Because women live longer, require more care and tend to be the primary caregivers in their families, long term care falls disproportionately on their shoulders.

Yet according to a recent survey by Genworth Financial women face challenges talking to their families about putting together a financial strategy to deal with long term care. Genworth’s survey found that 72% of women said that the biggest barrier to starting this conversation is the concern about upsetting family members, compared with 57% of men that voiced the same worry. Needless to say, seven out of 10 will need long term care in their lifetime.

Despite the difficulty in having these tough conversations, long term care is a hot button issue given that it is likely to be the greatest retirement expense facing Americans today. And as individuals continue to live longer the issue will only get worse. The number of persons aged 65 or older is expected to double in the next 20 years; there will be 110 percent more people 80 or older, according to the U.S. Census Bureau. The U.S. Department of Health and Human Services report that at least 70% of people over age 65 will require some long term care services at some point and more than 40% will need care in a nursing home.

The truth is that the cost of long term care has skyrocketed as well, increasing for the sixth consecutive year, with most of these increases outpacing inflation, according to Genworth Financial’s Cost of Care Survey conducted in April 2009. Genworth found that the national average median cost of one year in a private nursing home room is $74,208.

Yet families often think that health insurance and Medicare will cover these costs. But they cover almost none of the cost of nursing homes, assisted-living facilities or in-home care.

In fact, Olympic Gold Medalist Wendy Boglioli, who is now a spokeswoman for Genworth, said in a phone interview on Wednesday that not having long term care insurance can be a real danger for women. Women already take 11 years out of the workforce, she said, to take care of children and families, which means their retirement savings tends to be smaller, putting them at risk for outliving their retirement. And 90% of women will be solely responsible for their finances at some point in their life.

That is why it is important for advisors to talk to women about the options available to them to pay for long term care costs. Boglioli said the options are: count on family, welfare (for the indigent and poor), self-insurance, and a long term care policy.

“What I have seen in my experience in this industry is that families are either brought together or ripped apart by these decisions,” said Biglioli. “Having a long term care strategy in place and having it in writing gives a family more resources. Without a strategy you are voluntarily putting your family at risk to make huge decisions financially, physically and emotionally.”

How can advisors help their clients to strategize?

The first question to ask a client: What portion of your portfolio do you want to allocate to pay for your care?

Second, is to make sure clients understand that long term care costs will only continue to rise.

And lastly, make sure that clients realize that the top two risks for their retirement portfolio are: the rising cost of healthcare and outliving their income.