Parent Can't Make Decisions and Has No Power of Attorney?

If your parent can't make decisions and never signed a power of attorney, first find out whether they truly lack capacity for the decision in front of you, because a parent who can still understand a simple document may be able to sign one now. For medical care, most states let a close relative decide under a default surrogate law, no court needed. For money, Social Security and the VA can appoint you to handle their benefits, but bank accounts, property and anything bigger usually take a court guardianship or conservatorship.

Order matters: don't spend months in court on a problem a doctor's note and a signature could have fixed.

First, check whether your parent really can't decide

"Mom can't make decisions anymore" usually means something narrower: she can't keep track of the bills, or she was confused in the hospital last night. That may not be the same as lacking the capacity to sign a power of attorney.

Capacity is tied to the decision, not the person. The American Medical Association's ethics code speaks of capacity "appropriate to the decision at hand," and the Alzheimer's Association says that in most cases, if a person with dementia can understand the meaning and importance of a given legal document, they likely have the capacity to sign it. It adds that the level of capacity needed varies by document, which a lawyer can sort out, and that a doctor can help assess it.

A dementia diagnosis doesn't settle it, and neither does one bad day in a hospital bed. A parent who can't follow a mortgage refinance might still understand "I want my daughter to handle my bills if I can't."

• Ask the doctor directly. "Is my mother able to understand and sign a power of attorney and a health care proxy?" is a fair question. Ask whether a few more days of recovery might change the answer.
• Let a lawyer judge the signing. Don't download a form and slide it across the hospital tray. An elder law attorney may want to talk with your parent alone, then decide whether to go forward. That protects the document if a sibling or a bank questions it later.
• Don't push. You can't sign for your parent, and a document signed by someone who didn't understand it can be challenged. If the lawyer says no, move on to the routes below.

The National Institute on Aging notes that financial documents like a power of attorney must be created while the person still has the legal capacity to make decisions. If there's a window, use it.

Medical decisions: your state's default surrogate law

This part often works without any paperwork. Most states have a default surrogate law: when an adult can't decide and hasn't named anyone, the law picks a decision-maker from a ranked list. The federal Administration for Community Living (ACL) describes it as a default decision maker under state law, such as a spouse, parent, adult child or sibling.

Two real examples:

• Florida. Under section 765.401, the order is an existing court-appointed guardian, then the spouse, then an adult child (or a majority of the adult children reasonably available), then a parent, then adult siblings (by majority), then a relative who has shown special care and kept in regular contact, then a close friend. If there's no one, a clinical social worker picked through a bioethics committee can serve. The proxy decides based on what they reasonably believe your parent would have chosen.
• California. The San Diego Superior Court's conservatorship page says the provider may choose a surrogate from the spouse or domestic partner, an adult child, a parent, an adult sibling, an adult grandchild, or another adult relative or close personal friend who has shown special care and knows the patient's values.

A few states still have no general law like this, and some others cover only narrow situations. Massachusetts and Minnesota are two examples: bills to create a default surrogate list were introduced in both legislatures for 2025 and 2026 (see the Massachusetts bill page and the Minnesota Board on Aging's January 2026 legislative summary) but had not become law when this was written. Lists you find online go stale fast, so ask the hospital's social worker how the rule works in your parent's state.

At the bedside:

• Tell the team who's in the family. The doctor or social worker works out who's first in line. Mention a stepparent, an estranged spouse or a sibling across the country, because they may rank ahead of you or alongside you.
• Siblings may have to agree. Where the law uses a majority of adult children, one sibling deciding alone may not be enough. Get everyone on the same call.
• Emergencies don't wait. The AMA's ethics code says that when a decision is urgent, the patient can't take part and no surrogate is available, physicians may start treatment without prior consent and tell the patient or surrogate as soon as they can.
• You can still get information. Our guide to HIPAA authorization for a parent explains what doctors can tell family without a form.

California adds a twist: the San Diego court notes that a patient who still has capacity can name a surrogate directly with their health care provider, good for the treatment, the hospital stay or 60 days, whichever is shortest. If your parent has clear stretches, ask whether your state allows something similar.

The surrogate law covers health care, not money. If you're mid-hospital stay, our guide for when an elderly parent is hospitalized covers the first 48 hours.

Money: what you can do without a power of attorney

A bank won't let you into your parent's account because you're their child. There's no next-of-kin rule for money the way there often is for medical care, only some narrower tools.

Social Security: representative payee

Social Security doesn't use powers of attorney for benefit payments anyway. A Congressional Research Service summary explains that Treasury regulations don't recognize general powers of attorney for recurring federal benefit payments, so Social Security appoints a representative payee instead.

Under 20 CFR 404.2010, Social Security uses a payee when a beneficiary is legally incompetent, or mentally or physically unable to manage their payments. Under 404.2015, it relies on a court finding if there is one, and otherwise on medical evidence, such as a statement from a doctor who recently examined your parent about their condition, their chances of recovery and whether they can manage the money. Statements from relatives and friends count too.

