Care Agreements Document for Couples

Contributed by: Sandra Adams, CFP®

In the last several months I have been a part of several client conversations, many of which left me feeling a sense of great concern for at least one member of the couple. You see, these conversations all involved client couples that were dealing with one spouse having been diagnosed with some form of cognitive impairment, and the other serving as the primary care giver. In all of these cases, the caregiver expressed a multitude of emotions: responsibility, stress, worry, grief, and even a sense of being lost – as if they didn’t know where to go from here and they didn’t want to let their loved one know how they were feeling.

We all want nothing more than to love and care for our partners, to our best abilities, for the rest of our lives. At least that is what we vow when we marry on our wedding days. Little do we know what lies in our futures—chronic health issues or possible long term cognitive impairment—that may require intensive caregiving. What do we expect of our spouse in those cases? Will we want our spouse to provide personal care and will we want to remain at home, no matter the personal and financial sacrifice?  We have all heard and read that caregiver stress is a very real issue in the U.S., as many spouses and families strive to keep their loved ones cared for at home; unfortunately, this “I can do it all” approach leads to many caregivers falling ill and passing away before the “ill” spouse (or just giving up the quality of life once hoped for). So, how do we prevent this from happening?

I propose that when we are writing all of our other estate planning documents—our Wills, Patient Advocates, and Durable Power of Attorney Documents—that we consider writing a Care Agreements Document with our spouse or significant other.

What would this agreement include, you ask?

• If I get ill, or become cognitively impaired, how do I want to be cared for?

• If I am cognitively impaired/what do I expect of you as a caregiver and do I expect you to care for me at home (is there permission for you to make a move to a facility for safety reasons)?

• If I get ill or become cognitively impaired, do I expect you to provide the care, or do I give you permission to hire care and do I prefer that you visit with me and spend quality time with me.

• Any other items that seem important (i.e. whether or not it is important to keep pets, and or other items that are important to you if you become ill).

Having a Care Agreements Document between spouses/partners in advance of an illness does a couple of things:

1. It helps both partners make clearer decisions in times of stress if/when the time comes. It also takes away any feelings of guilt because you have had the conversation advance of an illness.

2. You have in writing what the care wishes are for your partner in the case of any disagreement from children (whether your children or from a second marriage, etc.). 

While a Care Agreement Document is not a legal document, it is something that helps express wishes for the person that is named in charge of making decisions for you (Durable Power of Attorney, etc.) and can be a great way to begin a conversation about those end of life issues that we don’t like to talk about, but need to. 

In next month’s blog, I will write about using the Care Agreements Document for family caregiving, so stay tuned!

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of Sandy Adams and not necessarily those of Raymond James. The information has been obtained from sources considered to be reliable, but Raymond James does not guarantee that the foregoing material is accurate or complete. You should discuss any legal matters with the appropriate professional.

Solutions for Serving Seniors and Vulnerable Older Adults

Contributed by: Sandra Adams, CFP®

I recently had the honor of speaking on a panel at the IA Watch Compliance Conference in Washington DC on the topic of "Solutions for Serving Seniors and Vulnerable Older Adults.” Conference attendees, who were financial firm owners, compliance officers, and financial advisors in compliance roles, attended the conference to get up-to-speed on industry hot topics such as SEC filing changes, Cyber Security, and, of course, how to best serve their aging client demographic.

The panel consisted of myself, Ronald Long, a Compliance officer from Wells Fargo Advisors, and Michael Creedon, a Gerontologist and Social Worker who writes and speaks on issues related to older adults. As the only financial planner and practitioner in attendance that works directly with clients, I was glad to be able to give practical tips for how to best help clients while continuing long term relationships with client families.

The message of the panel was clear:

No matter what our position, it is our job to best serve clients and their families, and addressing the issues of potential diminished capacity and other long term care issues head-on is the best way to do that.

I hope that presenting at this and other conferences is one more step towards spreading the word on this very important message to advisors in our industry!

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

A Webinar in Review: Elder Care Planning

Contributed by: Clare Lilek

What do you think of when you hear the term “elder care?” Well Sandy Adams, CFP®, who also has a Masters in Gerontology, thinks about how that term doesn’t exactly explain the type of planning involved and meaning it’s intended to represent. Instead, as Sandy discussed throughout the webinar, she suggests that elder care isn’t about the frail, but instead, it’s about longevity or long life planning for an active and engaged population. Sometimes this can be a sensitive topic, but really it’s about planning contingencies for potential risks as you or a loved one age, in order for that person to retain their dignity and remain in control. Elder care planning emphasizes the social and personal requirements for older adults in order to age in their desired manner.

