Long Term Care Varies, State by State

What if your parents live in Oklahoma, you live in Nebraska and your brothers and sisters live in New York and California? Having the important conversation with your aging parents about what the future might hold if one of them should need long-term care is going to be a challenge, to say the least.

It’s not just about whether they want to leave their home, reports the article “What is the best state for long term care” from The Mercury. There are many more complications. Every state has different availability, levels of care and taxes. If the family is considering a continuing care retirement community, or if the parents already live in one, what are the terms of the contract?

The differences between states vary, and even within a state, there can be dramatic differences, depending upon whether the facility being considered is in a metropolitan, suburban or rural area. There’s also the question of whether the facility will accept Medicaid patients, if the parents have long-term care insurance or any other resources.

Here’s what often happens: you open up a glossy brochure of a senior community in a warm climate, like Florida or Arizona. There are golf courses, swimming pools and a great looking main house where clubs and other activities take place. However, what happens when the active phase of your life ends, slowly or suddenly? The questions to ask concern levels of care and quality of care. Where is the nearest hospital, and is it a good one? What kind of care can you receive in your own apartment? Are you locked into to your purchase, regardless of your wishes to sell and move to be closer to or live with your adult children?

And what happens if you or a “well” spouse runs out of money? That’s the question no one wants to think about, but it does have to be considered.

For people who move to Florida, which has a very generous homestead exemption for property taxes and no state tax, the incentives are strong. However, what if you become sick and need to return north?

For seniors who live in Pennsylvania and receive long-term care and other services, the well spouse’s retirement funds are exempt for Medicaid regardless of the amount. However, if you move over the state’s border to New Jersey, and those accounts will need to be spent down to qualify for Medicaid. The difference to the well spouse could be life changing.

Delaware and New Jersey have Medicaid available for assisted living/personal care. Pennsylvania does not. The Keystone State has strict income limitations regarding “at home” services through Medicaid, whereas California is very open in how it interprets rules about Medicaid gifting. Utah also has Medicaid available for nursing home care and has a segment that helps with assisted living cost called the New Choice Waiver.

The answer of where to live when long-term care is in play depends on many different factors. Your best bet is to meet with an estate planning elder care attorney who understands the pros and cons of your state, your family’s  situation and what will work best for you and your spouse, or you as an individual.

Reference: The Mercury (March 4, 2020) “What is the best state for long term care”

 

Tips for Seniors Who Are Moving to Assisted Living

When you are planning your move into assisted living, you can quickly get overwhelmed with the endless list of things you need to do. If you are moving out of a home where you have lived for many years, the thought of having to downsize and get rid of most of your possessions can produce anxiety. If thinking about all the work ahead of you makes you feel sad or tired, it can help to have a roadmap. Here are some organizational tips for seniors who are moving to assisted living.

You will be dealing with two situations – your current house and your new home. Each one needs a tailored game plan.

How to Minimize the Stress of Packing Up Your House

When you move from a large home to a smaller environment, the logistics dictate that everything will not fit into the new space. You will have to part with some of your items.

Rule #1 is you should be the one to decide what you keep and take with you to your new home. No one should dictate what you can have. These strategies can help:

  • Some of the bulk of your items will be a simple matter, because you will have no use for some things in assisted living. For example, since the facility will likely take care of the yard work, all the lawn and gardening equipment can go to a new home. You can save someone a lot of money, by giving them these items when they buy a house.
  • If you move to a warmer part of the country, you might not need your winter gear anymore. Donating those things can help keep someone in need from being cold and reduce how much you have to move.
  • Walk into one of your rooms and make a list of the three or four things you love the most in that room. If you only keep your favorite things, when you are in your new home, everything you see will bring you joy.

Changing how you think about the process, can make it less emotional for you. Instead of thinking about losing most of your belongings, imagine how liberating it will be when you are not tied down by so many things. Most people discover a lightness and freedom, when they get rid of the clutter and things that do not matter.

Settling into Your New Home

When you pack up at your previous house, visualize how the items you keep will fit into the new space. Make sure you hold on to the things that will make you feel comfortable and at home. Arrange your favorite things, so you can see familiar items from every angle throughout your space. With a little planning, you can recreate the feel of your old home environment. Keepsakes matter. While you do not want to be crowded by clutter or create tripping hazards, a cherished clock, photographs, books and artwork can help you feel as if you belong from the first day.

