The Gaping Hole In Retirement Planning: What Are You Missing?

The Gaping Hole In Retirement Planning: What Are You Missing?

Sep 13, 2017 | aging, aging investor, cost of long term care, finances for elders, financial advisors, senior investor

Most financial professionals see themselves doing fine in helping their clients plan ahead for retirement. And their clients are probably in for a nasty surprise no one is talking about. The professionals have done the calculations, used the algorithms, had the conversations about their clients' goals. You may have forgotten something. Are you missing the elephant in the room: long term care?

At least a third of your clients are going to need it at some point. We're not talking about nursing home care here. We're talking about all the other out of pocket costs clients are not considering but that they will likely need as they age. Think about longevity today. Both men and women will probably live into their 80s at least. How many 85 year olds do you know who do not need any sort of help with anything in their lives? Not many, we'll bet.

As the body ages, it is harder to see, hear, get around physically, drive, and manage households and finances. Help with all of those things is actually an out of pocket cost we consider to be long term care. Medicare calls it "custodial care". That means all the kinds of support an aging person needs to stay out of a nursing home. The actual cost of a nursing home is another discussion altogether. When we talk about custodial care here we mean help with bathing, dressing, walking, eating, getting to the bathroom and getting out of bed onto a chair and back. These are called "activities of daily living" or ADLs. We are also talking about help with shopping, cooking, paying bills, cleaning the house and doing laundry. These are called "instrumental activities of daily living" or IADLs.

Your clients don't want to think about needing help. In this country, we insist on believing that we will always be independent--it's embedded in our culture and myths about aging. But those myths are not true. Independence declines with age for most of us. And help is expensive.

Consider that the averages you hear about do not address this at all when it comes to retirement planning. "The average couple age 65 will spend (fill in the blank here, anywhere from $265,000 to $400,000) on out of pocket medical expenses." OK. Custodial care is NOT medical care. Medicare does not cover it. Health insurance, including Medigap coverage does not pay for it. Who then does? Some long term care insurance policies cover some of it, with restrictions. Otherwise, it's all an out of pocket non-medical cost your client will have to cover. Imagine the costs when you calculate the "burn rate" of their retirement funds. Didn't factor that in? It's time for a second look at the plan.

if you have no idea how to calculate this or what your client's chances are for needing to pay for any kind of long term care, you can learn the basics and the costs in our newest book. Get the facts quickly that will help you in Hidden Truths About Retirement and Long Term Care: The Financial Advisors' Guide. Order your copy by clicking HERE.

 

Dr. Mikol Davis and Carolyn Rosenblatt, co-founders of AgingInvestor.com

Carolyn Rosenblatt, RN, Elder Law Attorney offers a wealth of experience with aging to help you create tools so you can skillfully manage your aging clients. You will understand your rights and theirs so you can stay safe and keep them safe too.

Dr. Mikol Davis, Psychologist, Gerontologist offers in depth of knowledge about diminished financial capacity in older adults to help you strategize best practices so you can protect your vulnerable aging clients.

They are the authors of "Succeed With Senior Clients: A Financial Advisors Guide To Best Practice," and "Hidden Truths About Retirement And Long Term Care," available at AgingInvestor.com offers accredited cutting edge on-line continuing education courses for financial professionals wanting to expand their expertise in best practices for their aging clients. To learn more about our courses click HERE
Your Retirement-Age Clients and Budget Politics

Your Retirement-Age Clients and Budget Politics

May 26, 2017 | aging, aging investor, elderly, finances for elders, senior investor

While advisors are there to serve those with investable assets, it is not only your clients who are affected by politics, the Federal budget and cuts to programs. It may be your clients' family members, their aging parents or struggling adult kids.

When family members are beneficiaries of various public programs that help them get by, your clients may not be affected except with feeling relief. But when programs are slashed, the reverberation can affect your own clients, who are likely to be better off financially and therefore expected to help. Every advisor needs to consider this. Cash flow projections on retirement savings can be totally disrupted when your client has to pitch in and give financial help to a low-income family member.

Imagine this: your Boomer clients are ready for retirement. You have carefully worked out what they will need to sustain their lifestyle and make their money last. One or the other of them has low income aging parents in their 80s. Their parents have part of their health care costs paid by Medicaid. Medicaid gets slashed. Your client has to help pay the 20% of costs Medicaid was previously covering for their parent's health care costs. And since those costs tend to rise with aging, your client will potentially pay the cost of a supplemental insurance policy or non-covered medications or other things.