Sandy emphasized the importance of starting to plan for yourself or your family as early as possible because you don’t want to be in a crisis situation guessing what your parents would have wanted, or perhaps you don’t want to cause your loved ones the stress of making a decision in case of an emergency. Having a well thought out plan with contingencies is the safest and smartest way to successfully age, especially as the “silver tsunami” is looming and the aging population increases and the question of “Who will care for us?” becomes top of mind.

Since these discussions, as important as they are, can be uncomfortable at times to initiate, Sandy provided some helpful tips, as well as resources, to help you start the conversation. Tips included creating a non-threatening environment, engaging the assistance of a professionals (like Sandy herself), including all the family, and having older adults in question do the majority of the talking—it’s their life, listen to what they want! Important topics to discuss are: home maintenance, transportation, and socialization. Sandy suggests framing these conversations using the C.A.R.E. framework: identify the Challenges, think about Alternatives, acknowledge your Resources, and stay true to the overall Experience you or your older parent wants to have.

Overall, Sandy suggests having an open and honest conversation about you and your family’s needs, discuss contingent plans for possible futures, start creating a plan early, and don’t be afraid to enlist the help of a professional team for support and guidance. For more tips on how to go about Elder Care Planning for you or your parents, check out the entire webinar below or feel free to contact Sandy for further guidance.

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In 2012-2014 Sandy has been named to the Five Star Wealth Managers list in Detroit Hour magazine. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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Five Star Award is based on advisor being credentialed as an investment advisory representative (IAR), a FINRA registered representative, a CPA or a licensed attorney, including education and professional designations, actively employed in the industry for five years, favorable regulatory and complaint history review, fulfillment of firm review based on internal firm standards, accepting new clients, one- and five-year client retention rates, non-institutional discretionary and/or non-discretionary client assets administered, number of client households served.

Any opinions are those of Sandy Adams, CFP® and not necessarily those of Raymond James.

A Key to Successful Aging: Livable Communities

Contributed by: Sandra Adams, CFP®

A topic that comes up often in conversations with clients while discussing plans for their futures as they age usually centers around, "where will we live?" It should not be a surprise that most folks are inclined to want stay in their own homes for as long as possible (or so they think). It may actually be the community, more so than the home, in many cases, that clients are really tied to. The community is where our social contacts are, where health care and other supports are, and often times where our friends and family are. So determining how livable one’s community is for the long haul is important. That is why when I came across the new Livability Index Tool developed by AARP's Public Policy Institute, I stood up and took notice.

The Livability Index (found at www.livabilityindex.aarp.org) scores neighborhoods and communities across the U.S. for the services that impact seniors' lives the most. It looks at housing, transportation, the environment, health, social engagement, and opportunity, all of which are determined by the Public Policy Institute's research and the opinion surveys of 4,500 Americans age 50+. A positive Livability Index means access to a variety of housing, with close proximity to jobs, and access to activities and services to keep seniors engaged and healthy.

So, when the topic of "Where will we live?" comes up, whether the client is looking to stay in their own home, move to a Continuing Care Retirement Community, Independent Retirement Community, or other Assisted Living Community, we may suggest looking up the location in the Livability Index to see how the community in which the housing is located ranks. In addition, of course, to determining how the community fits into the clients plan from a financial and long term care perspective. When discussing with your financial planner where you will live as you age, in addition to the financial aspect, make sure you discuss the livability piece. Making sure you live in a community that provides you substantial support with access to essentials and amenities can keep you socially active and engaged, which is the key to successful aging!

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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The information has been obtained from sources considered to be reliable, but we do not guarantee that the foregoing material is accurate or complete. Any opinions are those of Sandy Adams and not necessarily those of Raymond James. Raymond James is not affiliated with and does not endorse the opinions or services of Livability Index and/or AARP. Please include: Links are being provided for information purposes only. Raymond James is not affiliated with and does not endorse, authorize or sponsor any of the listed websites or their respective sponsors. Raymond James is not responsible for the content of any website or the collection or use of information regarding any website's users and/or members.

