Betting on Older Adults: A Problem Gambling

Transcription

Betting on Older Adults:
A Problem Gambling Prevention
Clinical Manual for Service Providers
Angelique Lemay BSc, MSW, CPGC
Evelyn Bakich RN, CPGC
André Fontaine, BTh
Centretown Community
Health Centre
Centre de santé
communautaire du Centre-ville
Funded by the Ontario Ministry of Health and Long-Term Care
© Sault Area Hospital, St. Joseph’s Care Group,
Centretown Community Health Centre, 2006
ALL RIGHTS RESERVED
Editors: Lauren Walker and Michèle Baril
Translation: Aubut and Associates
Cover: Hatakanka Design
Design: Carmen Misasi Design
Aussi disponible en français.
Permission granted to photocopy handouts.
Table of Contents
Preface
Acknowledgements
Introduction
Chapter 1:
Increasing Your Comfort Level .................................................................................................... 1
• Private Reflection ............................................................................................................................................................................ 2
• It’s Not So Easy .................................................................................................................................................................................. 3
Handout:
• How Do I Respond?
• Glossary ................................................................................................................................................................................................... 6
Chapter 2:
Older Adults and Problem Gambling ....................................................................................... 9
• The Growing Older Adult Population ......................................................................................................................... 10
• Generational Differences ...................................................................................................................................................... 10
• Older Adults: Reasons for Concern ............................................................................................................................... 11
• Reasons Older Adults Gamble .......................................................................................................................................... 11
• Signs of Problem Gambling ................................................................................................................................................ 12
• Barriers to Older Adults Getting Help ......................................................................................................................... 13
• Diversity Within Diversity ...................................................................................................................................................... 13
Chapter 3:
Developing a Skill Set ................................................................................................................. 17
• Public Awareness ......................................................................................................................................................................... 18
• Screening ........................................................................................................................................................................................... 19
Handouts:
• Leisure Wellness Screening Questions
• Windsor Problem Gambling Screen for Older Adults
• E.I.G.H.T. Gambling Screen
• Harm Reduction ............................................................................................................................................................................ 23
Handouts:
• Seven Steps
• Stage Related Changes of Older Adults and Gambling
• Tips to Keep Gambling Fun
• Gambling Diary
• Testimonials
Chapter 4:
Transition to Retirement Lifestyle ............................................................................................ 33
• Planning for Retirement ......................................................................................................................................................... 34
Handouts:
• Retirement Wellness Chart
• Leisure Wellness Chart
• Shifting Focus in the Life Cycle
Chapter 5:
Resources ........................................................................................................................................ 41
• Educational Resources
• National Resources
• Useful Web Sites
References
....................................................................................................................................................... 47
Preface
This manual was developed by the Ontario Resource Group on Problem Gambling and Older
Adults 55+ as a resource for individuals, allied professionals, and service providers who work with
older adults who have gambling problems as well as their families and significant others.
The Ontario Ministry of Health and Long-term Care (MOHLTC) had identified gaps in problem
gambling services targeting special populations such as older adults. In February 2000, the MOHLTC
awarded funding to three sites in the Province of Ontario (Sister Margaret Smith Centre, Lifestyle
Enrichment for Seniors (LESA) program, and the Sault Area Hospital Addictions Treatment Clinic) to
develop three-year pilot programs for problem gambling outreach services specifically for older
adults aged 55+ in their respective regions.
Over the three-year period, the participating sites provided all components of treatment services
including outreach services to the community, home-based counselling services, individual, couple,
family and group therapy. As well, the three sites began developing prevention and treatment
resources relevant to working with older adults experiencing gambling related problems and
presented their findings at problem gambling conferences in North America. They have also
collaborated with researchers in the area of older adults and problem gambling.
In February 2003, the MOHLTC announced permanent funding for the three provincial sites and
continued to support efforts to compile trends and data related to older adults and gambling, as
well as to develop clinical resources to share with other provincial service providers. In March 2004,
the three sites formed the Ontario Resource Group on Problem Gambling & Older Adults (55+).
In May 2005, in partnership with the Responsible Gambling Council, the Resource Group released
Betting on Older Adults: A Problem Gambling Awareness Kit. In the Fall 2005, the MOHLTC announced
plans to financially support the three sites in the development of this Resource Kit in French as well
as the development of Betting on Older Adults: A Problem Gambling Prevention Clinical Manual for
Service Providers.
