Financial professionals do their best to guesstimate how much income a person will need to maintain a client's lifestyle in retirement. Figures vary, with averages being $50,000 a year and up. They are based on various median ranges of things like out of pocket medical expenses, cost of living and the like. But you can't predict how long your aging client will live. All your calculations can be for naught if you totally miss how much it really costs to live to be in one's 90s.

Let's look at a real person who is in some ways atypical in that she is in pretty good health at 94 and can still get around on her own. A lot of those who are 90+ can't. They need more help and help costs more than most retirement calculators accurately predict. Could you do the math on this one, in advance?

"Evelyn" was widowed 8 years ago. She lived in a big house in a lovely gated seniors' community with all the amenities: golf courses, pools, recreation centers, clubhouses, restaurants and many activities. But after she lost her husband three pivotal things happened. First, she became more isolated. Some of her friends moved away to assisted living or to be closer to family.  Next, she got more and more lonely. And third, her own health began to decline in that it was harder to walk and use her hands due to arthritis. She decided to move.

She sold her free and clear house and invested the cash. One would think that the proceeds of over $350,000 would be a nice cushion to pay for her move to a smaller seniors' apartment where help was available, even though she was still able to do her own personal care unassisted. Moving from a 2800 square foot home to an 800 square foot apartment should be a savings, right? In the seniors' complex, meals, linen changes, cleaning and transportation to appointments are provided, along with many social activities on site and in the community. The transportation service allowed her to give up driving, which it was time to do at her age. It also eliminated the struggle of having to shop, do housekeeping and cook all the time. She had a community now. But at what cost?

In the four years since she sold her house, she depleted all of the sales proceeds from the home. Why? She has expenses she didn't really plan for. She was not able to predict these expenses accurately. Her out of pocket medical costs were for things not covered by either Medicare or supplemental health insurance. In a single year, that figure was over $2000.  The medications she takes for her blood pressure, heart and other chronic health conditions are keeping her going but the part not covered by insurance cost her another $5000.  A premium for her supplemental insurance (also called Medigap coverage) is almost $3000 a year.

The lowest level of "care" in the seniors' apartment means that no help is needed with bathing, walking, dressing, eating, bathroom, and moving from bed to chair and back.  The rent and services in a high-value real estate area where her apartment is located started at $5000 a month. Last year it cost $66,000 for the year and it increases every year. This year's rent is $300 a month more than it was in 2016. And that is without assisted living, which would cost at least another thousand dollars each month.

Evelyn had a hospitalization last year due to her blood pressure. After she came home, she needed a helper, whom she hired independently for a few weeks. That cost was also not covered by any insurance. In the years since her husband passed, Evelyn also had to get a lot of dental work done. In the space of a few years, she spent over $50,000 on her teeth, with implants and several surgeries to get it right. And it was harder to hear. She spent $5000 on hearing aids with the ongoing expense of battery replacements.  Dental and hearing aids are also not covered by Medicare or supplemental insurance.

What will it cost Evelyn to live an enjoyable but not extravagant life in a modest seniors' apartment next year, assuming she is still able to do her personal care independently? The tab will be at least $97,000 without dental and hearing aid expenses. Do you and your clients plan for that?

The long-term health conditions Evelyn has will likely push up the out of pocket expenses she faces as she reaches 95. She says she wants to live to be 100. She is a fortunate person in that her investment income is about the same as her cost of living.  But not every client you have is so blessed.

Sure some of Evelyn's costs of living are cheaper where real estate costs less. Medical costs may be somewhat less too in other parts of the country and you plan according to where your client lives. But the reality is that there are likely to be huge out of pocket medical cost with aging. When you do retirement planning it's not only about the calculator. It's about the very real, somewhat unpredictable effects of living a long time and the toll it takes financially on your aging investors.

Here are the important takeaways:

1. Widowhood changes the picture. Discuss with your clients what they would want if widowed. Where would they live? What would they need to be comfortable and safe?
2. Expect everything about living to age 90 and above to cost more than anyone says it will.3. Be sure your older clients understand that Medicare does not cover dental, hearing aids, much medical equipment, home-helpers, transportation and certain medications. They must be ready to cover these expected costs that are part of aging for almost everyone.
3. The cost of living in retirement does not go down, as people get older. The supports they are likely to need cost more over time, not less.

Learn more about the psychology of aging clients, how to communicate better with them and how to best deal with typical problems aging clients present in Succeed With Senior Clients: A Financial Advisor's Guide to Best Practices. Click here to get your digital or hard copy today!

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