, and for a health care power of attorney, witnesses are typically required under North Carolina law).
  • If capacity is not present, court authority is needed: When the adult child cannot meet the capacity/communication requirement, a guardianship petition and (if appropriate) an application to appoint a guardian are filed with the Clerk of Superior Court so the clerk can appoint a guardian of the person (health care), guardian of the estate (money/property), or a general guardian (both).

What the Statutes Say

Analysis

Apply the Rule to the Facts: The adult child is hospitalized long-term and has limited ability to communicate, and the parent needs authority for both health care decisions and financial matters (including dealing with a bank). If the adult child can still understand what a health care power of attorney and financial power of attorney do and can communicate a consistent choice to sign, then properly executed documents may work. If the adult child cannot meet the “make and communicate” capacity requirement (especially for health care decisions), a guardianship through the Clerk of Superior Court is usually the tool that creates clear authority that hospitals and banks recognize.

Process & Timing

  1. Who files: Typically a parent or other interested person. Where: The Clerk of Superior Court in the appropriate North Carolina county. What: A verified petition to adjudicate incompetence and, if needed, an application to appoint a guardian (guardian of the person, guardian of the estate, or general guardian). When: As soon as it becomes clear decisions must be made and the adult child cannot validly sign documents.
  2. Evaluation and hearing steps: The clerk’s process usually involves gathering information about the adult child’s condition and functioning, providing required notices, and holding a hearing to decide whether the adult is legally incompetent and, if so, what type of guardian is needed. The scope can be tailored to the needs (health care only, finances only, or both).
  3. Appointment and authority: If the clerk appoints a guardian, the guardian receives court-issued authority to act within the limits of the appointment. That court authority is often what banks and medical providers require when no valid power of attorney exists.

Exceptions & Pitfalls

  • Limited communication does not always mean no capacity: Some adults can communicate choices in nonverbal ways (writing, blinking, assistive devices). The legal question is whether the adult can understand and communicate a consistent decision about signing, not whether speech is perfect.
  • Execution problems can sink an otherwise good plan: Even when capacity exists, hospitals and banks may reject documents that were not properly signed, witnessed, or notarized, or that are incomplete or internally inconsistent.
  • Health care authority and financial authority are different lanes: A health care power of attorney generally does not give authority over money, and a financial power of attorney does not automatically authorize medical decision-making. When both are needed and the adult cannot sign, a guardianship appointment may need to cover both areas (person and estate) or be structured as a general guardianship.

For more background on how capacity issues affect medical decision documents, see capacity to sign a medical power of attorney. For property and banking access concerns, see legal authority to access an incapacitated adult child’s property.

Conclusion

In North Carolina, an adult child can sign a power of attorney only if they have the required capacity at the time of signing, and for a health care power of attorney that includes being able to make and communicate health care decisions. When communication limits or cognitive limits prevent a valid signing, the usual alternative is a guardianship case handled by the Clerk of Superior Court to appoint a guardian of the person, the estate, or both. The next step is to file a verified incompetency petition with the Clerk of Superior Court promptly once authority is needed and the adult cannot sign.

Talk to a Guardianship Attorney

If a family is dealing with an adult child who cannot clearly communicate and a hospital or bank needs someone with legal authority to act, a guardianship plan can help clarify 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.

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.