How Do You Advise Clients Who Plan To Self-Insure For Long Term Care?

How Do You Advise Clients Who Plan To Self-Insure For Long Term Care?

Sep 18, 2017 | aging investor, financial advisors

How Do You Advise Clients Who Plan To Self-Insure For Long Term Care?

By Carolyn Rosenblatt, RN, Elder law attorney, AgingInvestor.com

Of course, your clients think they will never need long term care and they likely resist talking with you about it. Retirement planning is much more fun when you're discussing cash flow, travel and leisure, and being free from the responsibility of work. And then there's this thing called reality: retirement is not all fun.

Here at AgingInvestor.com, we offer you the benefit of our experience in dealing with countless families with aging folks among them. The adult children are our most frequent clients in our companion endeavor, AgingParents.com, and the stories they tell us are a jarring wake-up call for anyone. No one expects to need to be taken care of so no one wants to look at how frighteningly expensive it is.

For the moment, let's leave aside the issue of long term care insurance. (My husband and I bought it if that's an indication of what I think about the subject). Knowing that so few people bite the bullet and shell out those premium dollars, we are looking at the vast majority of clients who choose to self-insure against the risk of needing to pay for long term care. What are you telling them about this prospect? What do you say about their risks?

Here is one thing every advisor with a retirement-age client who chooses to self-insure should know: health status at retirement matters. A lot. Maybe you think that your client's health is not your business, as you're in the money management field. Maybe you see the health questions as being outside your area of expertise and you want nothing to do with the subject. It's personal after all. And so is running out of money and needing care.

Measuring risk in investment products is at the heart of your job. If you want to add true value to your client's engagement with you, an elementary look at the client's health status at retirement is also part of your job. There is a direct correlation between chronic health issues and the likely need for long term care. I do not suggest that you need to be an expert or have any health background. You need your two eyes, your ears, and your common sense to ask a few essential questions. Those questions and the answers will give you some solid ground to stand on when you talk with a client about planning for this potential expense and how likely it is that the client will need this care. They may or may not listen to you, but if you fail to give them the facts, you are not serving them well.

Here are some of the essential questions you need to bring up when you talk with them about retirement, the long view, living past 80, and how long their assets can be expected to last.

  1. How is your health, generally speaking? Do you have any chronic conditions like heart problems or diabetes?
  2. Do you smoke?
  3. Has any doctor ever given you any warnings about your health or what you should do differently now?

With your client's answers, you then can progress to the discussion about why he or she probably has a higher risk than someone else without that problem/ condition/smoking history of needing long term care. At least a third of our population will need to pay for it at some point in their lives. Those with chronic illness may have to pay for long term care for years and years. It would also be helpful for you to do some calculations for your client. This is the "just in case, let's imagine you have to pay for a helper at home" conversation.

If you feel awkward about how to bring this up, what questions to ask and how to talk about the dollars involved in long term care we can help you. Our newest book, Hidden Truths About Retirement & Long Term Care: The Guide For Financial Professionals is loaded with tips, sample scripts and all the costs of different kinds of long term care spelled out for you. Get your copy here today so you can put your mind at ease!

 

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

Are Your Own Clients Being Ripped Off By Scammers?

Are Your Own Clients Being Ripped Off By Scammers?

Apr 10, 2017 | aging investor, elder investor, elderly, financial advisors, financial elder abuse, scammers, senior citizen investor, senior investor

Is financial abuse happening to your clients right now? Of course, it is. There is no escaping it. A recent study puts the amount stolen from elders every year in our country at over $36B. With a problem as big as this, no group of elders is immune. If you took a survey of your existing clients all age 65 or older and asked them how many have ever been taken advantage of financially, you would be sure to get some clients who would admit to this. If you look at your own experience and count up any instance you know of, whether it is in your family, your neighborhood or your book of business, you will likely find some financial abuse as well.

Why Is This Important for You?

The amounts stolen, fraudulently taken or just snatched from the unwary, are shocking. Remember that when your client loses assets, you lose fees. Portfolios that shrink because of fraud from predators take money from you, a manager, too.