Family Caregiving – The REAL Long Term Costs

Contributed by: Sandra Adams, CFP®

It is hard to avoid the statistics. They are in news articles. They are on TV. They are on social media. People are living longer and the potential costs that older adults can expect to pay for long term care are astronomical.  AARP recently published a study “Valuing the Invaluable: 2015 Update.”  The study reported that in 2013, about 40 million family caregivers in the U.S. provided an estimated 37 billion hours of care to an adult with limitations in daily activities.  This care equated to an estimated economic value of $470 billion (up from an estimated $450 billion in 2009). 

The Impact of Relying on Family Care

Many older adults either plan for their family members to care for them in older age or their failure to plan leaves them no other alternative but to rely on family members for care.  Unfortunately, older adults do not realize that they might be impacting their family members’ long-term financial future when they are put in the position of being a caregiver (especially when it wasn’t planned). 

The AARP study reported the following findings of family caregivers:

• 61% made workplace adjustments, which included cutting hours, taking leaves of absence, receiving warnings about attendance and turning down promotions; all of which affected pay negatively.
• 22% of retired caregivers left the workforce early, which affected potential retirement savings, pensions and/or Social Security benefits.
• 68% of caregivers used their own money to support long term care costs, which drained funds they had planned for their own future financial independence.

So what can be done to help avoid these potential pitfalls for the financial health of the entire family? 

1. First and foremost, plan ahead.  If you can plan ahead, especially from a financial perspective, for future long term care costs you can either pay for professional caregivers OR pay your family members to provide care and offset any benefits they might be giving up by stepping away from their planned career path. 
2. Secondly, know your resources.  Outside of your family, know what community and government resources might be available that can relieve stress from your family.
3. Last, communicate your plans.  If family caregiving is part of your family’s plan, make sure everyone is on board and has a way to make things fair (consider paid caregiver contracts, etc.).  It is easier for all family members to make things work if they know in advance what the contingencies might be.

If you and your family are planning for family caregiver situations and have questions I can help with, please don’t hesitate to give me a call.

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of Sandy Adams, CFP® and not necessarily those of Raymond James. The information has been obtained from sources considered to be reliable, but Raymond James does not guarantee that the foregoing material is accurate or complete.

Family and Finances: How to Help Aging Parents Stay in Control

Contributed by: Sandra Adams, CFP®

I recently attended my daughter’s college orientation.  During one of the presentations to parents, the speaker said something that struck a chord with me:

“As hard as it may be, it is time for you as parents to let go of the reigns and give your children control of their own lives. Let them take care of things for themselves and make their own decisions. This may mean that they make some mistakes, but this is the time for them to learn.” 

Wow!  Did that hit home!  How hard is it as a parent to let go and let your child start doing things for themselves when you have been doing things for them for the last 17 – 18 years?  But isn’t this what your child has been waiting for?  To be an adult and to have control over his or her own life?  Isn’t that what we all wait for?

Why Control Matters at Any Age

As I sat and thought about the issue of control a bit more, I began to think about the older adult clients that I work with and about how hard they fight to keep control over their lives as they age.  I thought about the adult children of those clients who often feel as if, at some point, they may have to take away that control if the older adult losses the capacity to maintain control for themselves.  It can be particularly stressful for adult children to be put in a situation of needing to take over “control” for their aging parents without having a clear idea of their parents’ desires for their lives as they age.  So, what can be done to avoid this potential situation?

• Have open and honest conversations about the older adult’s plans for their future aging life; this may include a family meeting (tips here on having your own) that is led by your financial planner to include conversations about financial assets and how longer term care planning and future housing options might be funded.

• Make sure that all of the proper estate planning documents are up-to-date and that they are accessible (consider keeping copies on file with your financial planner’s office, as well).  Particularly important are Durable Power of Attorney Documents for General/Financial and Health Care/Patient Advocate.

• Ensure that all wishes and plans for the future are documented in writing.  Also make sure to have your financial affairs organized and documented.  Our Personal Financial Record Keeping System & Letter of Last Instruction is one helpful tool you can use.

Control is something we all want to have over our own lives … and something we fight to keep.  As parents of young adults, we struggle to let go of the control for fear that our children might take a few falls.  At the same time, we might be struggling with the thought of having to take control from aging parents who might be struggling with capacity issues as they age.  But, if you’ve planned ahead and helped your parents communicate their wishes, you won’t have taken their control from them at all. Instead, you will be assisting them in carrying out their own well-designed future.

