Five million in assets isn’t what it used to be.

Retirement care expenses, market volatility and other costs have made a small fortune seem even smaller, and advisors should be prepared to take into account changing threats to their clients’ wealth, according to a recent study from UBS. Only 28% of clients with between $1 million and $5 million in investable assets- enough to be considered high net worth- reported that they considered themselves wealthy.

Lisa A. Chapman, a senior vice president with UBS in Long Beach, Calif., said the perception is not too far from reality. “Life has changed,” she said. “Cost of living has gone up. Rates of return have gone down in fixed income and stocks compared to what they were. You really have to change your outlook and your game plan.”

It should be something of a reality check for advisors as well, requiring them to become more focused on the larger financial planning picture and take into account different threats that can quickly drain even some of the more sizable client accounts, Chapman said. On her team of six, Chapman is one of three who holds a Certified Financial Planner designation and a fourth is in the process of being certified.

The first wake-up call for her and clients is recognizing what percent of those millions are locked away in retirement accounts and have yet to be taxed. Clients put money into an Individual Retirement Account pre-tax, for example, and by the time they are ready to retire, they are in a much higher tax bracket and withdrawals can be costly.

“If you have a million in an IRA and if you have to live on that IRA, it’s not really a million at the end of the day,” she said.

The clients polled for this survey, all of whom had at least $250,000 in investable assets, have also become more concerned with paying for health care for themselves and other generations in their family. Four out of five of the investors surveyed provide financial support for adult children or parents, and one in five said they shared a home, for example.  Thirty-six percent of respondents said they were not prepared for long-term care. Of investors between the ages of 25 and 49, 41% said they wanted guidance from advisors related to affording healthcare after retirement.

“That’s what’s eating into the estate is the cost of care,” Chapman said. “Now they’re more aware. Now they’re looking like, ‘I’m going to have to carry these people.’”

While many still did not consider themselves wealthy, 85% of investors said they felt confident in their estate when they worked from a financial plan that took into account long-term health expenses and providing support for other family members.

“There are more variables than there used to be,” Chapman, who has been a CFP since 1990, said. “The planning has gotten much more complex.”

Tell us what you think. How much money makes you wealthy?