More recently, the MOHLTC announced funding for six new agencies to provide specialized problem
gambling treatment services to older adults. These agencies now form part of the Ontario Resource
Group on Problem Gambling and Older Adults 55+. The Resource Group’s goal is to 1) provide all
components of service and develop additional resources relevant to working with older adults
experiencing gambling-related problems; 2) articulate program-level and system-level strategies to
enhance problem gambling services for older adults; and, 3) develop guidelines, recommendations,
and standards for services provided to older adults that support best practice, enhance access,
remove barriers, and increase the likelihood of positive outcomes for this population.
Acknowledgements
We would like to acknowledge the many individuals and organizations that have supported us
over the past six years as we have developed and provided services for older adults with gambling
problems.
We thank Leslie Coleman, Paula Rupert, Raimo Viitala, Nancy Black and Betty MacGregor for
generously providing their time, support and information from the very beginning. We are grateful
to Judith GlynWilliams from the Ontario Problem Gambling Research Centre for the invaluable
research resources she has provided. Staff at the Responsible Gambling Council have made many
contributions through their partnerships and support. As we developed this manual, Erin Pollard,
Karen McKinley and Celine Leipins have helped us stay on track with their excellent organizational
and technical skills!
We are indebted to the older adults who graciously and courageously shared their stories so they
could help us and others learn. Finally, to Vicente Gannam, who has always championed and
supported our work as individuals, agencies and as a provincial resource group, we extend much
gratitude and appreciation. He has helped us to form a great provincial team to provide services
and resources to the province of Ontario.
It has been our pleasure to work with all of you.
Regards,
Angelique Lemay, Sault Area Hospital Addictions Treatment Clinic, Sault Ste. Marie, Ontario
Evelyn Bakich, Sister Margaret Smith Centre, St. Joseph’s Care Group, Thunder Bay, Ontario
André Fontaine, Lifestyle Enrichment for Senior Adults, Centretown Community Health Centre,
Ottawa, Ontario
ONTARIO RESOURCE GROUP ON PROBLEM GAMBLING
AND OLDER ADULTS 55+
The Ontario Resource Group is composed of representation from each of the sites currently mandated
by MOHLTC to provide problem gambling services for older adults. These specialized programs develop
and share clinical resources, participate in current research initiatives, and provide data related to
gambling and problem gambling behaviour among older adults.
The goals of this group are to:
•
provide all components of service as well as developing resources relevant to working with
older adults experiencing gambling related problems;
•
articulate program-level and system-level strategies to enhance problem gambling services
for older adults;
•
develop guidelines, recommendations, and standards for services provided for older adults
that will:
• support best practices
• enhance access
• remove barriers
• increase the likelihood of a positive outcome for older adults.
Introduction
This manual is intended as a resource for individuals, allied professionals and service providers who work
with older adults who have gambling problems, their families and significant others.
This project builds upon the development of specialized resource materials aimed at primary and
secondary problem gambling prevention among older adults. Few resources exist for this age category
and given the increased participation of older adults in gaming activities, such specialized prevention and
awareness resources are critically needed.
Research has shown a dramatic increase in the proportion of people over the age of 65 who gamble
(National Opinion Research Centre, 1998; Social Gaming Survey, 1993). Statistics Canada indicates that the
number of seniors in this country will double by 2026. As this segment of the population increases, it is
expected that the number of seniors who have gambling problems will rise accordingly. Hence, there is a
concomitant need for an increase and specialization of services to meet the needs of this population.
Studies have shown that although older adults are often the target population for services, they are rarely
reached. Furthermore, older adults and the elderly do not generally seek out services; therefore it is
important that service providers be both flexible and mobile and take the services to the
neighbourhoods and to the home.1
In Setting the Course: A Framework for Integrating Addiction Treatment Services in Ontario,2 the Ontario
Substance Abuse Bureau set out directions for improving delivery of services. Early intervention is key:
older adults are often not identified until their addiction is well advanced, their health and relationships
have suffered and treatment is more difficult. Frequently signs of addiction in this population are
misdiagnosed as symptoms of depression, mental illness, aging or other physical and emotional problems.