That is the most basic reason this should be important to you as a financial professional. Doing the right thing to keep your clients safe is certainly a motivator as well. It shows that you do care about them. And beyond that, the regulators are increasingly aware that financial professionals are in a position to take action and, sometimes, to stop and prevent financial abuse. They will soon get past merely urging you to take action and to report abuse. They will ultimately make it mandatory.

And we think you can do more proactively than merely to understand how to report abuse after the fact. It would be great to catch more criminals but that is extremely difficult in many cases because they are very clever at evading law enforcement. And since family members are the most frequent abusers, we have an added problem in that many elders are reluctant to report abuse by their own to law enforcement. Mom just won't call Adult Protective Services on her son, even when she knows he has stolen from her. We have seen this with our own eyes here at AgingInvestor.com.

There are many instances of scammers getting into relationships with aging folks by phone or on the internet. The "friendly" relationships become addictive. These thieves persuade the victim to withdraw funds from their accounts. This is where the advisor comes in. Unusual withdrawals are an important warning sign of elder abuse. And when the advisor notices this in a client's account there are choices available about stopping abuse. They include contacting a trusted other the elder has identified and warning them of what is happening. There should be more than one trusted person identified for every client. And by all means, contact Adult Protective Services and report it if you suspect fraud.

If you are worried about privacy rules, don't be. The regulators of your industry want you to report abuse. They want you to make every effort to keep aging clients financially safer. If you are not sure about privacy, create a special privacy document that specifically permits you to call a third party with your client's ok. We can help you do so if you need guidance or a model document.

Financial abuse of your aging clients is likely, sooner or later. Take a deeper dive in our book "Succeed With Senior Clients: A Financial Advisor’s Guide To Best Practices", written just for you, the financial advisor. See particularly the chapter "Financial Elder Abuse: How You Can Fight the Crime of the Century". It's available right now. Click HERE to get your copy today.

by Carolyn Rosenblatt, RN, Elder Law Attorney, & Dr. Mikol Davis, Gerontologist, co-founders of AgingInvestor.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

One Man’s Shock At His Adult Children’s Neglect When He Needed Them

One Man’s Shock At His Adult Children’s Neglect When He Needed Them

Mar 13, 2017 | aging, Alzheimer's disease, diminished cognition, elderly, finances for elders, handling money for aging parents, long term care, seniors finances

All his life Philip worked hard and was successful. He amassed wealth beyond expectations. He gave generously to all of his kids, buying them homes and bestowing money gifts. In fact giving kids money was the only way he really knew how to show he cared. Expressing love in other ways was not his thing. He and his wife lived a luxurious lifestyle: country club, exotic vacations, lavish parties, fancy cars. She ran the house and he ran the flourishing business.

It all looked great when he retired. Until his wife developed Alzheimer's disease. Things began to fall apart when he was78, with a wife becoming increasingly dependent and in need of care. He wasn't used to running the house. Things descended into disrepair. Then his vision got cloudy and his hearing started to go.

He expected his adult children to step up and be there. But entitled kids, used to having Dad hand them things without having to work for them, never did take much responsibility. If they needed something, Dad would just buy it for them. Now Dad needed more from them but none of them had ever learned about giving back. Communication was poor. If the conversation wasn't about money, no one had much to talk about.

Things broke down among the family members. They were never good at talking to each other or to their parents about anything of substance. Now that the parents were both in need of help they could not rely on their adult children to work on household management, or budgeting for care or doing needed repairs.

Philip found himself depressed. He looked at what he had created, all the wealth, all the things and somehow he felt a loss. Financial success had not led to family success.

But he decided to act. He decided that this part of his life was going to be meaningful before his end and he set to work.

He gathered his adult children in his home for a meeting. He was frank with them and revealed how sad and disappointed he felt. He revealed his fears, something he had never done. He told them he expected more from them. The kids looked at each other somewhat sheepishly. They admitted that they had been off in their own worlds. They told their father how much they wanted to be closer but just didn't know how. They asked him to be open to telling them he loved them. He asked them to express more caring by showing up and pitching in. The paid caregivers for the parents were great but they were not there all the time.