Here's another thing to see in looking at how budget cut proposals can destroy your careful retirement income planning for your clients. Some have disabled siblings, adult children or others who benefited directly from the Medicaid expansion of the Affordable Care Act. Some of those folks are not yet eligible for Medicare and rely entirely on Medicaid for all health care coverage. With massive cuts to Medicaid, they are among the millions who would lose insurance altogether. If they have a well-to-do family member, your client, where will they look if a medical need arises and there is no way to pay for it? Probably to your client.

Then, lets look at your clients' lowest income family members who rely on the Supplemental Nutrition Assistance Program (SNAP), formerly called food stamps. Nearly five million seniors rely on this program in order to afford food. A massive cut (proposed) of $194 billion would surely affect them immediately. Can you imagine any client refusing a request from a low-income family member for money because he or she couldn't afford groceries? That grocery money contribution could be every week and go on indefinitely into the future.

Perhaps this is just a heads-up for every financial planner to build into clients' retirement planning that some cash may be needed on a monthly basis to help their relatives who can't get by without their help. In my own family, four of us pitch in every month to support a low-income sibling. He has Medicare and also Medicaid. For all of us who are Boomers and a bit older, a hit to the existing Medicaid benefit would cost each one of us more dollars every month than we are currently paying.

Your clients may be in the same situation. We at AgingInvestor.com hope you will bring up the subject and help your clients plan accordingly. You would do that by asking clients planning retirement if there is anyone in the family they may be called upon to help support.

Our political climate may not change for some time. And every lower income American who is a needy family member of your retirement-aged clients will be affected one way or another. Help them prepare for the anticipated expense.

 

Dr. Mikol Davis and Carolyn Rosenblatt, co-founders of AgingInvestor.com

Carolyn Rosenblatt, RN, Elder Law Attorney offers a wealth of experience with aging to help you create tools so you can skillfully manage your aging clients. You will understand your rights and theirs so you can stay safe and keep them safe too.

Dr. Mikol Davis, Psychologist, Gerontologist offers in depth of knowledge about diminished financial capacity in older adults to help you strategize best practices so you can protect your vulnerable aging clients.

They are the authors of "Succeed With Senior Clients: A Financial Advisors Guide To Best Practice," and "Hidden Truths About Retirement And Long Term Care," available at AgingInvestor.com offers accredited cutting edge on-line continuing education courses for financial professionals wanting to expand their expertise in best practices for their aging clients. To learn more about our courses click HERE
Know The Pros and Cons Of Assisted Living For Your Older Clients

Know The Pros and Cons Of Assisted Living For Your Older Clients

May 26, 2017 | aging, aging investor, elder investor, finances for elders, senior citizen investor

Mostly at the urging of their adult children, many seniors choose to move to senior communities where some help is available. These are usually called Assisted Living facilities (AL). When it is too difficult to keep up the family home or an elderly client of yours becomes too isolated after the loss of a spouse, AL can be a good choice.

No doubt you, the financial advisor have helped them consider the expense and the consequences or benefits of selling the family home. And they likely would not move if they could not afford the monthly cost of being in AL. However, there are things every advisor should know about AL so you can properly advise your clients.

The marketing departments of these homes can be very aggressive about promoting the benefits of AL. Indeed may of them are well appointed and have numerous convenient amenities. What they don't tell you are the hidden disadvantages. Having interfaced with many of these facilities in our work at AgingParents.com and AgingInvestor.com as consultants to families, we want you to be fully informed of what they can and can't do.

First, AL homes are not nursing homes, and they do not provide nursing or health care. If there is a nurse on staff at all, which is not required of any of them, the nurse is there to evaluate residents' suitability, hear resident concerns, consult with staff and make referrals. It is not to provide direct care, even in an emergency. The nurse in such a facility, seeing an emergency, will call 911, just as any layperson might do.

These homes are not licensed to offer health care. Assistance with things like bathing, dressing, walking, bathroom, eating and getting in and out of bed are the limit of the help they can provide.

Next, these homes do not provide full staffing at night. If your client is forgetful or wanders around at night and her family shares this with you, AL may not be the best choice. Some people hire additional help privately to watch their loved ones in AL more closely, especially at night and this arrangement can work well. However, it is a significant additional expense and must be paid on top of the regular monthly charges of assisted living. We know of one resident whose family was spending $12,000 a month for the combination of AL and outside supplemental caregiving.

