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Project GAMES (Gambling Awareness Made Especially for Seniors)

Disruptive Innovations
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In 2004, the Pennsylvania legislature legalized casinos. This allowed casinos to offer class 2 gaming which is essentially low risk games such as bingo. In 2010, legislation was passed to allow for class 3 gaming. Casinos immediately installed slot machines, poker, black jack, and roulette tables, etc. Since then, more than 10 casinos now populate Pennsylvania.

Accessibility to gambling has significantly increased not only in Pennsylvania but around the country. Currently 44 states, Puerto Rico, D.C. & U.S. Virgin Islands have lotteries, 38 states have casinos, 44 states have pari-mutuel betting, 28 states have off track betting, and three states have internet gambling (Council on Compulsive Gambling of Pennsylvania www.pacouncil.com).

Gambling has developed over the years to more than just Las Vegas and Atlantic City. It’s everywhere including state lotteries, race tracks, sporting events, slot machines, bingo, and the internet. According to the American Psychological Association, the internet can be as addictive as alcohol, drugs, and gambling. As a matter of fact, internet gambling has almost doubled every year since 1997 and has reached more than $2 billion in 2001.

Although gambling commonly starts as nothing more than a social activity, it can quickly evolve into an addiction. Gambling Addiction Prevention is designed to address safe gaming among seniors. Older adults are more vulnerable to gambling addiction. As they transition into retirement age they face more life changes than most. For example, the loss of a spouse and/or friends, health issues, boredom, chronic pain, and loneliness. In fact, gambling can become an escape for depression, boredom, and loss of identity after retiring from a life-long career. Some even perceive gambling as a way to supplement their retirement income as they may receive free money to play, access to food buffets, gifts and hotel rooms, etc.  

In 1998, the National Gambling Impact Study Commission reported to the President and Congress that the most substantial increase in gambling was among those over 65 years of age. Although the past few years have demonstrated that youth are quickly becoming one of the most susceptible age groups, seniors are still very vulnerable and here’s why:

  • Seniors are gambling away retirement savings and don’t have the working years necessary to make up the losses.
  • They may not understand addiction, making it less likely that they will identify a gambling problem.
  • They are often less willing to seek help than younger adults.
  • They could be hiding a gambling problem due to the stigma associated with it and the fear of losing their independence. 
  • The absence of screening for gambling pathology by medical providers.
  • Easy access to gambling and the time to visit casinos. In addition, seniors are the largest age group the casinos target with their advertising.
  • Possible cognitive impairments that may interfere with decision making abilities.
  • Medications used for chronic conditions such as Parkinson’s disease and Restless Leg Syndrome significantly increase the risk of developing a gambling addiction. 

Gambling addiction is a wide spread community health issue. According to the National Council on Problem Gambling “2 million (1%) of U.S. adults are estimated to meet criteria for pathological gambling in a given year. Another 4-6 million (2-3%) would be considered problem gamblers; that is, they do not meet the full diagnostic criteria for pathological gambling, but meet one or more of the criteria and are experiencing problems due to their gambling behavior…”.  Problem gamblers also have higher rates of suicide, divorce, and criminal activity than non-gamblers. In addition, it’s not uncommon for compulsive gamblers to have other addictions such as alcohol or substance abuse. According to statistics it isn’t unusual to find people in drug and alcohol treatment programs whose chief addiction is later identified as gambling.

In 2010, the Bucks County Area Agency on Aging (BCAAA) was invited by the Bucks County Drug and Alcohol Commission, Inc. (BCDAC) to attend their gambling needs assessment committee meeting. A county-wide needs assessment was conducted and gambling prevention funding was identified through a state grant. 

At this time BCAAA wrote a proposal to create a gambling prevention program specific to older adults to begin in 2011. A half-hour educational program called Project GAMES (Gambling Awareness Made Especially for Seniors) was written. The purpose of the program was to teach the warning signs of problem gambling, dispel myths, and suggest tips for safe gaming. In addition, educational material would be disseminated at local health fairs. Funding was used for administrative time, printing educational material, supplies, etc.