To ensure early identification and referral for treatment, the Bureau indicates that addiction agencies need
to help other health and social service agencies (e.g., mental health agencies, community health centres,
counselling centres and primary care providers) to develop the skills required to detect early signs of
addiction and make appropriate referrals.
Prevention efforts, however, cannot be focused solely on service providers. Programs are most effective
when the entire community is involved in the prevention effort. Studies have shown there is a significant
difference between the effects of problem gambling on seniors and that of other segments of the
population. Therefore, a prevention program that is based on the unique nature of gambling and
gambling-related problems among seniors would have the best possibility of success.3
The Problem Gambling Research Group at the University of Windsor has concluded that prevention
efforts must eliminate the emphasis on problem gambling and instead provide general information on
gambling with a focus on how to gamble safely and include personal interest stories about people who
gamble and those who have experienced problems. In addition, a range of materials and educational aids
must be developed for the community-at-large, which includes doctors, lawyers, community health
providers, financial experts, social service providers and the media, to increase awareness of the issues
related to responsible gambling and problem gambling.
This manual and Betting on Older Adults: A Problem Gambling Awareness Kit both provide additional support
to service providers who work in the area of problem gambling prevention with this special population
group.
1
Weiner, M.B., A.J. Brock, and A.M. Snadowsky. 1987. Working with the Aged: Practical Approaches in the Institution and Community. 2nd. ed.
Englewood Cliffs, N.J.: Prentice-Hall.
2
Setting the Course: A Framework for Integrating Addiction Treatment Services in Ontario. Toronto: Ontario Substance Abuse Bureau,
1999.
3
Govoni, R., R. Frisch & D. Johnson, 2001. A Community Effort: Ideas to Action. Understanding and Preventing Problem Gambling in Seniors. A
Final Report. University of Windsor: Problem Gambling Research Group.
This manual aims to:
•
Increase your comfort level about older adults and problem gambling
prevention;
•
Increase your knowledge about the relationship between older adults and
problem gambling;
•
Enhance your skill set to better communicate with older adults who gamble;
•
Increase your knowledge about retirement wellness and balanced living for
persons 55+.
1
Chapter 1
Increasing Your
Comfort Level
The goal of this chapter is to increase your comfort level when talking to older adults
about problem gambling prevention. It is always helpful to explore our existing
preconceptions that we may have in order to be able to provide clients and consumers
with a non-judgmental approach to prevention and early intervention.
This chapter provides exercises that can be done on your own or as team that will help
you to examine personal values and beliefs as well as organizational systems-level values
and beliefs.
• Private Reflection Exercise
• It’s Not So Easy Exercise
• How Do I Respond? Handout
• Glossary of Terms
Betting on Older Adults: A
Problem Gambling Prevention Manual for Service Providers
2
Private Reflection
This reflection can be done individually or in a group setting, as well as a warm up
exercise for presentations depending on the group you are working with.
Suggested instructions:
a) Sit comfortably in a chair and close your eyes. You will not be asked to say anything
out loud during this exercise. Your thoughts and reaction to the reflection are private.
Your comments are welcome and encouraged at the end the exercise, but not
required.
b) I am going to say some words related to gambling and ask some questions. I will allow
for periods of silence to allow you to reflect on the area.
c) See what response you have to the words and questions. Are you surprised by any of
your responses? What did this exercise bring up for you? Are there areas that you
want/need to explore further to inform your work with older adults and problem
gambling?
•
What do you think of when you hear the words, “gambling,”“money,”“work,”
“success,” or “fun”?
•
Where did you first learn about money? How old were you?
•
Did you have an allowance? Was it fixed or flexible?
•
Who handled the money in your house?
•
Who handles the money in your house today? Is it the same as in childhood? If so,
why or why not?
•
What is your first memory of learning about gambling?
•
Who taught you how to gamble?
•
What gambling do you do?
•
When did you start? Have you ever won anything?
•
If you don’t gamble, why?
•
What does “aging” mean to you? Getting older?
•
What do you think of when you hear the word older adults? Seniors? Aging baby
boomers?
•
What does the phrase “retired people” mean to you?
•
What does success look like?
•
What is financial security for you?
•
What or who comes to mind when you hear the term “problem gambler”?
•
What is your belief about borrowing money?
•
Do you ever not repay a debt? Why? Why not?