If you are planning to move to an assisted living facility, reach out to your qualified elder law attorney. They may be able to help you with government benefits and are familiar with the process of transitioning.

References:

A Place for Mom. “Moving Seniors: Settling in to Senior Care.” (accessed November 21, 2019) https://www.aplaceformom.com/planning-and-advice/articles/moving-seniors

American Life Expectancy Has Gone Down

The good news is, people might not need to save quite as much money for retirement as before. The bad news is the reason for that statement. The life expectancy for the US is in a decline. In fact, American life expectancy has gone down for the last three years in a row.

This undesired streak marks the first time in 100 years that the life expectancy in the U.S. has declined for three or more consecutive years. American life expectancy declined for four years in a row from 1915 to 1918. To appreciate those circumstances and put our current decline into perspective, both the worldwide epidemic of Spanish Flu and World War I occurred during those four years.

The Numbers

Life expectancy is a curious beast. You will have one life expectancy at birth and a significantly different likelihood, if you live to age 25. Surviving to age 25 increases your life expectancy, and making it to middle age extends the projections even farther.

For example, a baby born in 2016 had a life expectancy of 76 years for a male and 81 for a female. Once that baby turns 25, the estimates are 89.5 years for a female and just under 87 years for a male. People who were middle-aged in 2016 had a good chance of living beyond these years. The projections in 2016 saw a decrease of six months, compared to 2015. The lowered life expectancy projections for our country are continuing.

Factors Driving the Decline in Life Expectancy

The Centers for Disease Control (CDC) suggests that, while many elements go into the calculation of life expectancy, these three issues might be responsible for some of the downward slide of the American life expectancy:

  • Increased suicide rates. Suicide in the United States has skyrocketed during the last 20 years. The suicide rate is 33 percent higher now than it was in 1999. You might attribute the increase to the Great Recession, but the most dramatic surge in numbers was in 2017, with a 3.7 percent jump. On a side note, worldwide suicide rates went down by almost 30 percent during the same time.
  • Drug overdoses. The epidemic of drug overdoses is now so massive that it is affecting national life expectancy. Within the last ten years, fatal drug overdoses increased by 72 percent. These numbers include deaths from street drugs and prescription drugs. More than 70,000 people in the U.S. died from drug overdoses in 2017. Over 47,000 of those deaths involved opioids, like heroin and prescription painkillers. Doctors today prescribe three times as many opioids as they did in 1999.
  • Liver disease. Deaths from cirrhosis and other chronic liver diseases have gone through the roof during the last decade. Genetics and the heavy consumption of alcohol get much of the blame for this phenomenon.

Many other factors contribute to life expectancy. Lifestyle choices, like nutrition and activity, can help a person live a longer, healthier life. We spend more on healthcare per person than any other country. While the life expectancy in our country has decreased, the projected lifespan is still increasing in France, Sweden, the Netherlands, and Germany, albeit at a much slower rate than before.

References:

CNBC. “US Life Expectancy has been declining. Here’s why.” (accessed November 14, 2019) https://www.cnbc.com/2019/07/09/us-life-expectancy-has-been-declining-heres-why.html

Financial Advisor. “U.S. Life Expectancy Now 6 Months Shorter.” (accessed November 14, 2019) https://www.fa-mag.com/news/u-s–life-expectancy-now-6-months-shorter-29781.html

Relocating for Retirement? What You Need to Know

Sometimes having too many choices can become overwhelming. Move closer to the grandchildren, or live in a college town? Escape cold weather, or move to a mountain village? With the freedom to move anywhere, you’ll need to do some serious homework. A recent article titled “Don’t Relocate in Retirement Without Answering These 5 Questions” from Nasdaq contains some wise and practical advice.

There are some regions that are more retirement-friendly than others. If you end up in the wrong place, it could hurt your retirement finances. Therefore, ask these questions first:

What are the state’s taxes like? If you are living on Social Security benefits, retirement savings and a pension, the amount of money you’ll actually receive will vary depending on the state. There are 37 states that don’t tax Social Security benefits, but there are 13 that do. There are also some states that do not tax distributions from retirement accounts. Learn the local rules first. If you currently live in a state with no income tax, don’t move to a state that may require a big tax check.