Finally, any home whether it is AL or any other place where care is delivered should be held accountable for the safety of your client who may become a resident there. No one is going to check on your aging client every hour in AL. Falls can happen anywhere, including a so-called "supervised environment". The concept of AL was originally meant to give all levels of care but today that is not the case. The law requires separate licensing of any unit or facility that offers skilled nursing. Even when it is given on the same campus as AL, skilled nursing facilities are a separate entity from AL.

If you are talking to any client about the possibility of AL, be sure that your client is educated and that the family does not have unrealistic expectations of AL. The expense of these places is one consideration. The overall plan for the future of taking care of a client's needs is another. Help your client be a wise consumer.

 

Dr. Mikol Davis and Carolyn Rosenblatt, co-founders of AgingInvestor.com

Carolyn Rosenblatt, RN, Elder Law Attorney offers a wealth of experience with aging to help you create tools so you can skillfully manage your aging clients. You will understand your rights and theirs so you can stay safe and keep them safe too.

Dr. Mikol Davis, Psychologist, Gerontologist offers in depth of knowledge about diminished financial capacity in older adults to help you strategize best practices so you can protect your vulnerable aging clients.

They are the authors of "Succeed With Senior Clients: A Financial Advisors Guide To Best Practice," and "Hidden Truths About Retirement And Long Term Care," available at AgingInvestor.com offers accredited cutting edge on-line continuing education courses for financial professionals wanting to expand their expertise in best practices for their aging clients. To learn more about our courses click HERE
How Much Should You Plan On For Retirees’ “Out of Pocket Medical Costs”?

How Much Should You Plan On For Retirees’ “Out of Pocket Medical Costs”?

May 1, 2017 | aging, diminished cognition, elderly, finances for elders, financial advisors, financial judgement, handling money for aging parents, handling money for seniors, long term care, medicare, seniors finances

How Much Should You Plan On For Retirees' "Out of Pocket Medical Costs"?

For those outside the caregiving world, there is a lot of confusion about this cost. Calculations abound in retirement planning circles for helping your clients ensure that they have enough for the things they are likely to need medically. The usual calculations outline Medicare Part A premiums (deducted from Social Security payments), Medicare Part B supplemental health insurance premiums, also called "Medigap" and for medication expenses, as some are not covered my Medicare. In plain English, this means that your client's Social Security is less to them when the Medicare payment comes out and they have to pay out of pocket for the other kind of insurance that covers outpatient care, clinic and doctor visits, as well as prescription meds.

OK what's wrong with these calculators? Can't you rely on them? I think for an unusually healthy person who is your client, one who needs little care and has no chronic illnesses, they would be fine. I'm not sure where the folks making up the calculations get their statistics but I think they grossly underestimate the real costs of out of pocket medical care in retirement.

From personal experience with thousands of elders I visited at home as a nurse over a career, I did not see much of the unusually healthy. What I did see was the average person then taking numerous medications, having multiple chronic conditions and being at risk for those getting worse with age. And now, decades later, we live longer, have more health risks as a result of greater longevity and we have to pay more for the problems that go along with living to be 100. We have better diagnostics and we can catch and treat conditions more. That means more out of pocket expenses for those exotic tests Medicare will not cover. That also means more and more drugs being prescribed to manage and control chronic illness. They work, but we pay. You would be amazed at what Medicare does not cover.

Here's the message I want every retirement planning advisor to heed: you cannot predict how much out of pocket medical expense your client will have unless you really know a lot about both their genetic disposition and their health habits and condition. And then it's only an educated guess. How educated are you?

We do know that the way we age is about 30% due to our genetics. The other 70% of the picture is directed by how we choose to live. That means what we eat, how much we move our bodies, how we manage stress, how we socialize and how we succeed or not in our relationships with others. All of these factors affect our health and longevity and consequently, how much it's going to cost to keep living with conditions like heart disease, diabetes, cancer, hypertension, arthritis, etc.

We haven't even touched on the subject of Alzheimer's disease. If you are calculating out of pocket medical I'll bet you never calculate what it costs to care for someone at home 24/7 with specialized skill for dealing with this devastating disease. It can last 20 years. Nursing home care and caring for a person with any serious illness at home is long term care. That is not in the calculations in those handy tables describing the out of pocket medical costs for an average couple retiring at the age of 65 and living to be 85.