•
What does the word “poor” mean to you?
•
What do you think of when you hear the word “winner”?
•
What do you think when you hear the word “loser”?
Increasing Your Comfort Level
Chapter 1
3
It’s Not So Easy
This exercise is designed so that it may be completed individually or in a group setting.
Suggested Instructions:
1) Read each scenario and the corresponding questions.
2) Consider the issues and problems that present themselves.
3) Contemplate and formulate your options.
4) Ask yourself, what reaction you had to the scenario? Professionally or personally?
5) Recognize that these are common scenarios involving people experiencing gambling
related difficulties. Recognize it’s not so easy to come up with quick solutions.
SCENARIO 1
Your father, age 62, a gambler, and his girlfriend own a house together. He has not paid
his share of expenses for several months, despite working full-time. You are afraid he and
his girlfriend will lose the home if you don’t cover his share of the expenses.
W ha
ou do? Do you ‘bail out’ your father and assume his share of the expenses?
hatt do yyou
SCENARIO 2
Your sixteen year-old grandson is a gambler like his father. His mother (your daughter)
has just been diagnosed with breast cancer and you know she is under great stress. Your
grandson tells you that his father refuses to pay his gambling debts from playing poker.
He says that he’s afraid to go to school because he will be beat up.
ou do? Do you refrain from telling your daughter and pay off your grandson’s
W ha
hatt do yyou
debts?
SCENARIO 3
Your brother, age 56, a gambler, doesn’t pay his share of the money he, your sister and
you agreed to give your elderly parents to enable them to remain in the family home.
W ha
ou do? Do you and your sister assume your brother’s share of the
hatt do yyou
commitment?
SCENARIO 4
Your parents have borrowed money from a payday loan company and used your father’s
car as collateral. Your mother has lost all the money gambling and if she doesn’t repay the
debt today, your dad will lose his vehicle.
W ha
ou do? Do you give your mother the money to cover the debt? Do you give
hatt do yyou
your dad the money?
4
SCENARIO 5
Your husband, a gambler, has been contributing less and less each month to your
household expenses, and now you are about to be evicted for non-payment of rent. Your
friends tell you to leave him, but you know you cannot afford your own apartment and
meet other expenses on your income. The little your husband gives you each month
helps keep you afloat.
W ha
ou do? Do you take out a personal loan and then get a job to pay it back so
hatt do yyou
you can remain in your apartment. Do you leave him?
SCENARIO 6
You’re working with an older adult who is constantly struggling to pay her monthly
expenses. In fact, she hasn’t paid her rent for the last two months. This is confusing to you
because you know that she has enough money coming in each month and should be
able to cover expenses and then some. You know that she likes to go to the casino
several times a week.
W ha
ou do? Do you confront her about her gambling? Do you ask about her
hatt do yyou
finances?
SCENARIO 7
You’re working with an older adult, experiencing depression, whose husband recently
died. She has received a sizeable life insurance policy from her husband’s death. During
one of your home visits, she tells you that she has decided that she is going to spend
$5,000.00 a month gambling until all the money is gone. She tells you that she knows
going to the casino is a place for her to escape from her painful grief over the loss of her
husband and she doesn’t care if she gambles away all the money.
W ha
ou do? Is this a problem?
hatt do yyou
Handout #1
How Do I Respond?
•
Be supportive and caring.
•
Remember that no one has the ability to make another person change. You can only provide
encouragement and allow people to proceed at their own pace.
•
Respect that people ultimately decide when and how to deal with their problem.
•
Let the individual know that help is available and offer/outline options such as Gambler’s Anonymous,
Credit Counselling, individual/family or group counselling. The Ontario Problem Gambling Helpline can
provide you with information about problem gambling treatment services for older adults. Call 1-888-2303505 -toll-free, confidential, anonymous, open 24 hours.
•
Be aware of the possibility of depression or other mental health concerns, and encourage clients to talk to
their doctors or get help at another helping agency, including Crisis Intervention/Response.
•
Do not ‘bail out’ the person who is having gambling problems. Sometimes, we try to help by offering
money to pay bills and other debts. However, sometimes the person uses this money to gamble to try to
win back their losses. Instead, you can help by arranging for transportation to counselling or a GA meeting,
or providing direction to local food banks.