If you live in a high tax state and don’t have enough money saved for a comfortable retirement, then moving to a lower tax state will help stretch your budget.

Is there an estate or inheritance tax, and is that a concern for you? If leaving money to heirs doesn’t matter to you, this isn’t a big deal. However, if you want to pass on your assets, then find out what the state’s inheritance taxes are. In some states, there are no taxes until you reach a pretty large amount. However, in states with inheritance taxes, even a small estate may be taxed, with those who inherit sometimes owing money on even small transfers.

What’s the cost of living compared to where you live now? When you’re working, moving to a place with a higher cost of living is not as big a deal, since your wages (hopefully) increase with the relocation. However, if your cost of living goes up and your income remains fixed, that’s a problem. The last thing you want to do is move to a place where the cost of living is so high, that it decimates your retirement savings.

If you live somewhere with high taxes and high prices, moving to a lower cost of living area will help your money last longer, and could make your retirement much easier.

Is it walkable or do you need a car? Cars present two problems for aging adults. One, they are expensive to maintain and insure. Two, at a certain point along the aging process, it becomes time to give up the keys. If you live in a walkable community, you may be able to go from having two cars to having one car. You might even be able to get rid of both cars and do yourself a favor, by walking more. This also gives you far more independence, far later in life.

What’s healthcare like? Even people who are perfectly healthy in their 50s and 60s, may find themselves living with chronic conditions in their 70s and 80s. You want to live where first-class healthcare is available. Check to see what hospitals and doctors are in the area before moving. You should also find out if medical care providers accept Medicare. Consider the cost of a nursing home or home care in your potential new community. Some areas of the country have much higher costs than others.

Reference: Nasdaq (Aug. 9, 2019) “Don’t Relocate in Retirement Without Answering These 5 Questions,”

Things That Can Drain Your Retirement Savings

You can follow all the rules, work hard and save the amount of money the experts recommend for your retirement and still get blindsided by an unexpected situation that wipes out your retirement savings and leaves you on shaky financial ground. There is a limit to how much money anyone can save for retirement, so advising you to save even more money for retirement might not be the solution.

Becoming aware of the threats to your retirement savings might allow you to avoid some of them or develop strategies, in case you find yourself in one of the situations one day. Here are some of the things that can drain your retirement savings.

Inflation and the Cost of Living

Remember what a newspaper, loaf of bread, or house cost 25 or 30 years ago? Chances are, those and many other things cost significantly more today than they did then. Many people live for two or three decades after they retire. If, for example, $4,000 of income would have provided a comfortable lifestyle in the year a person retires, it might not be adequate in 15 or 20 years.

The good news is that you can inflation-proof some of your living expenses. If you have a fixed-rate mortgage, you will lock down the amount of your housing cost. Of course, paying off your mortgage before retirement is an even better option. People who rent instead of buy, however, will face ever-rising payments for rent. That lovely apartment that cost $2,000 a month when you moved in could cost double that price after a few decades.

You can also press the pause button on some other expenses, like insurance. Some disability and long-term care policies offer a cost-of-living protection option. You should also check to see if your retirement plan administrator offers any fixed rate or guaranteed return investments that come with cost-of-living adjustments.

Spend Your Time, Not Your Money

When you are no longer working full-time, you might decide to get involved in activities you wanted to engage in before but did not have the time. Joining a local service club like Rotary or the Lion’s Club can be a wonderful way to connect with like-minded people and serve your community, but it can also be expensive. You will have membership dues, but those are just the start.

Many service clubs meet at mealtimes, so you will have to pay the cost of the meal, which is usually at a restaurant. Because service clubs perform projects to help deserving causes, there will be constant fundraisers and appeals for contributions. This is not intended to discourage people from joining service clubs, rather, to inform you about the costs involved if you choose to do so. Your community probably has a volunteer corps you can participate in at no charge, if your goal is to help others without going broke.

Stay Healthy

Face it. If you are retired, you cannot afford to get sick. The cost of healthcare goes up every year. Current retirees pay on average about $5,000 to $6,000 a year for Medicare premiums, copays, and prescription drugs. A significant medical crisis can wipe out your retirement savings.

