Entitle the document "Power of Attorney." Although this is not a legal requirement, it can help avoid legal ambiguity concerning the document's function and intent.
Prepare a statement in which your family member -- the "principal" -- states she is of sound mind, executing the power of attorney voluntarily and revokes any prior power of attorney she may have signed in the past.
Draft a statement in which your family member identifies you by name and address, and states that she is appointing you as her "agent" or "attorney-in-fact" with the powers listed in the document. You may also prepare a statement in which she appoints an alternate agent in case you become unable or unwilling to serve.
State when the powers enumerated in the power of attorney document take effect. Normally, a power of attorney takes effect as soon as the principal signs it or, alternatively, whenever the principal becomes unconscious, mentally incompetent or unable to communicate. State whether the power of attorney is durable or non-durable. A durable power of attorney remains in force if and when the principal becomes incompetent; a non-durable power of attorney lapses during this period.
State specifically which powers the principal authorizes you to perform on her behalf. Draft this part with particular care. If you state these powers too narrowly, you may find yourself unable to effectuate the principal's intent. If you state them too broadly, your principal may be giving you more authority than she intended. The principal may, for example, authorize you to choose between alternative medical treatments, but not to deny treatment altogether.
Prepare signature lines for you, your family member and two witnesses. Identify each person by name and function below each signature line--"John Doe, Principal," for example.
Locate two adult witnesses, both of whom must be mentally competent, agree to witness the signing of the power of attorney and sign the documents themselves.
Add a statement confirming the principal may revoke the power of attorney, in writing, at any time provided she is mentally competent, and that a revocation does not affect the liability of a third party until the third party learns the power of attorney has been revoked. Although this disclaimer is simply a statement of existing substantive law and third parties do not have an unqualified duty to honor a power of attorney, it may encourage them to honor the power of attorney without fear of liability.
Explain the content and consequences of the power of attorney to your relative, make sure she understands your explanation, and have her read it if possible
Sign the power of attorney, and have your family member sign it, in the presence of a notary public and both of your witnesses. Have your witnesses sign the document, in the presence of a notary public, only after witnessing both you and the principal member sign it.