As Seniors Gamble for Fun, Some Find Only Trouble

15 April 2014 Author  Melinda Miller

ginaAfter skipping doctor’s appointments for months, Gina’s father was diagnosed with Stage 4 cancer in January. That’s when she realized he had other problems, too.

While helping arrange her dad’s medical care, Gina obtained power of attorney to manage his finances during his hospitalization and recovery.

Parkinson’s Drug Feeds Gambling Addiction

The study of Parkinson’s disease, and how the brain sends signals for movement and mood, also is shedding light on the physiology of gambling.

When patients being treated for Parkinson’s developed gambling addictions, it didn’t take long to find the link.

“There are many groups of dopamine receptors in the brain,” explains Jian Feng, a neurologist and professor in the University at Buffalo’s School of Medicine & Biomedical Sciences: “One type controls locomotion, one controls the normal cognitive state - when that is not working right, you might see schizophrenia - and the third group affects reward behavior.”

Parkinson’s results from the death of dopamine neurons in areas associated with locomotion. The illness is commonly diagnosed when people are in their 60s, Feng said, although its onset could be earlier.

Drugs called dopamine agonists, such as pramipexole (brand name Mirapex) and ropinirole (Requip), help restore connections in those receptors, calming the tremors associated with the illness and giving the patient more movement control.

But they affect the entire brain, not only the locomotion areas, which is why, Feng said, they can have unwanted side effects on personality.”

Feng said that when a person experiences an unexpected reward, like a $50 slot machine win, dopamine triggers a pleasure response. The brain wants to repeat that experience, so it signals the impulse to keep gambling. The very randomness of the reward is what heightens the pleasure, and medication that enhances a patient’s reception to dopamine heightens that pleasure even more - it can make him crave it.

“It’s addictive behavior,” Feng said. “The other aspect is gambling itself. It is basically an addictive thing.”

Mayo Clinic researchers in 2011 estimated that more than 20 percent of patients on Parkinson’s medications also experienced problems with impulse control - including a sudden, compulsive urge to gamble. (Other problems could be hypersexual behavior, binge shopping or overeating.) Indications are that the higher the dose of medicine, the greater the chance a patient will experience the side effects.

Gina’s full name is not being used to protect her father’s privacy.

“So, I’m going through his papers and his bank accounts,” Gina said, “and I see he has $18 in the bank, and ATM withdrawals showing he was going to the casino every three or four days.”

Risked Income—and Home

In one week in January, her 83-year-old father gambled away his entire monthly income from Social Security and a small pension.

And that still wasn’t the worst of it. It looks like he will lose his home.

“He hadn’t paid his mortgage payments for 16 months, and his house had gone into foreclosure,” Gina said.

Gina doesn’t know when her father started casino gambling. She gets no answers from him, she said.

“He just fluffs it off.”

Problem gambling, while affecting a small percentage of total gamblers, is growing among people age 60 and older, a key customer base of the burgeoning casino gambling industry in Western New York. With bus trips from senior centers and casinos opening not just here, but across the country, gambling is easier than ever for retirees to pick up and, for a vulnerable minority, a hard habit to quit.

Seniors may not be more likely than other age groups to have a gambling problem. A 2012 study in Ontario indicated seniors are somewhat less likely to get addicted than younger gamblers. But they are not immune, and as more casinos create more gamblers, they also create more problem gamblers of all ages.

“Not everyone develops a problem, but for those who do, it can be quite devastating,” said David M. Ledgerwood, a researcher at Wayne State University and a clinical psychologist who has seen firsthand the harm of gambling gone wrong with several casinos in the Detroit-Windsor, Ont., area. “And a big factor I’ve found is bereavement. An older gambler who has lost a loved one might play for hours so they don’t have to think a lot. It’s soothing, in a way.”

‘The New Senior Centers’

Some people refer to casinos as “the new senior centers,” and a visit to the Seneca Buffalo Creek Casino might show why.

It was a recent Wednesday afternoon, but the casino was so full you might have thought it was a busy Saturday night.

The gambling tables were buzzing and the rows of slot machines were chiming as the credits rang off. Almost all of the folks at the slots and half those at the tables would qualify for AARP membership.

When asked, many seniors say they would like to win but don’t count on it. One after another, they say they go to the casinos for “something to do” and a chance to have a little luck.

But they also make grim jokes about what the casinos take.

At the Seneca Niagara Casino and Hotel, the morning gamblers – almost all seniors – pile into the lunchtime buffet and say they plan to “eat up” their losses. A gray-haired woman whose jacket bears the casino’s logo laughs when asked if it was free.

“Ha! Free! I’d say I only paid about the price of a car for it over the past two years,” she said.

In 2008, Wayne State researchers found the prevalence of problem gambling in 10.4 percent of people older than 60 in the Detroit-Windsor area, where they have easy access to four casinos. The study concluded that gambling could become a serious health problem for seniors, particularly those who are alone and have incomes below $20,000.

“With the recently retired, or those in their late 70s, there are a few things that stand out as risks,” Ledgerwood said. “One, exposure to gambling, which happens as more casinos open; two, they may or may not have things to fill the free time of retirement; three, if there is a decline in health, going to a casino and gambling is easier than other activities.”

What’s more, medications may also increase the propensity for gambling. Some medications for Parkinson’s disease – mostly prescribed to seniors – can trigger obsessive behavior, including gambling addiction, in 10 percent or more of those who take it.

No Refunds Allowed

Losses can be hard to comprehend for consumers accustomed to legal protections when they overspend. Laws give people a “cooling off” period to back out of contracts, and stores let shoppers with buyer’s remorse return their purchases.

There is no procedure allowing a gambler to get a refund from a slot machine.

“They don’t realize that you can spend a lot more money than you think you’re spending, very easily,” said Renee C. Wert, a Buffalo therapist who treats addiction problems of all kinds.

Most clients she sees thought they were just having a little fun before their gambling habit went south, she said.

But when they do overspend, regret kicks in, and the hole keeps getting deeper the more they dig.

“A lot of people think, ‘If I just keep going, I can win the money back,’ ” Wert said. “And they might win it back and then walk away thinking, ‘OK, that’s how to do it!’

“But the next time, and the time after that, it doesn’t work.”

Admitting to gambling away money you couldn’t afford to lose is never easy, and for seniors it can be especially hard. The players can feel like losers personally as well as financially.

“It can be difficult to ask for help. They’re pretty embarrassed about it,” Wert said. “For all their lives, they’ve been responsible and handling their money, and all of a sudden they find themselves in debt because of gambling. It can really sneak up on them.”

Only Did Scratchers Before

That’s what happened with Gina’s father.

“He was a mechanic his whole life,” Gina said. “He worked until he was, like, 70. He didn’t gamble. Just scratch-off tickets. I would see those sometimes.”

Her parents divorced when she was a child, and Gina didn’t see her father often, but she tried to stay in touch. Recently, he was making that harder, not answering his phone, not wanting her to visit.

When she forced the issue around the holidays, she found out why. His life revolved around gambling. His house was unkempt, he had no food, and he had a pile of overdue bills.

“He never told me anything about this,” Gina said. “Anytime I called, he said everything was fine.”

That first doctor’s visit in January was only the beginning, Gina said. Her father was ignoring other health problems, too. She found overdue bills for medical co-pays and presumes her father was avoiding doctors because he didn’t want to pay the $45.

“He would rather spend it at the casino,” she said.

This is Part 1 of a series. Melinda Miller wrote this article for the Buffalo News with support from a MetLife Foundation Journalists in Aging Fellowship, a program of New America Media and the Gerontological Society of America.