Do everything you can to stay healthy. Eat well and stay hydrated. Talk regular walks and avoid falls. Stay away from sick people. You should also keep a positive attitude. Maintaining your health is one of the most effective ways to make sure you do not run out of money in retirement.

References:

AARP. “5 Threats to Your Retirement Savings.” (accessed July 16, 2019) https://www.aarp.org/retirement/planning-for-retirement/info-2019/5-threats-to-your-retirement-savings.html

When Retirement Is Devoted to Elderly Parents

Lynda Faye planned to spend her retirement gardening and visiting eight grandchildren. Instead, she is caring for her mother, 99-year-old Yetta Meisel. The former art teacher is busy all day long, helping her mother bathe, making meals, picking up prescriptions, scheduling home aides and transporting a wheelchair for excursions, reports The New York Times in the article “At 75, Taking Care of Mom, 99: ‘We Did Not Think She Would Live This Long.’”

Ms. Faye and her mother are part of what is expected to be a growing phenomenon, of children in their 60s and 70s who are devoting their retirement years to caring for parents who are in their 90s and beyond.

The financial cost of caring for an older parent is not an easy one. In Ms. Faye’s case, she persuaded her parents to move to their hometown. An addition was added to the Faye’s home, but her parents chose to move to a three-bedroom condo nearby. The Faye’s turned the addition into a bed-and-breakfast suite.

When Mrs. Meisel’s husband died, she qualified for a state program that paid some of the costs of home aides. While Mrs. Faye kept the B&B busy, she paid for 24/7 care and other expenses for her mother from the $25,000 nest egg that her father had. In a few short years, that money was gone.

Now the family home is on the market. Mrs. Faye and her husband have moved into their mother’s condo. Her mother lives in a one-bedroom unit in the same building. To save money, Ms. Faye cut back on the home aides and cares for her mother herself three days a week. Her mother’s Social Security and the state program pay for the balance of her care. There’s an additional $1,000 needed every month, which comes from Ms. Fay’s pension.

With no assets, her 99-year-old mother does qualify for nursing care paid by Medicaid. However, Ms. Faye has made the decision not to go that route. She considers herself fortunate to have a living mother with a good sense of humor who appreciates what her daughter has done and is doing for her.

A study being conducted on the relationships of 120 parents who are 90 and older and children who are 65 and older found that many late-in-life caregivers suffer from their own failing health, which can worsen with the stress, physical tasks and isolation that accompanies caregiving. It can be tough financially, when retirement funds are needed for caregiving. If the child does not have a good relationship with the parent, it can become toxic.

It may be helpful to seek professional advice to find out what financial and caregiving resources are available. Children who are draining their own retirement savings should consider a nursing home that accepts Medicaid. A geriatric care manager will be able to help estimate the costs of different types of care a parent may need over time, and a financial advisor can assess how much the caregiver can afford before their own retirement is at risk.

Reference: The New York Times (June 27, 2019) “At 75, Taking Care of Mom, 99: ‘We Did Not Think She Would Live This Long.’”

Retirement-Age Workers Crack the 20% Mark

At some point last century, single income families vanished.  It now seems the idea of Americans being able to retire after age 65 may be headed in the same direction. For the first time in 57 years, the participation rate in the work world of people of retirement age has gone to more than 20%, says Crain’s New York Business in the article “America’s elderly are twice as likely to work now than in 1985.”

As of February 2019, the ranks of people who are 65 and older who are retirement age and either employed or seeking employment has doubled from a low of 10% in 1985. The biggest group of older workers? Those who have a college degree. The share of employees age 65 and older with at least an undergraduate degree is now at 53%, up from 25% in 1985.

The dramatic increase has pushed the demographics inflation-adjusted income to an average of $78,000, which is 63% higher than what older workers earned in 1985. By comparison, American workers below age 65 saw their average income increase only by 38% over the same period.

A study by United Income, which drew on data from the Census Bureau and the Bureau of Labor Statistics, shows a mismatch between older workers who need the money the most and those who are college educated and still working.

The wealthier, college-educated workers who are in better health are working, but the less-educated workers are more in need of the income.

The Bureau of Labor Statistics expects the aging baby boomers to continue to represent the strongest growth in the labor force participation through 2024. At that point, they’ll be between 60–78. Many will likely continue to work, even after starting to receive Social Security benefits.