For adults, the preference list starts with a legal guardian, spouse or other relative who has custody or shows strong concern for the person's welfare. The CRS summary says Social Security investigates proposed payees, including a face-to-face interview where practicable and a check for certain felony convictions. A payee must use the money for your parent's needs, keep it separate from their own and account for it when asked, per 404.2035.

VA benefits: the fiduciary program

The VA Fiduciary Program says the VA finds someone unable to manage their financial affairs only after receiving medical documentation, or if a court has already decided it. The fiduciary is normally chosen by the beneficiary and goes through an investigation that may include a criminal background check, a credit report review and an interview. Usually it's a family member or friend.

Both programs share one big limit. The Consumer Financial Protection Bureau's guide to financial caregiving options says the person can manage only the benefits from the agency that named them. The old employer pension, the savings account and the house stay out of reach.

Joint accounts: useful, but not a plan

If you're already a joint owner on one of your parent's accounts, you can probably keep paying bills from it. The same CFPB guide points out that a joint owner automatically gets the money when the other owner dies. That can override what the will says and leave siblings out. And you can't add yourself now: that's your parent's decision, and a parent who can't understand it can't make it. The CFPB's guide for agents under a power of attorney tells agents to avoid joint accounts and get legal advice before changing an existing one, and that caution fits here too.

Small things that need no authority

• Bring in the mail and keep every bill and statement in one place.
• List what's due and when, including what's on autopay. Our guide to organizing an elderly parent's bills has a one-page inventory.
• Call companies to explain and ask about a hold. They may not let you change anything, but some will add a note to the account.
• Watch for exploitation. The CFPB agent guide's warning signs include a parent who suddenly can't pay usual bills, stops getting statements, or has unfamiliar names on accounts.

What not to do: sign your parent's name, use their card on your own judgment, or move money "to keep it safe." Good intentions look very different to a judge, a bank or a sibling later.

When guardianship or conservatorship is the answer

If your parent can't sign, and the surrogate law and benefit payees don't cover what needs doing (selling a house, managing investments, choosing a care home, paying for it from savings), the remaining route is a court.

ACL describes guardianship, also called conservatorship in some states, as a process in which a state court finds a person incapacitated under state law and appoints someone else to make decisions for them. The Uniform Law Commission's model act uses "guardian" for personal decisions and "conservator" for money and property, and its summary notes that some states use other terms. California, for one, uses "conservatorship" for both.

A guardianship can be limited to the areas where the court finds your parent can't decide, or full (plenary). ACL points out that either kind limits a person's choices, sometimes including where to live, what medical care to get and even whether to vote.

What the process looks like

The outline is similar from state to state:

1. A petition. Usually a family member files with the probate or county court, saying what your parent can't do and why.
2. Notice. Your parent is formally told about the case and can respond.
3. An independent look. In Deschutes County, Oregon, a court visitor interviews the person, the petitioner and family, then reports within 15 days on whether a guardian is needed and whether the proposed one is suitable. In San Diego, the court decides whether a court investigator should contact the parties before the hearing, and it appoints an attorney for the parent when the petition alleges dementia.
4. A hearing. A judge decides whether a guardian or conservator is needed, who it should be and what powers they get.
5. After the order. The court issues papers, often called letters, that you show to banks and agencies. Then the ongoing duties start.

Emergencies

Many states have a faster, narrower track. In Florida, once a petition to determine incapacity has been filed, a court can appoint an emergency temporary guardian when there appears to be imminent danger to the person's health or safety, or to their property. The court must appoint a lawyer for your parent, notice generally goes out at least 24 hours before the hearing, and the authority lasts 90 days (or until a guardian is appointed), with one possible 90-day extension. California's version is a temporary conservatorship, which the San Diego court says has much more limited powers than a permanent one.

Costs and time, in general terms

There's no national figure. Expect some combination of:

• Court filing and investigation fees. San Diego lists both on its fee schedule and offers fee waivers.
• Lawyers. Yours, and sometimes one for your parent. The Ventura County court recommends that conservators of an estate have a lawyer and says attorney fees must be approved by the court, generally paid from your parent's assets.
• A bond. Ventura requires one in most estate cases. The CFPB's guide for court-appointed guardians of property explains that a bond protects your parent's money if it's lost or stolen, its cost may come from your parent's funds, and someone with a bankruptcy may not qualify.
• Ongoing work. An inventory of everything your parent owns and owes, filed by a court deadline, plus regular accountings. San Diego also requires most new conservators to take an orientation class within six months.

Ask the court's self-help center or the attorney how long cases usually take in your parent's county.

