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How is a power of attorney "assigned." Is it a signature on a piece of paper from the patient for someone specific to do specific tasks? Or does it have to go through an attorney to be legal?

POA is not granted. It is given, and it is given by the Principal, the person you would be POA for.
Look up POA for your state.
A POA is CONFERRED UPON. That is to say that an elder decides they wish to make future plans for their care should they become incompetent in their own decisions.
Let us pretend this situation is you and your mom.

Mom, being of sound mind and competent mentally asks you if you will be her POA.
If you say yes, then the two of you see an attorney (sorry, but don't use the online forms and papers because no one will accept them).
The attorney explains to your mother the gravity of putting you in charge of all of her money, her care, etc. The attorney helps the two of you do an advance directive for medical care your mom wants in case of catastrophic illness in which she cannot direct her own care. Does she want tube feedings? Dialysis? Ventilators? CPR? and etc. Then the POA is done. You both will sign this paper and it will be notarized.

This POA won't be used unless and until mom is declared incompetent by two examining doctors (one a neuro-psyc doc). If she has become incompetent in her own care you get registered as the signee on her bank accounts in which her bills will be paid with her name, followed by your name and the words "as POA". You will decide on placement for her safety and etc.

You will keep meticulous records of every bill paid, every penny in and out of the accounts, and a court can call you to account with your records at any time as you have become a legal fiduciary.

This is a massive subject and I will leave the rest of your research to you.
If the "principal" (in this case "mom") is ALREADY too mentally compromised to confer POA on anyone, then you are moving on to the more legal and more expensive court directed conservatorship or guardianship, which is EVEN MORE COMPLICATED.

My advice? NEVER EVER EVER EVER become POA for a difficult and demanding and uncooperative person. It will likely be the worst day of you life.
Good luck.
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Reply to AlvaDeer
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The person assigning needs to be competent to do so. No Denentia or Alzheimers.

I would go through a lawyer. They make sure the person is competent, understands what POA means and is not coerced.
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Reply to JoAnn29
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The person who wishes to have someone as a PoA is called the principal. The person they choose as their PoA is called the assignee.

The best way to do it is to make an appointment with a certified elder law attorney. In my case, my Aunt was the principal and I was her assignee. We both went to the attorney together. The attorney took my Aunt aside to privately interview her for legal cognitive capacity, and to make sure she wasn't being coerced into doing it.

The PoA authority is outlined in a document that the attorney prepares. The principal and assignee sign it in front of a notary with 2 non-family witnesses. In our case we signed 2 originals of the same PoA document so that my Aunt had 1 original copy and I had one.

The principal can specify in the PoA document what the assignee can do on their behalf, and when the authority becomes active.

You can also do this online through sites like Legalzoom.com or Rocketlawyer.com or others, but you need to make very sure the PoA done this way will never have a chance to be contested. I did it this way with my Mom (who is single) and I'm an only child. It was faster, much less expensive, and we still were able to consult with attorneys online who were licensed in our home state.
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Reply to Geaton777
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