The outlook for retirement for all Americans is not great. Most people will need at least 80% of their pre-retirement income to maintain their lifestyles, when they stop working. Social Security only covers about 40-50%. The typical worker on the bottom half of the income distribution has no retirement savings and is completely dependent upon Social Security.

People in the middle range have a median of $60,000 saved, so they are not really prepared for retirement either.

The top 10% of earners have a median amount of $200,000 saved. While this number does not include real estate or other tangible assets (and it does not include any potential inheritances), they aren’t fully ready either.

With most experts recommending people have at least $1-2 million saved to retire comfortably, it’s no wonder that most Americans will be working well into their so-called “golden years.”

Reference: Crain’s New York Business (April 22, 2019) “America’s elderly are twice as likely to work now than in 1985”

The Big Eight: Don’t Risk Your Retirement with These Mistakes

During our working lives, we have a cash flow called a “paycheck” that we rely on. A similar cash flow occurs when we retire and start the process of “deaccumulation” or creating income streams from sources that include our retirement funds. However, generating enough income to enjoy a comfortable retirement requires managing that cash flow successfully, says CNBC.com in the article “Here are 8 costly retirement mistakes to avoid.”

Preparing for the risk of a bear market. If markets take a nosedive the year you retire and you stick with your plan to withdraw four percent from your portfolio, your plan is no longer sustainable. Better: have an emergency fund in place, so you don’t have to tap investment accounts until the market recovers.

Investing with inflation in mind. We have been in such a low inflation environment for so long, that many have forgotten how devastating this can be to retirement portfolios. You may want to have some of your money in the market, so you can continue to get rates above any inflation. If inflation runs about 3.5% annually, a moderate portfolio returning 6% or 7% keeps up with inflation, even after withdrawals.

Be ready for longevity. Worries about outliving retirement savings are due to a longer overall life expectancy. There’s a good chance that many people alive today, will make it to 95. One strong tactic is to delay taking Social Security benefits until age 70, to maximize the monthly benefit.

What about interest rates and inadequate returns on safer investments? This is a tricky one, requiring a balance between each person’s comfort zone and the need to grow investments. Current fixed-income returns lag behind historical performance. Some experts recommend that their clients look into high-dividend stocks, as an alternative to bond yields.

Prepare NOT to dump stocks in a temporary downturn. Without strong stomachs and wise counsel, individual investors have a long history of dumping stocks when markets turn down, amplifying losses. We are emotional about our money, which is the worst way to invest. Try working with a financial advisor to remove the emotion from your investments.

Don’t withdraw too much too soon. It looks like a lot of money, doesn’t it? However, even 4% may be too much to take out from your investments and retirement accounts. It all depends upon what other sources of income you have and how markets perform. Be careful, unless going back to work in your seventies is on your bucket list.

Prepare for cognitive decline. This is way harder to conceive of than inflationary risks, but it becomes a real risk as we age. Even a modest level of age-related cognitive impairment, can make managing investments a challenge. Have a discussion with family members, your estate planning attorney and a financial advisor about deciding who will manage your investments, when you are no longer able.

Are you ready for health care costs? If at all possible, wait until 65 to retire, so you will be eligible for Medicare. Even when you have this coverage in place, there may still be considerable expenses that are not covered by Medicare. If you don’t have long-term care insurance, get it as soon as possible.

Reference: CNBC.com (March 5, 2019) “Here are 8 costly retirement mistakes to avoid.”

Are You Retiring in 2019? Here’s What You Need to Know

There are more than few steps you’ll need to complete, before packing up your desk, cubicle or locker and saying good bye to your work family. Even if your 401(k) and IRA is in order, there are things you need to during the last few months of working, says Next Avenue in the article “Tips to Prepare for Retiring This Spring or Summer.”

There’s detailed planning, organization of documents, and additional financial details that need attending. You may also want to start creating your “bucket list” — a list of things you’ve always wanted to do, but never had the time to do while you were working. Getting all of this in order, will speed your waiting time and prepare you better, when the last day of your working life does finally arrive.

