Long-Term Care Options and Planning in a Nutshell

First, some items to ponder about age demographics in the United States from an article[1] by Thomas Day, Director of the National Care Planning Council:

As if the current lack of planning for long-term care were not a great enough burden on the immediate or extended family, the failure to plan, for the current generation of baby boomers, could be even more devastating on spouse or family in the future. Here is a list of factors that will make long-term care in the future an even more pressing burden than it is today.

  1. We are living longer. The population segment of the “very old”, older than age 85, is the fastest-growing age group in the country. The older the person, the more likely the need for long-term care and the more likely a need for care which lasts not just months but years. Over 50% of the age group over 85 is receiving long-term care.
  2. The older the person the more likely the risk of onset of dementia. The Alzheimer’s Association estimates about 46% of people over the age of 85 have dementia or Alzheimer’s
  3. The number of overweight and obese people in the United States is increasing dramatically. Obesity is a major contributor to disability and poor health in the elderly. Estimates are that the effects of obesity will increase nursing home enrollments by an additional 15% to 20% by the year 2020.
  4. The ranks of the elderly are growing larger. The population of elderly over 65 will double from about 37 million people today to about 77 million people in 2035, 30 years from now. Based on current estimates of the rate of long term care this means that in 30 years about 17 million elderly Americans will be receiving long term care.
  5. It is estimated that 6 out of 10 people will need long term care sometime during their lifetime.
  6. With a large and growing number of single person households there is no spouse and oftentimes no children to provide care. About 40% of the population is single.
  7. The birthrate is going down, families are getting smaller. The combination of fewer children, the increasing number of single person households and a growing number of elderly will eventually create a situation where there are more people needing care than there are available family caregivers.
  8. Out of approximately 116 million women in this country who could be employed in the workforce about 60% or 69 million are employed.  With women being the traditional caregivers, this means only about 40% of traditional caregivers are at home and able to provide long term care for loved ones without having to juggle a work schedule as well.
  9. Children are moving far away or the elderly are relocating after retirement and this makes it difficult or impossible to provide the resulting long-distance caregiving.
  10. The number of elderly as a percent of the population is growing larger putting a burden on the tax base and availability of money for government programs and the availability of younger caregivers. Over the next 50 years the elderly will grow from about 12% of the population to over 20% of the population.
  11. Medical science is preventing early sudden deaths which often results in a prolonged life with impaired health and a higher potential need for long-term care.
  12. Government programs are already stretched thin for long-term care services and will experience even greater stress on available funds in the future.
  13. The government does not seem inclined to provide a national long-term care insurance plan
  14. There is a worldwide trend, in all major industrial countries, to not deal with the problem of long-term care and very few countries, including the United States , have taken the initiative to adequately address the problem.
  15. Most healthy people in their 50s and early 60s prefer to ignore this future problem and their lack of planning will further burden public programs in the future.

(source for statistics: statistical abstract of the United States, 2005) (Emphasis supplied)

Houston, we have a problem–at least most of us do, or will soon. And unfortunately, time is (probably) not on our side. The problem? Long-term care. Such care runs the gamut. Home care, whether by spouse, children, friends, in-home nursing, and the like. Assisted-living facilities. Nursing home care. Combinations of these. Whatever the method, there’s a substantial cost involved, whether it’s an expenditure of time and money caring for a spouse at home—and the possible loss of income that involves—or full on 24/7 nursing home care, which can run as high as $10,000 per month or higher.

There are essentially four ways to pay for long-term care—if it’s needed:

  1. Private or self-pay,
  2. Long-term care insurance,
  3. Medicaid, and
  4. Veteran’s Benefits.

The drawbacks to private or self-pay are obvious: few people have the money to pay $4,000 – $10,000 per month for LTC without depleting retirement funds beyond repair. If family members can pitch in—and they often do—the burden may be bearable.

Long-term care insurance—whether it’s tradition LTCI or life insurance with an LTC rider—can reduce or even eliminate the burden, and if it’s purchased early, the monthly cost can be more manageable than private pay, and better yet, the cost generally comes during the insured’s working years. That said, LTCI can be hard to come by. Many insurers have left the playing field. Nevertheless, if the client is young enough and still healthy, it’s an option worth looking at.

Medicaid can step in the often huge gap between needs and resources, but as I’ve pointed out above, that help comes with some very strong strings attached.