6
Glossary
This glossary defines some common terms used in relation to gambling and to
older adults with gambling-related problems.
Ageism: Prejudice or discrimination against people because of their age.
Bailout: Money given to a gambler that allows them to pay debts without
suffering the negative consequences.
Chasing: The attempt by a gambler to make up previous losses through
additional gambling, a common symptom of a problem gambler. Chasing often
involves making larger bets and/or taking greater risks.
Gamblers Anonymous (GA): An international network of self-help groups for
people attempting to recover from problem gambling. Gamblers Anonymous is
a 12-step abstinence based program modelled after Alcoholics Anonymous.
Local chapters provide fellowship in which people share their experiences,
support, and hope in order to stop gambling.
Gambling: Gambling involves risking something of value in a situation where
the outcome is determined by chance. Once a bet has been placed, it is
irreversible. Types of gambling include: casino games, bingo, Keno, slot machines,
lottery tickets, scratch or nevada pull-tab tickets, games such as Tambala, stock
market speculating and sweepstakes. Gambling also involves betting on card
games, mahjong, dominoes, horses or other sports, as well as games of skill such
as golf or pool.
Gambling to Escape: Gambling provides relief from loneliness, boredom, pain,
anxiety, and other uncomfortable emotions.
Harm Reduction: An approach that focuses on reducing the risks and harms
associated with problem gambling. In using the harm reduction approach, we
work with the older adult to achieve practical short-term improvements in
different aspects of their life and to reduce the harm.
Homophobia: Irrational fear, hatred, prejudices or negative attitudes toward
homosexuality and people who are gay or lesbian, bisexual, transgendered,
transsexual, queer, two spirited, men who have sex with men (MSM), and women
who have sex with women, (WSW).
Leisure Wellness: A time when we are free to do what we choose to do. A state
of being when we experience personal satisfaction, an enriched sense of selfworth, an inner calm, and the joy of recreation.
Loss of Interest in Routine: The older adult has lost interest in activities that
they previously enjoyed. These activities have been replaced by gambling.
Problem Gambling is not just about losing money. Gambling can affect a
person’s whole life. Gambling becomes a problem when it interferes with normal
activities and responsibilities, threatens mental or physical health, causes
financial loss, damages a reputation or causes problems with family and friends.
Increasing Your Comfort Level
Chapter 1
7
Problem Gambling Risk Continuum: Involvement in gambling can
be represented on a continuum from occasional or social gambling to
turbulent or problem gambling. The more involved the older adult
becomes in gambling activities and risk behaviours, the higher the level
of risk for developing a gambling problem.
LEVEL OF RISK
STAGE
L o w RRisk
isk
Social
M
isk
Moo d e rraa t e RRisk
Solo
Habitual
Secretive
High RRisk
isk
Enchanted
‘Stage-Related Changes of Older Adults and Gambling‘ is discussed in Chapter Three
Low Risk: Older adults in this category do not experience
problems, but it is possible for them to move along the
continuum to moderate risk if they continue to be exposed to
low-risk behaviours. Examples of risk behaviours include: persistently
betting more and more money, spending more time in gambling
activities, using gambling to cope with stress or sadness, and
choosing gambling over other social activities and responsibilities.
Moderate to High Risk: The likelihood of older adults developing
a gambling problem increases for those in the moderate-risk
category and is greatest among those in the high-risk category.
Older adults in these areas continue to practice risk behaviours
as well as experience a distorted thought process. Examples of
faulty thinking include the mistaken belief that they can control
the outcome of games with strategies or that luck or lucky items
can influence their success. 4
Racism: Prejudice or discrimination against people because of their race,
culture, religion, ethnicity, and colour of skin.
Sexism: Prejudice or discrimination against people because of their
gender.
4
Ontario Problem Gambling Research Centre, “Problem Gambling Framework,” at: http://
www.gamblingresearch.org/contentdetail.sz?cid=2007&pageid=284 and Women’s
Information Referral Exchange Inc.
