U.S. Trust's "2013 Insights on Wealth and Worth" found that family health has emerged as the new risk to family wealth.

Long-term care and out-of-pocket health-care costs, combined with financial support for extended family, are weighing heavily on families, particularly women and younger generations, yet are risks to wealth that are not well reflected in financial planning.

U.S. Trust recently published findings of a survey of 711 high net-worth adults in the U.S. with more than $3 million in investable assets, which found:

47 percent of all respondents have created a financial plan to address long-term care needs that they and their spouse or partner might need, but only 18 percent have a financial plan that accounts for parents' long-term care costs.

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27 percent of baby boomers and 16 percent of those who are older than 68 say they never expected their parents might turn to them for financial assistance. Yet, one-third of Generation X and nearly half (46 percent) of Generation Y expect their parents or in-laws to rely on them for financial assistance at some point in their lives.

63 percent of wealthy people feel responsible for financially supporting their parents or in-laws if needed, even if it jeopardizes their own financial security, and 55 percent feel a responsibility to provide financial assistance for less financially fortunate siblings if they were to need it. Fifty-six percent of wealthy parents say they provide financial support to their adult children.

46 percent of respondents have provided substantial financial support (not a loan) to adult family members other than their own spouse or partner. Two-thirds (69 percent) do not have a financial plan that accounts for the financial needs of any of these other adult family members.

"Insights on Wealth and Worth" found that the wealthy have a heightened sense of financial security and have shifted their investment priorities from asset protection to asset growth. Yet their well-documented aversion to risk still prevails. Lower risk trumps the pursuit of higher returns as a priority in managing their wealth.

"The majority of people we surveyed grew up in middle-class families and created their own wealth. They don't see themselves as wealthy, and many are unaware of risks and circumstances that grow increasingly complex as wealth accumulates," said Keith Banks, president of U.S. Trust. "The wealthy have been disciplined about protecting their assets from market loss, but may have a false sense of financial security. They are not adequately planning for family health concerns or for the retirement that they want. We need to shift the conversation about wealth management to these important topics and expand their understanding of risk."

Key findings are:

88 percent of people surveyed say they feel financially secure right now, and 48 percent feel even more financially secure today than they did five years ago. Those who don't feel confident about their future financial security are more likely to be women, members of Generation X (adults aged 33 to 48) and households on the highest tier of the high net worth segment, all of whom share a primary concern about income in retirement.

60 percent high net worth investors say asset growth is a higher priority than asset preservation, a reversal of goals from a year ago when nearly six in 10 (58 percent) said that asset protection was more important. Yet, nearly two-thirds (63 percent) still say that reducing risk and achieving a lower rate of return is more important than pursuing higher returns by increasing risk.

56 percent of high net worth investors have a large amount of funds still sitting in cash accounts. Only 12 percent are content leaving their cash on the sidelines, yet few (16 percent) have immediate plans to move it. Two in five plan to gradually invest cash holdings over the next two years, and 35 percent have no plans to invest it.

57 percent of respondents say that pursuing higher returns regardless of the tax impact is a higher priority than minimizing taxes. Only 34 percent feel very well-informed about the impact of recent tax law changes on the total return of their investment portfolio.

37 percent of respondents, including 42 percent of men and 30 percent of women, feel very well-informed about how the tax law changes affect their income. And two in three respondents do not feel well-informed about strategies available to them to help minimize the impact of taxes on income, investments or their estate. Nearly seven in 10 (69 percent) of high net- worth investors aren't changing investment strategy in order to minimize taxes.

86 percent agree that a long-term buy-and-hold approach still is the best growth strategy, with 35 percent strongly agreeing with this.

62 percent of high net worth households, including 52 percent of those still working, are very confident they will have sufficient income in retirement, in contrast to the rest of the U.S. population.

Only one in three high net worth adults under the age of 49 envisions working beyond age 65. Meanwhile, six in 10 baby boomers, many already of retirement age, now have plans to work beyond age 65.

Once retired from their current occupation, 11 percent of respondents say they are likely to continue working full-time in a new endeavor and 41 percent expect to continue working on a part-time basis. More than half (54 percent) of the wealthy would like to spend time volunteering.

Only one-quarter of all survey respondents attribute the majority of their wealth to an inheritance. Those who have inherited wealth are more likely to want to leave an inheritance themselves. Seventy-seven percent of people who inherited the majority of their wealth, and 63 percent of those who earned it, consider it an important goal to leave a financial inheritance to the next generation.

Two in three baby boomers do not expect to receive an inheritance; 57 percent of adults under the age of 32 do expect an inheritance. Sixty-four percent of baby boomers, compared to 78 percent of adults younger than age 32 and 72 percent of those over age 68, think it's important to leave an inheritance.

88 percent of parents agreed that their children would benefit from discussions with a financial professional. One in three (31 percent) respondents received formal financial training themselves from a professional advisor. Yet only 16 percent of parents have provided, or have plans to provide, their children with access to formal financial skills training.

two-thirds of wealthy parents say they would rather have their children grow up to be charitable than to be wealthy.

89 percent of wealthy parents believe their children appreciate the value of a dollar and the privileges of growing up in a family with good fortune.

65 percent of wealthy households surveyed own investments in some type of tangible asset, ranging from real estate to oil and gas properties to farmland, a trend particularly evident among younger investors. One-third (35 percent) of investors under the age of 32 say that tangible investments are important to their overall wealth strategy given the current tax, political and economic environment.

six in 10 wealthy individuals feel that they can have some influence on society by how they invest, and 45 percent agree that it's a way to express their social, political and environmental values. Nearly half (46 percent) of respondents feel so strongly about the impact of their investment decisions that they would be willing to accept a lower return from investments in companies that have a greater positive impact. Forty-four percent would be willing to take on higher risk.

59 percent high net worth individuals dedicate a portion of their wealth to the collection of valuable assets such as such as fine art, watches and jewelry, antiques, fine wines and rare coins and books or classic and high-performance cars.