Whether you are three months or six months from retirement, here are some tips for your to-do list:

Social Security. Figure out when the best time for you to take Social Security benefits will be. Can you delay it until age 70? That’s when you’ll get the biggest payout. The earlier you start collecting benefits, the smaller your monthly check will be. Take it early, and you are locked in to this lower rate.

Health Care. Figuring out how to manage health care costs, is the single biggest worry of retirement for most Americans. An injury that puts you in a nursing care facility can make a huge dent in your retirement funds, even if it’s just for a short while. This is the time of your life, when focusing on your health is most important, even if you’ve been careless in earlier decades. Evaluate your health status and get check ups with your regular physician and your dentist.

Investments. Check with your HR department about when you’ll need to roll over your 401(k) plan. If you transfer the funds into a low-cost IRA, you may save in fees. Work with your financial advisor to determine what your withdrawal rate will be. You may need to reevaluate some of your retirement goals or consider working part time during retirement for a few years.

Medicare. If you’re almost 65, you can start enrolling in Medicare now. The government lets you start the process within three months of your 65th birthday. Start this process, so you are covered, once you are not on the company’s health care plan.

Expectations. The first six months to a year of retirement can be both wonderful and terrible. While enjoying freedom, many people find it hard to withdraw money from the same accounts they spent so many years building. What if they don’t have enough for a long life? Take a realistic look at your lifestyle, budget, and spending habits, before you retire to make sure you are financially ready to do so. If you think you might work part time, look into the positions that are available in your area and what they pay.

Lifestyle. Often, we are so busy planning for the financial side of retirement, that we forget to plan for the “soft” side: what will you do in retirement? Will you volunteer with an organization that has meaning for you? Write the novel you’ve started on a dozen times? Spend more time with your grandchildren? Travel? What will make you feel like your time is being well-spent, and what will make you fulfilled?

Don’t forget the legal plan. Retired or not, you need to have a will, power of attorney, and health care power of attorney to protect your family, whether you are preparing for retirement or in the middle of your career. Speak with an estate planning attorney to ensure that these important documents are in place.

Reference: Next Avenue (March 6, 2019) “Tips to Prepare for Retiring This Spring or Summer”

Challenges for Women Facing Retirement are Especially Daunting

Add to the challenges facing women in retirement are the rising costs of health care, as well as other deeply-rooted economic factors, says Next Avenue in the article “What Could Help Women Facing financial Challenges for Retirement.” This issue is top-of-mind for many, with a focus from the Senate and the EBRI pushing this public policy matter into the spotlight.

The barriers for women to accumulate wealth are very real. At the Senate hearing, Linda Stone, a WISER member (Women’s Institute for a Secure Retirement) presented some hard facts: there are 5.7 million more women than men at age 65, and of those who are over 85, 67% are female. One out of two women alive right now, will live until age 90. However, many people over age 85, and especially women, end up living in poverty or in near poverty, even if they were never poor throughout their lives.

The longer lifespan of most women comes with a resulting need for more income. Women traditionally have nine years with zero earnings, usually because they are rearing children or caring for elderly parents. Women’s careers also average 29 years compared to 39 years for men.

The gender mortality difference and the tendency for women to marry older men, leads to them outliving their partners and be more likely to live alone. This increases their chances of descending into poverty. Couples’ finances are also often exhausted by caring for the husband’s medical needs.

How can women be helped to achieve financial security in retirement?

  • Study ways to offer retirement protection to women, who spend significant time as caregivers, including considering providing Social Security credits for those years.
  • Encourage employers to offer retirement plans.
  • Allow part-time and temporary workers to participate in employer-sponsored retirement plans.

A briefing presented by the EBRI looked into the reasons why women tend to save less than men. The program referenced a blog post from Kimberly Blanton, of the Boston College Center for Retirement Research, which noted that “if the difference between paychecks for men and women is a gap, then the difference in wealth can be described as a chasm.”

The median net worth for women age 45 to 65 adjusted for inflation has actually declined in recent years. Older women of color have seen the largest decline in their net worth. The study was conducted by the University of Pennsylvania’s School of Social Work and the nonprofit Asset Funders Network.

The takeaway: there is a strong need for more public policy initiatives to help women save more for retirement.

Reference: Next Avenue (February 12, 2019) “What Could Help Women Facing financial Challenges for Retirement”