Veteran’s Benefits are for veterans of course and come in two varieties: Service-related benefits and VA Improved Pension. The first is for veterans with service related disabilities, the second is for eligible wartime veterans and is capped. Veterans who qualify should plan on eventually applying for Medicaid.

I Can Help

If you would like to explore these or other ideas further, schedule a virtual meeting with me by clicking on the red button in the lower right-hand corner of this webpage for a free consultation.


[1] https://www.longtermcarelink.net/eldercare/why_long_term_care_planning.htm accessed March, 21, 2019.

Seminar this Wednesday: Estate Planning for Blended Families

I’ll be presenting a seminar at the Orem Public Library on Estate Planning for Blended Families.
When                 Wed, April 5, 7pm – 8pm
Where                Orem Public Library, Media Auditorium (map)
Description       Couples with blended families face special challenges when it comes to making sure that stocks, bonds, real estate, and other property and family heirlooms go to the right persons at the right time when a spouse dies. This seminar will address such issues and discuss ways to solve them, using wills, trusts, and other estate planning documents.
.
Hope to see you there.

Just Leave It Alone?

As many will recall, then candidate Trump promised to eliminate the estate tax. That was then. This is now–he’s the President. What will he actually do? Will he also eliminate the estate tax’s two siblings: the gift tax and the generation skipping tax? No one knows, though many people care, especially those who preach tax fairness.

Given that married couples currently have to be worth almost $11 million dollars before  the estate tax kicks in–it’s more complicated than that, but still–eliminating the estate tax is going to help only the very, very wealthy. And maybe that’s a bad (or a good) thing.

I’m here to argue for the advisor. Estate planning attorneys, life insurance and investment advisors, CPAs and financial planners. I’m betting that each and every one of them agree with the following:

Because the estate tax generates a meager 0.005 percent of annual tax collections, according to I.R.S. figures, it generates far more political debate than federal revenue. And among many tax planners, the calls aren’t so much for reform as for stability, or at least a period of benign neglect.

“Just leave it alone so we can plan,” Mr. Jenney said. “But every administration seems to want to put their own twist on the estate tax.”

Estate Planning Seminar at Pleasant Grove Library

I’ll be presenting a seminar on DIY — Do It Yourself — Estate Planning at the Pleasant Grove Library on Wednesday, March 8, 2017 at 7 PM. Come an enjoy the discussion. The address is 30 E Center St, Pleasant Grove.

If you have a question about wills, trusts, and other aspects of estate planning, maybe I can answer it.

Caregivers, Does this Describe You?

Northwestern Mutual recently published a survey of caregivers, those who take care of the infirm and aged. Among other things, this is what they found, according to Financial Advisor magazine:

Caregivers comprise a massive population segment, with 40 percent of the survey’s 1,003 respondents saying they were caregivers. Another 20 percent expect to step into that role.

While only 25 percent of future caregivers thought of financial support as a key attribute of caregiving, 64 percent of current caregivers ended up providing some level of financial support to their charges. Expenses related to giving care comprised nearly one-third of their budgets, according to the current caregivers.

Most future caregivers, 70 percent, expect to incur financial costs, yet only 60 percent said that they were equipped to handle the potential financial aspects of caregiving. (Emphasis supplied)

Just one more reason for people–both caregivers and those who will need it–to plan for the future. Long-term care insurance, life insurance, trust planning anyone?

When Dave Ramsey’s Wrong, He’s Really Wrong

Zander_2016-04-15_1200I’ve listened to Dave Ramsey. My wife owns a couple of his books. I get what he does, and I think he probably does a some good–in the debt area, at least. But he’s not always right. For example, I don’t care for some of his opinions about life insurance and much of his investment advice is off the mark as well. Further, his one-size-fits-all approach and his dismissive attitude towards insurance agents and other financial advisors are a real turn off for me. Seems that everybody’s out to get you but Dave and those he recommends. (I have more to say on this point, but I won’t.)

In short, I’m basically not a fan.

So you will not be surprised that I’m posting this link to a blog post by attorney Richard Chamberlain in response to a wildly uniformed excerpt about living/revocable trusts from one of Dave’s books. Make sure to read the entire post and the links in the post.