Agreements were made. Some stumbling and awkwardness happened at first. But as the next month passed, the kids finally started to show up with a schedule. And empty talk was replaced by family history, expressions of thanks and acknowledgment to each other of the changes they were making.

The last years for Philip were much better. He was able to express his feelings in ways he had never done before. Maybe age just made him not care about what people might think. It had a profound effect on his family. All of them grew closer, in spite of their differences. They learned to accept each other far better, led by Philip.

Philip passed away in peace at age 84. His story is one to share with any child who grew up in wealth and any parent who did not expect enough of the kids in a younger day. Adult children can learn to give more to parents as they age and become more vulnerable. Parents can learn to express love and affection apart from cash and objects. It's not too late in your advanced years to change for the better.

Carolyn Rosenblatt, RN, Elder Law Attorney, & Dr. Mikol Davis, Gerontologist co-founder of AgingInvestor.com

Smart Retiree’s 10 Point Checklist

Smart Retiree’s 10 Point Checklist

Feb 27, 2017 | aging, long term care

You're in the planning business. You look ahead, analyze, budget and calculate. But your clients may not be on the same page in your view of the future, especially when they retire. They are busy being in denial that they may ever get ill and die. You can help them. In doing so, it may also make your job of talking about such issues as long-term care, budgeting and spending easier.

Many of us in this society have a very negative image about aging in general. We don't want to be "old". It is fueled by advertising on TV, movies, print media and other outlets with a consistent message: aging is bad, being younger and turning back the clock is good. We are a work ethic driven culture. When we are older and no longer "productive" we are generally seen as less valuable.

Then there is the fear and denial about dying and death. Our culture has been called the only one in the world that thinks of death as something optional. Note how we talk about it to family--"in case anything ever happens to me..." Besides it being a fantasy that maybe "something" won't happen to us, it keeps us from planning, from preparing our loved ones and from being responsible about our older years, possible declining health and the burden ignoring these things can put on our families. Reaching retirement age is a time to do planning about more than money.

Most people do not want to burden their loved ones. Most of them do not want to trouble adult children unnecessarily as they age. That is your best selling point for bringing up some important personal matters. These include how every senior and every retiree needs to plan for things in their own lives that go beyond how much money they've saved and how it will be spent having a great retirement. Has your client signed a Durable Power of Attorney document? Given the family all they would need in an emergency? Talked about who should keep the records and stored information all the heirs would need if your client becomes impaired? These are not about money particularly. These subjects are about responsibility and life cycle.

Here at AgingInvestor.com we see the messes people leave behind when they nurture the Great American Fantasy that losing independence won't happen to them and that they will live happily to age 100 and die peacefully in their sleep. Family members can spend years cleaning up the disaster their older loved ones leave because of failure to plan and simply provide access to information. It is truly not fair to anyone. It leads to anger, resentment, family conflicts and sometimes to loss of wealth through ignorance. We've heard it and seen it countless times.

To empower every retiree, we put a retiree's checklist together to help people avoid these disasters created by the fantasy. We want you to help them use it.

How can you do this?

You can give your clients this checklist next time you sit with them and review the portfolio. You can gently urge them to do what the list says is needed. We've broken down the essentials into 10 points, a "to do" list if you will. You can encourage them to take care of the items on the list, if they haven't already. In general, the to do list includes updating the estate plan, having critical documents in the right hands, providing necessary financial, computer and account information to trusted family and having a family meeting to educate one's heirs about the older person's affairs. This is how your client gets a family ready. This is how they avoid unduly burdening anyone. This is how they free their loved ones from distress and unnecessary work when they have to take action as an aging parent declines and passes away.

Some of your clients will brush off your suggestion. They love that Great American Fantasy and aren't about to give it up. Others will thank you as they have thanked us and will go forward. Their families will be forever grateful. You'll look like the caring, smart and responsible planner that you are. Get your free Smart Retiree's 10 Point Checklist now by clicking here.

 

By Carolyn Rosenblatt, RN, Elder Law Attorney, & Dr. Mikol Davis, Gerontologist co-founder of AgingInvestor.com