Less restrictive options the court will ask about

ACL says state laws generally allow guardianship only as a last resort and require the consideration of less restrictive alternatives, though some courts don't consider them in practice. In San Diego, petitioners must consider them first.

• Supported decision-making. Your parent keeps the right to decide, with help from people they choose. ACL says it can be a formal written agreement, an informal one, or a mix, and the San Diego court notes it doesn't involve the courts.
• A protective arrangement for one problem. The Uniform Law Commission's 2017 model act lets a court enter a single limited order for a specific need instead of a full guardianship or conservatorship. Whether that's available depends on your state.

Your first week, in order

1. Sort out what's urgent. A medical decision in the next day goes through the default surrogate route. A bill about to bounce goes on the list for later in the week.
2. Look for documents your parent may have forgotten. Desk, file cabinet, safe, and a call to any lawyer they used before. Our list of important documents for aging parents shows what to look for.
3. Ask the doctor about capacity. Can your parent sign now, and might that change? Ask for a written note either way.
4. Call an elder law attorney. If there's any chance your parent can sign, this call might save months. If not, it starts the court process.
5. Start the benefit routes. Contact Social Security about becoming payee, and the VA if your parent gets VA benefits. Bring the doctor's note.
6. Protect the money you can see. Make the bill list, collect the mail, and if you suspect someone is taking advantage of your parent, tell the attorney right away.
7. Talk to the family. Who's doing what, who's first in line, and whether anyone objects to a guardianship. Disagreements cost far less before a hearing than during one.

What to bring to the elder law attorney

Adapted from the Alzheimer's Association's checklist of what to bring to the lawyer, plus a few items for a parent who may not be able to sign:

• A list of assets (bank accounts, safe deposit boxes, vehicles, real estate) with rough values and whose names are on each
• Any estate planning documents you found: will, trust, old powers of attorney, health care directives
• Deeds and recent tax returns
• Life, long-term care and health insurance policies
• Names and phone numbers of family, caregivers, financial advisers and accountants
• The doctor's note on capacity, a medication list and a diagnosis list
• Social Security and VA benefit letters
• A one-page timeline: what changed, when, and which decisions are coming

Questions to ask: Could my parent sign a power of attorney with your help, and how would you check? If not, what's the least restrictive option here? How often do you handle guardianships in this county? How do you bill, and what court costs should we expect?

How to find an elder law attorney

• NAELA. The National Academy of Elder Law Attorneys has a find a lawyer directory searchable by zip code. The NIA and the Alzheimer's Association both point families to it.
• Eldercare Locator. Call 800-677-1116 to find local aging services, including legal help.
• Low-cost help. The NIA suggests Area Agencies on Aging, state legal aid offices, state bar associations and local nonprofits, and LawHelp.org lists free or reduced-cost legal aid.

Pick someone who handles guardianships regularly in the county where your parent lives.

The lesson for every parent who can still sign

The other parent, an in-law or an aunt may still be able to sign everything in an afternoon. A financial power of attorney, a health care proxy and a HIPAA release cost far less than a court case and leave the choice of decision-maker with them.

One extra most families miss: under 20 CFR 404.2018, a Social Security beneficiary can name one or more people they'd want as representative payee, in order of priority, and Social Security considers them first. The catch is that it can't be done once Social Security has information that the person can't manage their payments. Since the VA fiduciary is normally chosen by the beneficiary too, talk about both early.

If starting that conversation is the hard part, try our scripts for talking to aging parents about finances.

Frequently asked questions

Can I get power of attorney for a parent who has dementia?

Only if your parent still has enough capacity to understand and sign it. A diagnosis alone doesn't settle it; an elder law attorney, often with input from the doctor, decides whether your parent can go ahead.

Who makes medical decisions if there is no health care proxy?

In most states, a default surrogate law ranks relatives, usually starting with a spouse, then adult children, parents and siblings. Some states add other relatives or close friends. In a state without such a law, a guardianship may be needed.

Can I pay my parent's bills without power of attorney?

Only in limited ways: from a joint account you already share, from autopay your parent set up, or as Social Security payee or VA fiduciary for those benefits. Other accounts generally need a power of attorney or a court order.

How long does guardianship take?

It depends on the state and county. A regular case needs a petition, notice, often an interview by a court investigator or visitor, and a hearing. If there's a real emergency, ask about a temporary or emergency appointment.

Keep a record as you go

Whatever route you take, write it down: who the surrogate is, who the payee is, where the court papers are, which accounts are covered. A notebook and the lists above will do. If you'd rather have it organized for you, Emergency Binder Now builds a printable binder for your parent from about 25 minutes of guided questions, with pages that record whether each legal document exists and where it's kept, plus a list of what's still missing. You can see a sample binder first.

This article is general information, not legal, medical or financial advice. Surrogate, guardianship and conservatorship laws differ by state, and benefit rules change. For your parent's situation, talk with an elder law attorney in their state.