If your clients are middle-aged or older, learn about old-age care options.

Ten or 20 years ago, financial planners might have been asked if they knew anything about assisted living facilities, or continuing care retirement communities (CCRCs), as they're formally called. The client might say something like, "My grandmother is getting a bit scatterbrained, and we're thinking about finding her some help. Do you know anything about those assisted living homes?" Planners didn't need to answer these questions with great expertise. If they could just point the client in some helpful direction, he was grateful.

But, oh, what a difference a few decades make. Now it's the clients' parents-or the clients themselves-needing this information. And replying with, "I have a friend whose mother just went into the Bayside Home for Very Old People and she seems to like it," isn't going to suffice. Nowadays, planners should be seeking the necessary experience to guide clients through local care facilities, help them compare these facilities' financial and other contractual terms, and even deal with the emotional and psychological issues that often accompany this major life change.

Some advisors' initial experience, if they're middle-aged themselves, is in dealing with their own parents. J. David Lewis, owner of Resource Advisory Services Inc. in Knoxville, Tenn. says, "My mother had dementia which first showed up as confusion. When my sister discovered she hadn't been eating properly, she took my mother to the emergency room for treatment, and eventually ended up living with her in her home for a few months. When she left, we hired someone to be in the house with mother to prepare meals and help out, while I took over paying mother's bills. My sister and I knew we'd need to make other arrangements, but mother didn't want to leave her house. We'd have to force her, and I didn't want to do that. Eventually her confusion progressed. She said she'd do anything she needed to do, so we moved her to an assisted living facility. I made the arrangements. Those were very emotional times."

The technical services that advisors are beginning to provide to assist in situations like Lewis' represent another area of planning to be learned. It's not difficult to apply one's analytical skills to the comparison of different contracts or to the assessment of client funds vis-a-vis alternative care options. Says Michael Potito, a principal of Singer Potito Associates Inc. in Amherst, Mass, "We do this type of analysis routinely by quantifying how long a client's capital is apt to last given the costs associated with the assisted living facility, and by identifying the salient points in the facilities' disclosure documents."

Echoes John Ritter of Ritter Daniher Financial Advisory LLC in Cincinnati, Ohio, "We were working with a client who was making the decision for her mother. We started on the technical side reviewing her mother's assets, the value of her home, how long her money might last, and the types of facilities we should be looking at. We know many of the retirement homes in our area since I have two grandmas in town at different facilities. We were able to provide further technical assistance by explaining how some facilities offer full care-independent living, assisted living and nursing care-while others provide only one or two of these care features."

But does the assistance you can provide your clients end here? No. There is greater assistance you can provide on the technical side and, of course, we haven't yet talked about the "soft side" of assisted living advice. A financial advisor with an established niche in this field, Chris Cooper of Toledo, Ohio, has a second company in addition to his planning firm with a name that reflects the broader expertise Cooper feels is needed to serve the older client. His firm is ElderCare Advocates Inc., which he describes as a "geriatric care management firm."

Says Cooper, who comes out of the health care industry with a background as both a paramedic and a nurse, "We evaluate assisted living facilities, home care, and other clinical issues of retirement planning, but I also see a need by individuals and families to have a frank discussion [with a qualified advisor] about planning for the management of care, whether that care is provided by the family or is delegated." And that is what Cooper does through ElderCare Advocates, a subsidiary of his planning practice. "We provide geriatric care and consulting. Then, I may hire nurses, occupational therapists or other specialists, as needed, to assist the client."

A little-known fact, says Cooper, is that dementia is the largest single cause of what he calls clients' "falling out of retirement." "Dementia can happen in a person's forties, much less eighties, and it has a very serious effect on retirement planning that isn't being taken into account by most advisors." So how should financial plans factor in this risk? "Advisors need to sit down and talk about it with their clients, first of all. It might be hard for those who're just investment managers, or who specialize in retirement projections, but there are questions they should be asking."

Those questions focus on the client's health history. "'Were you ever a cigarette smoker?' is a very important question," says Cooper, because "that person is likely to need care ten to 15 years earlier than a non-smoker, even if he smoked and quit as long as 25 years ago." Other questions advisors should be asking are "Has any member of the family ever had dementia?" "What is the family's longevity?" and "What have family members died of?" Cooper suggests advisors specifically ask about diabetes because it's often a precursor to dementia. "Eventually you've got to factor this information into your client's long-term projections because fully 70% of those who ultimately need long-term care are diagnosed with dementia."

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