Turbulent
9
Chapter 2
Older Adults and
Problem Gambling
The goal of this chapter is to increase your knowledge about older adults and problem
gambling. There are six areas of focus:
•
The Growing Older Adult Population
•
Generational Differences
•
Older Adults: Reasons for Concern
•
Signs of Problem Gambling
•
Barriers to Older Adults Getting Help
•
Diversity Within Diversity
10
The Growing Older Adult Population
•
•
•
•
•
•
There are more than 2.2 million Ontarians ages 55 and over;
Between 1996 and 2016, there will be an increase of 38% in the number of people age 55 and over;
Older adults are more active and affluent, and live longer than older adults in the past;
1 in 8 Canadians is 65 years or older;
Average adult age 65+ has 7.7 free hour/day;
Gambling Anonymous membership is increasing in age. 5
Generational Differences
Drawing from a study conducted by the National Endowment for Financial Education this
section examines differences in values and beliefs between two generations. It is
important to note that, as a result of both familial and societal influences the diversity
among adults over the age of 55 is broader than ever before. Many life attitudes may be
shared between these two generations and it is important to recognize “diversity within
diversity” both in sub-groups of older adults and on an individual level. A more detailed
analysis of the diversity within diversity of the older adult population is provided later in
this chapter.
THE SILENT GENERATION: BORN BEFORE 1946
Members of the “Silent Generation” are more likely to be compliant, deeply rooted in a
strong work ethic, and accepting of a lifelong career of relative sameness. This group is
less inclined to ask for, and more resistant to, financial help and is learning to live on
limited resources in retirement. The oldest female members of this generation often have
less knowledge about managing money.
Having held a lifelong belief in the adage “work hard, get ahead” this generation is often
split between those who desire to continue working in their later years and those who
believe that retirement is their due. Members of this generation expect leisure in
retirement but have limited experience in developing leisure activities. Although a
majority of members were raised with the belief that marriage is a long-term
commitment, there has been an increase in divorce rates among this group.
This generation doesn’t particularly embrace “personal growth” as important to one’s life.
They are not accustomed to relying on therapists or counsellors to help them “fix” aspects
of their lives, however, they do tend to trust “experts” such as their doctors.
BABY BOOMER GENERATION: BORN 1946–1964
Described as the “noisy” generation, Baby Boomers challenged conventions and mocked
the “establishment” in a dramatic and visible manner. Now members of the “establishment”,
Boomers are more financially savvy, yet they are also burdened with more debt than were
their parents. This generation has many more complex financial choices to make and
must be more self-reliant for financial security than the previous generation. Their status
as the “sandwich generation” may require them to assist aging parents financially.
5
Problem Gamblers: Seniors Specialty,” Toronto: Centre for Addiction and Mental Health, at: http://www.camh.net/
Care_Treatment/Program_Descriptions/Problem_Gambling/problem_gambling_seniors.html [accessed 9 March 2006].
Older Adults and Problem Gambling
Chapter 2
11
In work matters, Boomers have little faith in company stability and have much less
corporate loyalty than did the Silent Generation. Many have created second careers or are
self-employed. Boomers seek “meaning” in their work. They expect – and often desire – to
work well beyond traditional retirement age. Because they do not take time to plan for
leisure time, many Boomers experience leisure only in short bursts. With aging parents,
members of this generation are beginning to consider their own mortality and taking
steps to maintain their physical health. Stress associated with career pressures, high debts
loads and family issues is affecting their health.
Boomers place a high priority on home life but feel its quality is often compromised. They
are introspective about their lives and want to experience personal growth. However, this
generation believes they were entitled to a better world and have paid for it and are now
reaping the results of their spending habits. Divorce, unemployment, mid-life health
issues and death of family members are frequent problems.
Older Adults: Reasons for Concern
The Centre for Addiction and Mental Health indicates that gambling has become the
new pastime of the 21st century, especially among older adults. As a result of increased
access, social acceptance and disposable time and money, increasing numbers of older
adults are gambling and form a significant market for the gaming industry. Gaming
operations often design special incentives such as promotions, cheap transportation and
free lunches for this target group.6
University of Windsor research indicates that older adults who become addicted to
gambling are using it as a way to escape loneliness, depression, boredom and loss. More
than 92% of seniors in the study who scored in the pathological gambling range,
reported childhood trauma – with a history of neglect, abuse or abandonment coupled
with past dissociate reactions. The study further reports that men and women over the
age of 60, who are at any risk for problem gambling, provide more reasons for gambling
than do those who are not at risk. This group is also more likely to gamble for excitement
and to escape unpleasant feelings.7
Reasons Older Adults Gamble
The consequences for those older adults who do develop gambling problems are often
far more devastating than for other age groups. As McNeilly (1999) points out, the real
tragedy is that they “aren’t going to be able to get that income back.”8 Furthermore,
Fowler (1997) states that gambling “is an increasing problem for older adults with a
shortened rate of time (1–3 years) for ‘escape’ gamblers to reach a crisis stage in
gambling.”
