The proportion of NHS Grampian beds “blocked” because patients have no one legally able to make decisions for them has more than doubled in a year.
Almost one in five cases where people remain in north-east hospitals longer than they should is now due to delays seeking guardianship.
The shock figure has led health chiefs to draw up plans to encourage people to make arrangements before they become incapacitated.
They hope to copy a Glasgow initiative promoting the use of “power of attorney” to avoid lengthy court processes.
Health chiefs in the city ran a campaign which significantly increased take-up of the legal arrangement, potentially heading off future delays.
The power allows a designated person to step in if the patient becomes too ill to decide for themselves, for example about care or finances.
Without it, social services are responsible for making key choices and families face lengthy court battles for the right to take over.
NHS Grampian records show that in October last year only 16 of 190 “blocked” beds were down to delays seeking legal guardianship.
By last month that had risen to 26 of 136 – an increase from 8.4% to 19.1%.
Concerns about the mounting problem have been discussed by the Aberdeenshire Health and Social Care Partnership (HSCP) – one of three bodies which oversees health and social care across the Grampian area.
Integration joint board vice-chairwoman Linda Lynch said it was not about “writing anybody off”.
“It is an incredibly distressing situation not to be able to help your family member in the way you would wish because the technicalities are not in place,” she said.
“It’s not that you are writing anybody off – there are real benefits to having this in place. I have seen it from a family perspective.”
HSCP manager, Philip English, said: “Many people wrongly believe a family member or next of kin can act on your behalf.
“However, no one automatically has the right to make decisions for you unless legally appointed to do so.
“Courts can appoint someone to be your guardian but this is a long and often very expensive process, especially if it is contested by other parties.
“No one likes to think it will happen to them but not being prepared could end up being very costly and distressing for relatives.
“We would urge people to think carefully about power of attorney. It will only be invoked if you are unable to make decisions for yourself.”