December is the month when tax-planning professionals tell their clients to maximize their deductions and minimize income as much as possible in order to reduce their income taxes. This means making contributions to churches, other charities, and IRA’s.

And for those who have taxable estates (now anything over $2 million per person), tax professionals suggest, among other more complicated strategies to reduce estate taxes, making gifts of the annual exclusion (now $12,000 per person). In this way, for example, an individual can give away $12,000 to as many people as he or she desires without affecting his/her lifetime gifting limit. And, by using gift splitting, a husband and wife can give away $24,000 to as many individuals as they desire.

However, the vast majority of those who read NextSteps are not among the one percent or so of our population who are concerned with estate taxes. Our readers seldom ask about strategies to reduce income and estate taxes but, instead, are concerned with how to meet increasing prescription, medical, insurance, and living costs on fixed incomes; how to make sure that if one of them requires long-term care, the other won’t become destitute; and how, in the final analysis, to make sure each is provided the best quality of life available.

Based on our reader responses, we are seeing less concern about passing assets to children and gifting, and more about whether they will outlive their money. This type of thinking is a paradigm shift from the way your parents and ours planned for retirement, trying to make sure that they passed something on to their children. Today, it appears, seniors have more debt than ever and are more concerned about self preservation than generosity during life or at death.

Still, most folks are not sufficiently informed about how to plan, as is pointed out in some of the repetitively asked questions we receive:

1. "Why do I need to plan? Won’t Medicare will pay for my nursing home care?"

2. "The nursing home told us that once Mom’s money is gone, she will qualify for Medicaid. Is this true?"

3. "My second husband and I have a premarital agreement. Doesn’t this mean that I won’t be responsible for the cost of his nursing home care or his medical bills?"

4. "If I let Medicaid pay for my wife's nursing home care, will she receive the same quality of care she receives as a private pay patient?"

5. "I hold my Dad’s power of attorney. After he got sick, I used it to make gifts of all of his property to myself, my brother, and my sister. He is going into a nursing home. Will this affect him qualifying for Medicaid?”

6. "The nursing home told me that since my father was no longer making progress, they would have to stop therapy services. Is there anything I can do to make sure he gets continued therapy? "

7. "After we filed a Medicaid application for our mother, the nursing home told us they were going to discharge her because they do not accept pending Medicaid applications as payment. Can they do this?"

8. "I heard that there was little we could do to plan for the potential of a nursing home stay until my husband and I become incapacitated. Is that true?"

9. "Everything my parents acquired is in my father’s name. He had a stroke and will be in a nursing home. Does this mean that all the property he and Mom accumulated will have to be paid to the facility before he will be able to qualify for Medicaid and that she will have nothing?"

If you are not able answer these questions, you should consult a qualified attorney who can help you make plans appropriate to your situation.