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In 2012-2014 Sandy has been named to the Five Star Wealth Managers list in Detroit Hour magazine. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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Five Star Award is based on advisor being credentialed as an investment advisory representative (IAR), a FINRA registered representative, a CPA or a licensed attorney, including education and professional designations, actively employed in the industry for five years, favorable regulatory and complaint history review, fulfillment of firm review based on internal firm standards, accepting new clients, one- and five-year client retention rates, non-institutional discretionary and/or non-discretionary client assets administered, number of client households served.

This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of Sandy Adams, CFP® and not necessarily those of Raymond James. The information has been obtained from sources considered to be reliable, but Raymond James does not guarantee that the foregoing material is accurate or complete. You should discuss any legal matters with the appropriate professional.

Beyond Retirement: An End of Life Planning Lesson

Contributed by: Sandra Adams, CFP®

As we work with clients at The Center, we talk about how to “live your plan.” To us, that means focusing and achieving your financial goals so that you can you can live those goals that you have been envisioning within your planning.  To be honest, this phrase often arises in the context of conversations about living out dream retirement wishes, like traveling the world, writing that book you always dreamed of writing, or owning a second home on the beach – not in the context of end of life planning.

I recently witnessed a client “live” her end of life plan.  While you might not think this to be a very significant or exciting accomplishment, it brings me to tears and smiles (all at the same time) every time I think of it.

Communicating Your Wishes

“Ann” was in her early 90’s and quite a strong character. Although she suffered from a chronic disease, she was relatively active early on in our planning.  She needed to update her estate planning because she had outlived all of her blood relatives and needed to put plans in place for when she knew she might not be able to handle her own affairs.  What she did know was that she would NEVER want to go to a nursing home – she wanted to be cared for her in her own home and we needed to find to a way to make that happen.  Ann put her wishes in writing and communicated those wishes to everyone involved along the way.

Outlining Your Plan

Over the next several years, Ann’s health worsened and she needed to hire a geriatric care manager and caregivers. Toward the end, there were caregivers at her home nearly 24 hours a day with some Hospice care provided. With careful planning, Ann was able to support this with her financial resources. I do not tell you that this was easy. There were many times over the years when Ann became anxious, claimed she was living too long, and wasn’t sure what to do. But she was never willing to compromise on moving from her home.  Ann had specifically outlined how she wanted to live (and how she didn’t want to live – in a nursing home).  On one of her last days, Ann said, “I am happy.” To me, this confirmed that she had carried out her plan for her end of life to her satisfaction.  These are the types of situations that I help my clients with often.

End of Life Reading

Being Mortal by Atul Gawande is a book that I read recently on end of life issues.  It brings to light that most of us do a very poor job of planning for or thinking about our end of life, and we certainly don’t communicate our wishes to our families. We do a lot to plan for our ideal lives, our ideal retirements, so why not end our lives right?  By taking the next steps and planning for the end of our lives, as well, we can make this happen (even though it is not always the most pleasant topic to discuss).  My favorite takeaway from the book is this:

            “All we ask is to be allowed to remain the writers of our own story.  That story is ever changing. Over the course of our lives, we may encounter unimaginable difficulties. Our concerns and desires may shift.  But whatever happens, we want to retain the freedom to shape our lives in ways consistent with our character and loyalties.”  -Atul Gawande

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In 2012-2014 Sandy has been named to the Five Star Wealth Managers list in Detroit Hour magazine. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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Five Star Award is based on advisor being credentialed as an investment advisory representative (IAR), a FINRA registered representative, a CPA or a licensed attorney, including education and professional designations, actively employed in the industry for five years, favorable regulatory and complaint history review, fulfillment of firm review based on internal firm standards, accepting new clients, one- and five-year client retention rates, non-institutional discretionary and/or non-discretionary client assets administered, number of client households served.

This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of Sandra D. Adams, CFP®, and not necessarily those of Raymond James. Raymond James is not affiliated with and does not endorse the opinions of Atul Gawande. You should discuss any legal matters with the appropriate professional. The experience described here may not be representative of any future experience of our clients. Past performance is not indicative of future results.

Aging in America: Financial Planning’s New Frontier

Contributed by: Amanda Toia

I had the opportunity to attend the Raymond James National Conference in April. It is a time when colleagues from all across the country gather to share ideas, host seminars, and learn new and exciting information to take back to their practices. One of the experts on a panel on aging happened to be our resident gerontology expert, Sandra Adams (she did a fantastic job).  When it comes to degenerative disease that accompany aging like dementia, the statistics are staggering.  

