Broward Older Adult Compulsive Gambling Pilot Project

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Broward Older Adult Compulsive Gambling Pilot
Project

• Stephen Ferrante, M.S.W.
• Broward Co. Elderly Veterans Services
• [phone]

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Purpose of Presentation

• Research and Theory to Practice
• Project Development
• Project Implementation
• Project Outcomes
• Findings

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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

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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 Countys Lead Elder Veteran Agency
• Agency Mission and Philosophy
• Enhanced Consumer Outcomes
• Comprehensive Assessment Service Planning
• Resource Maximization Collaboration
• Prevention and Wellness

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Gambling Options in Broward County

• Casinos
• Cruises
• Horse Track
• Dog Track
• Jai Alai
• Bingo
• Lottery
• Internet
• Stocks
• Sweepstakes
• Private games
• Other

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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

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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

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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

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Establish Bank of Recreational Alternatives
through Surveying

• Create Survey Instrument
• Incorporate into Community Education
  Presentations
• Use Brainstorming Activity
• Draft and Submit Report(s)

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Examine Gaming Industry Incentives

• Create Survey Instrument
• Incorporate into Community Education
  Presentations
• Use Brainstorming Activity
• Draft and Submit Report(s)

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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

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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

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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

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Aide Stakeholders in Assessment

• Train Professionals on Topic
• Initiate Memorandum of Understanding
• Offer Community Education and Screening
• Create Simple Referral Process Form

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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

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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

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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

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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

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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

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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

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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

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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

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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

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A Personal Perspective

• The Impact
• of
• Gambling Addiction
• on an
• Older Adults Life