Q: if a parent can no longer care for themselves, do the child have to go to the next parent? Or can it be next of kin?
A: Assuming the other parent is capable, typically it is the other parents decision to make.
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A: It is a somewhat complex analysis depending on the particular facts of the case, but the simple answer is that the claims of a parent is going to defeat the claims of a non-parent. That doesn't mean that all the involved parties can't agree to a schedule that gives grandma (or whoever) some custodial time, with the bulk of the child's time spent with the fully functioning parent. But if the third party is attempting to fight with the fully functioning parent and is seeking primary custody, they will likely lose.
You are going to want to speak with a family law attorney about the specifics of your case.
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