The Impact of Alzheimer’s

There are over five million people affected with some form of dementia in America today.  While there are various diseases that fall under the umbrella of dementia, Alzheimer’s disease is the most common.  In fact, 80% of dementia is related to Alzheimer’s disease. While we are seeing a decline in other diseases across the board (breast and prostate cancers, heart disease/strokes and HIV), Alzheimer’s is rapidly increasing. 

As we begin to age, our mental effective power begins to slow down.  This slow down starts in our early thirties and continues to decline through our aging process.

Every 67 seconds, one person in America is diagnosed
with Alzheimer’s disease.

An alarming 1 in 9 Americans (aged 65+) has this progressive disease (and there are 10,000 people turning the age of 65 each day).  Americans over the age of 85 will have a 1 in 3 chance of living with this form of dementia.

Dementia and Financial Planning

As our aging population is rising, so are some of the issues in financial planning. Statistics show that by 2050, we could have 16 million people living in America with Alzheimer’s disease (Alzheimer’s Association). The expected costs related to the diagnosis, treatment, and societal factors of dementia could be as high as 1.2 trillion in today’s dollars. (Yes, I wrote “trillion.”) Today, average nursing care is running around $75,000 and this is for basic, skilled care – not a lavish facility. With healthcare and long term care costs on the rise, it is necessary for clients and planners to begin the long term care plan early in life taking into account the rising risk factors of dementia as they can strike earlier in life.

Sandra Adams and the other panelists discussed engaging and educating ourselves and our clients on the issues of aging and the effects on the financial planning landscape.  While aging has been a part of the financial planning process for some time, it has become somewhat of a new frontier as the aging population, health care, and long-term care costs increase by leaps and bounds.  Creating a financial plan no longer includes just assets and insurances for your long term goals.  Your intentions for your health care and mode of living beyond retirement are now viewed as appropriate topics to broach with you planner and other professionals alike.  Building a care management team will ease the burden should the time come when your health begins to decline.  Making sure members of your inner circle are aware of your wishes as they relate to treatment options, modes of living, and end of life care are also very helpful. 

Aging and the concerns surrounding it can be a tough subject to tackle as no one really knows what the future will hold.  We are fortunate to have a specialist in our office who keeps us up to date on all matters of aging and we are here to help do the same for you providing financial guidance as you move through your life.

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The information has been obtained from sources considered to be reliable, but we do not guarantee that the foregoing material is accurate or complete. Any opinions are those of Amanda Toia and not necessarily those of Raymond James.

Aging Investors: Top 3 Reasons Why Do-It-Yourself May Not Be The Answer

Contributed by: Sandra Adams, CFP®

The demographic shift is underway.  A whopping 10,000 Americans are turning 65 each day – a trend that will continue for the next 15 years.  And Americans are living longer than ever. At the same time, the chance of being affected by dementia doubles every 5 years after age 60. Even those without dementia have a 30% of being affected by cognitive impairment without dementia by the time they are in their 80s.  And on top of all that, fluid intelligence – our ability to analyze new information and concepts (especially numbers and financial concepts) – begins to decline after our peak years between ages 30 and 40. (American Association of Individual Investors Journal September 2011).  

Particularly in the area of investment management, there are a number of risks to aging investors.  Here are some of the top risks and why it makes sense to consider working with a financial planning partner in the investment area to avoid these risks.

Reasons to Consider Working with a Financial Planner

1. Fraud/Undue Influence – one of the biggest risk factors as you age is that becoming a primary target of financial frauds and scams.  Someone may want to steal your identity, sell you inappropriate financial products, or family members or others my attempt to steal from you.
2. Diminished Ability to Make Decisions or Understand Concepts - this occurs when you -- whether due to dementia, cognitive impairment, or normal aging -- begin to struggle with understanding numbers or financial concepts.  Now, more than ever, you need a professional fiduciary to watch out for your financial best interests rather than trying to handle investments on your own.
3. Primary Decision Maker becomes incapacitated and spouse has no game plan or is caregiver and cannot handle another task – generally, there is one partner in a marriage that primarily handles the investments.  If that person becomes incapacitated and the spouse is not up to speed, and doesn’t know “the plan,” it is important that there is a professional financial planner involved. With a financial planner working as your partner, they can help you keep things running smoothly and make sure that the investments are handled appropriately to meet your long term care and retirement needs. This is especially important if you are also the primary caregiver for your spouse and already dealing with added responsibility.