What we didn’t anticipate was how unwelcomed the program would be by this age group. As a matter of fact, it was completely rejected. All conversation and educational information was avoided by the majority of older adults. We were unable to recruit volunteers to help facilitate the program, and were unsuccessful at getting an invitation to present the educational piece anywhere in the County. It wasn’t until 2014 that a presentation was facilitated and soon after, this model of education was removed from our gambling prevention program.

Resources available at senior health fairs was ignored. Participants were observed putting material back on the table once they realized the topic. In one particular instance, a woman was seen scolding her husband for picking up a brochure and told him to put it back, which he did. It was discovered that the only way to hand educational material out was to stuff it in a bag and then offer a free bag to attendees. In our quest to have more meaningful interactions and draw attention to our table, a trivia wheel was purchased in 2016. Participants were invited to spin the wheel and then were asked an educational question about gambling prevention. It didn’t matter whether their answer was right or wrong, the participant was given a bag of resources. This method was so successful that a line formed in front of the table with seniors waiting their turn to spin the wheel. Not only was this a great way to increase interaction, but we realized those waiting in line were listening to all the educational information given to each person. This meant they were receiving more educational information than just what they would’ve received during their own turn to spin!

In 2013, BCAAA proposed an educational gambling conference as part of our gambling prevention program. This free training is designed for front line professionals and staff serving clients with addictive behaviors. These professions include, but are not limited to: family practice health professionals, adolescent and geriatric medicine health professionals, registered nurses, public health nurses, school nurses, mental health specialists, social workers, psychologists, addiction/treatment counselors and specialists, teachers and administrators, prevention specialists, peer specialists, and clergy. The first gambling conference was held in June 2013 and offered the 38 registrants Continuing Education Credits for Social Worker through the National Association for Social Workers (NASW-PA), RN’s and School Nurses through the Pennsylvania Department of Health, along with Advanced National Council Certification credits through the Council of Compulsive Gambling of Pennsylvania. In later years, Pennsylvania Certified Board (PCB) credits through BCDAC were also offered. By 2017, Gambling Conference registrations increased to 70. Funding is used to pay administrative costs, speaker fees (speakers are supplied by the Council on Compulsive Gambling of Pennsylvania, Inc.), food, adverting, printing, supplies, etc.

Looking ahead to 2017-2018, we will continue to use the health fairs and gambling conference programs, however some new components will be added to our prevention work. 

In a new pilot called Trips ‘N Tips, an educational video will be played on all available buses traveling to a casino identified through the local senior centers. This 14-minute video by Fanlight Productions is titled “When Gambling Is No Longer Fun” and tells the stories of three former older adult compulsive gamblers. Each participant will also receive a free bag of resources. If the program is successful it will open the door for other health & wellness programs to play videos of a variety of topics during bus rides. The one challenge we may experience would be whether all the buses have the necessary equipment to play a DVD.

The other new addition to the program will be gambling screening questions that are added to the end of state program registration forms. There are quite a few evidence-based health & wellness workshops facilitated by BCAAA. Each workshop requires a registration form that asks for a variety of information including specific health questions. By adding a few preselected gambling screening questions, we will be able to start collecting data about older adults in Bucks County. All participants will be given a 1-800-Gambler card. Those who self-identify risky behaviors and request more information will be referred to a professional screener that has been predetermined through a partnership with the Council on Compulsive Gambling of Pennsylvania, Inc.

The message we will focus on promoting is that of a neutral stance -- that we are not for or against gambling. We well understand that older adults enjoy activities such as casino trips, bingo, and raffle tickets. Our prevention work is strictly that of providing education, increasing awareness, and when needed, providing an appropriate referral. This position will allow for more effective communication within the older adult population.

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Issue 39 | Disruptive Innovations