Broward Older Adult Compulsive Gambling Pilot Project

Slide 1:Broward Older Adult Compulsive Gambling Pilot Project Stephen Ferrante, M.S.W. Broward Co. Elderly & Veterans Services (954) 537-2805

Slide 2:Purpose of Presentation Research and Theory to Practice Project Development Project Implementation Project Outcomes “Findings”

Slide 3:Broward Pilot History 8/03 - Joint FCOA Workshop 10/03 – Florida Coalition for Optimal Mental Health and Aging Conference 11/03 – Florida Council on Compulsive Gambling Think Tank Subcommittee Meeting 12/03 – Proposal Submission 1/04 – Concept Approval 3/04 – 1 Day Conferences & Local Media 4/04 – Pilot Implementation

Slide 4:Why Initiate Collaboration & Pilot Prevalence Study Results Typical Older Adult Gambler in South Florida Typical Older Adult Gambler in Armed Forces Older Adult Gamblers in Need of Most Services in South Florida Broward County’s Lead Elder & Veteran Agency Agency Mission and Philosophy Enhanced Consumer Outcomes Comprehensive Assessment & Service Planning Resource Maximization & Collaboration Prevention and Wellness

Slide 5:Gambling Options in Broward County Casinos Cruises Horse Track Dog Track Jai Alai Bingo Lottery Internet Stocks Sweepstakes Private games Other:

Slide 6:Broward Pilot Goals In Collaboration with the Florida Council on Compulsive Gambling: Develop and deliver an elder specific prevention / education / outreach model Establish a bank of recreational alternatives through consumer and provider surveying Examine gaming industry incentives Provide screening in variety of settings Aide other stakeholders in assessment

Slide 7:Broward Pilot Goals – Continued In Collaboration with Florida Council on Compulsive Gambling Certify staff in compulsive gambling counseling Accept referrals from FCCG HelpLine and provide community follow-up Technical assistance with FCCG to other Florida Regions Participate with FCCG in creating an evaluation tool and other related program materials

Slide 8:Develop & Deliver Elder Specific Prevention / Education / Outreach Model Receive & Review Literature from Florida Council on Compulsive Gambling Meet with Recovering Older Adult Compulsive Gamblers Draft Curriculum with pre-test, post-test & handouts Train staff on Curriculum content Announce availability of presentation to community organizations Outreach to locations where seniors reside and congregate Pilot / Test Curriculum

Slide 9:Establish Bank of Recreational Alternatives through Surveying Create Survey Instrument Incorporate into Community Education Presentations Use Brainstorming Activity Draft and Submit Report(s)

Slide 10:Examine Gaming Industry Incentives Create Survey Instrument Incorporate into Community Education Presentations Use Brainstorming Activity Draft and Submit Report(s)

Slide 11:Provide Screening in Various Settings Train staff on Florida Council on Compulsive Gambling Screening Tools Demographic Profile Older Adult Screen Significant Other Screen Develop Consent Form Offer Screening After Community Presentations At Community Events Screen Elders in Other Agency Service Areas Initiate with Veteran Population

Slide 12:Role of Screening Aspect of wellness and prevention Taking prevention to the next level Screen as part of the group process: - promote self identification Screen through use of tool / instrument Enhances early intervention

Slide 13:Conducting Screenings Non-threatening Approach Non-threatening Setting Assessing Readiness Assuring Confidentiality Respectful Introduction Population Heavily Targeted by Gaming Industry Seeking to Gain Understanding of Activity Connect with General Wellness; Well-being Link with Other Screening, Assessment and Evaluation processes

Slide 14:Aide Stakeholders in Assessment Train Professionals on Topic Initiate Memorandum of Understanding Offer Community Education and Screening Create Simple Referral Process & Form

Slide 15:Stakeholders Engaged(through May 31, 2004) Area Agency on Aging of Broward County Memorial Hospital Senior Resource Centers MediVan Project YMCA Broward County Housing Authority United Jewish Community of Broward Hispanic Unity Catholic Charities Local Senior Centers Retirement Communities About 447 Individuals Reached

Slide 16:Some Risk Factors Associated with Older Adult Compulsive Gambling Cardiac Problems / High Blood Pressure Affective Disorders Abuse of Alcohol or Other Substances Stomach Problems Stress Suicide Risk Isolation Insomnia No Money No Food No Medication No Shelter No Support System

Slide 17:Screening Data (through May 31, 2004) Offered to 106 Older Adults including Veterans 36 Older Adult Screens Completed 2 Significant Other Screens Completed 3 Positive Screens 2 Males (56 Vet & 60), 1 Female (No Age) One Hispanic Male, Other 2 Caucasian Males = Lottery and Casino; started at 16 & 18 Males’ Income = $5 - $14,000; $45 - $60,000 Female = Lottery and Bingo

Slide 18:FINDINGS: Types of Elder Gamblers Action Gamblers Gambling for thrill, fun, entertainment Serious gambler; major hobby Chases the win, competitive More frequent in males Escape Gamblers Later Onset / Shorter Gambling Career Block emotional issue, problems, stressors, loneliness, boredom More frequent in women

Slide 19:FINDINGS: Co-occurring Conditions Differential Diagnosis High comorbidity incidence (Mood/Affective Disorders) Depression Anxiety Bipolar Disorder Similar Symptomatology & Diagnostic Criteria Careful Consideration and Assessment Dual Additions Substance Abuse and Compulsive Gambling Alcohol Consumption Typical & Acceptable Activity in Gaming Establishment Trading Addictions

Slide 20:Similarities: Substance Abuse & Compulsive Gambling Progressive Preoccupation / Escape Factor Denial / Shame / Guilt Lack of Control Chasing a “High” / Immediate Gratification Poor Self Esteem Dysfunctional relationships Poor Coping Skills

Slide 21:Differences: Substance Abuse & Compulsive Gambling Invisible addiction High is internal, not external No substance ingested / No overdose Perception/Acceptance of Disorder Far few resources / programs Little prevention activity Minimal public awareness Higher suicide attempt rate More difficult to discuss

Slide 22:Enhancing Coping Skills Education Gamblers Anonymous (Peer Sponsor) Supportive Counseling (Individual/Group) Self Management Training: A-B-C Approach Enhancing Natural Support System Role of Family / Significant Others Substitution of Healthier Activities that Meet Same Need INDIVIDUALIZATION Other:

Slide 23:Keeping Gambling Recreational Know how much money one can afford to spend and lose Treat winning as a bonus Do not gamble on credit Do not use cash sources at gambling establishments Set a time limit to gamble Do not substitute gambling for other worthwhile activities Use a “buddy system” If in a gambling establishment, remember there are often other non-gambling activities available Know the 24-Hour HelpLine # 1-888-ADMIT-IT Other:

Slide 24:A Personal Perspective The Impact of Gambling Addiction on an Older Adult’s Life