For many reasons, it is important to work with a financial planner.  Particularly as an aging investor, it is crucial to have a financial planning partner to help protect you and your family against financial predators, to make sure appropriate decisions are made, and to help relieve the burden of yet another responsibility that you might have in the aging process.  Make sure a CERTIFIED FINANCIAL PLANNER® professional is part of your professional planning team. 

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In 2012-2014 Sandy has been named to the Five Star Wealth Managers list in Detroit Hour magazine. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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Five Star Award is based on advisor being credentialed as an investment advisory representative (IAR), a FINRA registered representative, a CPA or a licensed attorney, including education and professional designations, actively employed in the industry for five years, favorable regulatory and complaint history review, fulfillment of firm review based on internal firm standards, accepting new clients, one- and five-year client retention rates, non-institutional discretionary and/or non-discretionary client assets administered, number of client households served.

This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of Sandy Adams, CFP® and not necessarily those of Raymond James. The information has been obtained from sources considered to be reliable, but Raymond James does not guarantee that the foregoing material is accurate or complete. You should discuss any legal matters with the appropriate professional. Investing involves risk and investors may incur a profit or a loss.

Health Care Dollars and Aging

Contributed by: Sandra Adams, CFP®

I ran across an interesting article recently by Howard Gleckman, author of the book "Caring for our Parents." The article “How we Spend Our Health Care Dollars As We Age” discussed current trends in health care spending for seniors and affirmed for me some of the key issues we discuss with clients regarding health care spending and aging in retirement.

Spending on Health Care Changes with Age

The article referenced recent research by the Employee Benefit Research Institute indicating that out-of-pocket spending for routine health care changes very little after age 65, and remains relatively unchanged even after age 85 for these routine expenses (trips to the doctor or dentist, medications, etc.). That’s mainly because Medicare covers the bulk of those expenses. The story changes dramatically when it comes to very high cost medical procedures/care or long-term support or services. As we age, we are far more likely to need these high cost services (about 27% of those age 65 - 74 had an overnight stay in the hospital during the period of 2010 - 2012, while more than 42% of those 85 and over spent at least one night a hospital during that same period). The key here is this: Medicare is the primary source of health insurance for those over the age of 65. MEDICARE IS NOT LONG TERM CARE INSURANCE.

How to Plan for Potential Health Care Expenses

According to a study by the Kaiser Family Foundation, out-of-pocket costs alone for someone spending two years in a nursing facility can run $24,000 - $67,000. If you do need skilled care for a period of time for either rehabilitation or long term care, the costs can be devastating to your finances. So what do you do to plan ahead for these potential costs?

1. Discuss options with your financial planner for long term care insurance. There are ways to purchase policies as part of employer groups and associations or individually. There are also new hybrid life/long term care or annuity/long term care policies that may fit well in your overall financial plan.

2. Discuss options with your financial planner to self-insure the costs for potential health/long term care costs using existing assets. You can earmark specific assets or income streams for those potential future costs in a way that least disrupts your overall financial plan.

3. Discuss with your financial planner any possible future government benefits that you may be eligible for that might help to cover any future long-term care costs (i.e. Veteran's Aid & Attendance Benefits). Determine if you may be eligible and put the proper financial and legal planning in place for future eligibility when and if needed.

As always, planning now for the future what if's is always better than planning in a crisis. Have a conversation about your future health care and long-term care planning with your financial planner at your upcoming financial review.

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In 2012-2014 Sandy has been named to the Five Star Wealth Managers list in Detroit Hour magazine. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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Five Star Award is based on advisor being credentialed as an investment advisory representative (IAR), a FINRA registered representative, a CPA or a licensed attorney, including education and professional designations, actively employed in the industry for five years, favorable regulatory and complaint history review, fulfillment of firm review based on internal firm standards, accepting new clients, one- and five-year client retention rates, non-institutional discretionary and/or non-discretionary client assets administered, number of client households served.

This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of Sandra Adams, CFP ® and not necessarily those of Raymond James. The information has been obtained from sources considered to be reliable, but Raymond James does not guarantee that the foregoing material is accurate or complete. Long Term Care Insurance may not be suitable for all investors. Please consult with a licensed financial professional when considering your insurance options.