Here's an example. Mort is 95. He has multiple health issues and early dementia. He can't do anything by himself. He has 4 caregivers in shifts every day in his home. He isn't sure he wants to keep going but he doesn't want to stop the numerous medications he takes to stay alive. It costs over $250,000 a year just for the caregivers, not for the other costs of housing, utilities, transportation via handicap van and such. And the out of pocket medical is still there. The dentist, the hearing aids, the medications that no insurance pays for, the stair lift, the ramp on the front of the house, the high-end wheelchair and more.

If you want to help your clients plan so they won't run out of assets, you'll need to be realistic. Lots of cash may need to be available at the later end of life. It is more likely than not. Forget reliance on a calculator or use one that has the highest number you can find. Then add on expenses like Mort's and you're on the right track.

Get a lot more detail on caregiving, costs of care and what is needed as we age in The Family Guide to Aging Parents: Answers to Your Legal, Healthcare and Financial Questions. Check it out here.

Carolyn Rosenblatt, RN, Elder law attorney & Dr. Mikol Davis, Gerontologist

AgingInvestor.com and AgingParents.com

 

Dr. Mikol Davis and Carolyn Rosenblatt, co-founders of AgingInvestor.com

Carolyn Rosenblatt, RN, Elder Law Attorney offers a wealth of experience with aging to help you create tools so you can skillfully manage your aging clients. You will understand your rights and theirs so you can stay safe and keep them safe too.

Dr. Mikol Davis, Psychologist, Gerontologist offers in depth of knowledge about diminished financial capacity in older adults to help you strategize best practices so you can protect your vulnerable aging clients.

They are the authors of "Succeed With Senior Clients: A Financial Advisors Guide To Best Practice," and "Hidden Truths About Retirement And Long Term Care," available at AgingInvestor.com offers accredited cutting edge on-line continuing education courses for financial professionals wanting to expand their expertise in best practices for their aging clients. To learn more about our courses click HERE

What To Do When Your Aging Client’s Health Is Failing

What To Do When Your Aging Client’s Health Is Failing

Apr 17, 2017 | aging, declining health, elderly, financial capacity, financial judgement, handling money for aging parents, health, resources for senior, resources for seniors, Uncategorized

What To Do When Your Aging Client's Health Is Failing

Financial professionals can find themselves in an uncomfortable position when they have a long time aging client who is in declining health. Of course, you know the client and can see that she's struggling with a lot of issues. You may want to do something but this stuff is just not in your wheelhouse. Longevity is great but not when you start to lose the ability to manage on your own. What are you supposed to do for these clients?

You're trained to understand economics, taxes, financial products, planning. But you're not trained to direct aging people to whatever resources they may need as they get older. If they have family, you may expect family to step up, but you see that it may not be happening. Should you call them? Do you even know them? Do you have your client's permission? And what if they don't have family? That's even worse. Here they are getting frail and more vulnerable by the day and you are just watching helplessly.

It doesn't have to be that way. You can get acquainted with some basic resources in your area and the areas where your clients live. Maybe they never figured they'd live so long as to actually need help. When they do, you can be a starting point to help them find what's out there.

Let's imagine you have an aging client who is having trouble getting around and she needs some help with chores at home. She tells you about it when you ask her how things are going. She is shy to ask for help and reluctant to admit that it's harder and harder to live alone. You don't know what to say. Or do you?

One source of help everyone should know about is the Area Agency on Aging. These Federally funded programs connect elders to appropriate community organizations and places to get assistance. Their mission is to help older adults and people with disabilities live with dignity and choices in their homes and communities for as long as possible.

AAAs contract with local service providers to deliver many direct services, such as meals, transportation and in-home services. However, most agencies are direct providers of Information and Referral/Assistance, case management, benefits/health insurance counseling and family caregiver support programs.

Some are incorporated into a county's health and human services departments. Some are separate. Large states have many AAAs. Smaller less populated states have fewer of them.

One thing you can do now to be ready to assist your own client who may demonstrate a need is to research where the nearest Area Agency on Aging is in your client's community, download a brochure or information package and let your client know it's there. If he needs help at home, transportation services, vetted information about local service providers, an AAA is a great place to start.

This whole aging client issue can be a reflection of things you have experienced in your own family. Perhaps you have an aging parent or ill grandparent. Another problem solving source of information is our book the Family Guide to Aging Parents: Answers to Your Legal, Healthcare and Financial Questions

. Learn what's in it here. It can get you more comfortable with those difficult conversations.

Carolyn Rosenblatt, RN, Elder law attorney

AgingInvestor.com and AgingParents.com