I must add my two cents on living/revocable trusts: Though they are just one part of a well-executed estate plan, they are an important part. Among many good reasons to establish a living/revocable trust, there’s this: setting one up and funding it will help you and yours get your minds around what you own, how you own it, and how you want it distributed or handled upon your death or incapacity. Mind you, I could add more than two cents to this conversation, but I’ll stop here.

Divorced? Going through a Divorce? Be Afraid. Be Very Afraid. And Change Your Beneficiary Designations

At least that’s the moral of this story. Actually, here’s the moral as stated at the end of that story:

“The moral of the story for practitioners is clear.  Whenever you have a client that is either going through a divorce or is already divorced, do everything you can to get the client to change both his/her beneficiary designations and his/her will as soon as possible.  The results in Smoot and Egelhoff could easily have been avoided with proper planning.”

Read the story and then follow the writer’s advice. Got it?

Stretch IRAs Under Seige?

What’s a stretch IRA, you say? Well, it’s not a new type of IRA, rather it’s a strategy to preserve the value of an inherited IRA, to defer the tax on as much of the IRA as possible for as long as possible. As the law now stands, the owner of an IRA has to begin taking required minimum distributions (RMDs) for his or her IRA at 70 1/2. Those RMDs are based on the person’s life expectancy at that time.

Should the IRA owner die, the beneficiary of the IRA must then take RMDs based on the beneficiary’s life expectancy–regardless of how old the beneficiary is at the time. Typically, beneficiaries are spouses, people of roughly the same age as the owner, so their RMDs will be more or less the same as the IRA owner’s.

To “stretch” the tax deferral benefits of an IRA, some advisors suggest their clients change the beneficiary designation on their IRA from their spouse to their children, that is, if their spouse has other income and will have no need for the income from the IRA. Though the children beneficiaries will have to take RMDs as well, those RMDs will be “stretched” out over a longer life expectancy and therefore will be much smaller and therefore more dollars will remain in the IRA for a longer period, safe from the tax man–for now.

Got that?

Well apparently stretch IRAs are under attack, according to a piece at Wealthmanagement.com. Here’s the first paragraph, with a teaser at the end. Yes Virginia, there are some possible solutions to the problem.

The stretch IRA is under siege.

If it’s eliminated, a non-spouse beneficiary of an IRA will be required to pay income taxes on the entire inherited IRA within five years of the IRA owner’s death. Here are two promising solutions using tax-free income that your clients can act on before the law changes. Let’s discuss Roth IRA conversions and life insurance.

There’s much to talk about with regard to IRAs, so check back later.

Two-Year-Old Granddaughters and Estate Planning

My entire immediate family was in town for the last five days. My three children, my son-in-law, and my one grandchild–a two-year-old girl with lots to say and not enough words to say it.

Now actually, what I just wrote is true and not true at the same time. What I just described is that part of my immediate family that has my blood flowing through its veins (no, my son-in-law, doesn’t, but you get my point). I also have four sons by marriage, three daughters-in-law, and four more grandchildren, plus two very much on the way. I love them all and treat them as my own. That part of my family–colloquially known as my stepfamily–presents estate planning issues, issues I’ve discussed elsewhere and which I’ll return to in the future.

But today it’s that two-year old. She’s sparked some thoughts on the nature of estate planning. Sure it’s about the immediate future. I want my wife taken care of should I die. I want to pass something on to my children. I was to avoid taxes if possible. And on and on. But what about the two-year old? What do I do about her, if anything?

My daughter, her mother, turns 40 a month from tomorrow. Forty years old. Her little girl won’t be 40 for 38 more years. Will my estate plan be durable and well-thought-out enough to have an impact on her life? I most likely won’t be around then to make it happen. So what can I do?

Two thoughts come to mind: trusts and life insurance. Both tools have more permanence than I do. If set up and funded properly, both can be there when I can’t to make sure my hopes and dreams for my granddaughter are fulfilled. Yes, I could rely on her parents–and I might–but if I absolutely, positively want my hopes for her fulfilled, trusts and life insurance are the tools of choice.

How are you going to insure that your dreams for your family come true?

The Wyoming State Bar does not certify any lawyer as a specialist or expert. Anyone considering a lawyer should independently investigate the lawyer’s credentials and ability, and not rely upon advertisements or self-proclaimed expertise. This website is an advertisement.