They can no longer sign — and there's no power of attorney. What now?

It's the paperwork version of a missed exit: everyone meant to set up a power of attorney, and then a stroke, a fall, or advancing dementia arrived first. If you're searching this at midnight — take a breath. Families navigate this every day. Here are your real options, plainly.

First, check what capacity remains

Capacity isn't all-or-nothing, and it isn't the same as a diagnosis. A person with early dementia may still legally be able to sign documents if they understand, at the time of signing, what the document does and who they're empowering. A doctor's assessment plus an experienced elder-law attorney (many will meet your parent and judge for themselves) can answer this. If any capacity remains, getting documents signed now — properly, with no pressure — is by far the cheapest and kindest path. The essential documents guide.

Check for what already exists

Before assuming there's nothing: look through files and ask their bank, lawyer, and financial advisor. Many people signed POA paperwork decades ago and forgot. Banks sometimes have their own POA forms on file; the VA and Social Security have their own representative systems (a Social Security "representative payee" doesn't need a POA at all). Hospitals can often work with next-of-kin for medical decisions under state default-surrogate laws — ask the hospital social worker what your state allows.

The formal route: guardianship / conservatorship

When real decisions must be made and no documents exist, the court process is the backstop: a judge appoints someone (often a family member) as guardian (for personal/medical decisions) and/or conservator (for finances). Honestly, it has real costs: it takes months, involves attorneys and court fees, requires ongoing reporting to the court, and removes rights from your parent in a public proceeding. Sometimes it's genuinely necessary — but it's a last resort, not a first step, and courts increasingly expect families to show that less-restrictive options were considered.

Less-restrictive options worth asking about

• Default surrogate laws — most states let next-of-kin make medical decisions without any paperwork; the pecking order is set by state law.
• Representative payee (Social Security) and VA fiduciary — handle benefit income without a POA or court.
• Joint problem-solving with the bank — some banks will honor limited arrangements; ask for their elder services or fraud team.
• Supported decision-making — recognized in a growing number of states for people who can still participate in choices with help.

Get one hour of real advice

This is the topic where a one-hour consultation with an elder-law attorney in your parent's state earns its fee many times over — the rules are genuinely state-specific, and the right move depends on what decisions actually need making. Many offer flat-fee consults; your Area Agency on Aging can point to low-cost legal aid for seniors. And if you're reading this before the crisis: today is the day to do the documents checklist with the people you love. Every family that's been through this says the same sentence: "I wish we'd done the paperwork earlier."

This is general information, not legal advice — guardianship and surrogate rules vary significantly by state. Related: Having the hard conversations · Getting access to medical records