6
Problem Gambling Project: Promoting Community Awareness of Problem Gambling Resource Package. Older
Adults and Gambling. Toronto: Centre for Addiction and Mental Health, 2001.
7
Mandal, V. “Seniors Gamble to Beat Loneliness, Study Shows,” The Sault Star, 19 Feb. 2004.
8
McNeilly, D., 1999. “Late Life Gambling: The Attitudes and Behaviors of Older Adults.” Omaha: University of
Nebraska, Nebraska Medical Center.
12
Older adults are often dependent on a fixed and modest monthly income. As Robert
Williams points out, “even though the expenditures of older problem gamblers tend to be
lower than other age groups, it is important to note that their experienced guilt tends to
be much higher.”9
Signs of Problem Gambling
Non-Problem Gambler:
Problem Gambler:10
Win money
Exciting fun
Exciting fun
Win money
To socialize
To be around others,
decrease isolation
To socialize
To be around others,
decrease isolation
Other
Forget about problems
Problem gambling is often called the “invisible
addiction.” For family members, friends, and
service providers who do come to realize that
there is something wrong in the older adult’s life,
they may be unaware how serious the problem
is. Realization of the problem can be sudden and
unexpected. Some of the warning signs of
problem gambling among older
adults that may arise are:
• MONEY ISSUES
• The older adult has less money available for outings with friends and family, buying
gifts for grandchildren, or to meet their basic financial needs.
• The older adult may have many unexplained unpaid bills, i.e.: hydro, rent/mortgage,
house and car insurance.
• The older adult may be constantly receiving phone calls from collection agencies,
and subsequently not answering their phone.
• The older adult may have money missing in their bank account; they have cashed in
their RRSPs and life insurance.
• The older adult may have valuables disappearing.
• The older adult is asking to borrow money and focuses only on money issues.
• BEHAVIOURAL ISSUES
• The older adult may slowly withdraw from family or social events, i.e.: not going to
their regular “bridge game night,” or not attending their grandchild’s school concert.
• The older adult may begin to neglect their daily household duties and personal
needs.
• The older adult may have disappeared for many hours at a time.
• The older adult may shift all their interest on gambling activities.
• The older adult may have a change of eating and sleeping habits.
• The older adult may have a decline in physical and emotional health.
• RELATIONSHIP ISSUES
• The older adult may decrease contact with family and friends except to ask for money.
• The older adult may seem more depressed to family members and friends.
• The older adult may always appear to be very busy.
• The older adult may be secretive about their whereabouts and their daily activities,
as well as avoid answering any uncomfortable questions.
9
Robert Williams, PhD, C. Psych, e-mail correspondence with author, 2006.
Weibe, J. et al., 2004. “Gambling and Problem Gambling Among Older Adults in Ontario.”
10
Chapter 2
13
•
The older adult may seem to be always on edge, defensive and often reactive
towards family and friends.
Barriers to Older Adults Getting Help
Six barriers have been identified that prevent older adults from accessing office-based problem
gambling services11:
1. Transportation issues;
2. Psychological health issues (e.g., depression, and isolation);
3. Physiological health issues: (e.g., mobility limitations acute/chronic conditions);
4. Cultural practices and/or religious beliefs (e.g., perspectives on money);
5. Comfort issues (e.g., time required to travel to services, difficulty sitting in office chairs);
6. Lack of independent living (lack of privacy, use of vehicle).
Diversity Within Diversity
This section highlights specific segments of the older adult population: impoverished
groups; ethno-cultural groups; Gay/Lesbian/Bisexual/Transgender groups; older women;
and Aboriginal people.
IMPOVERISHED GROUPS
•
Poverty is often well hidden in Canadian communities. Marginalization, exclusion,
discrimination, disapproval, and shame strain a person’s physical and mental health.
•
Poverty is especially prevalent among people who live alone, especially women.
•
When employment stops, income falls, and many things are no longer affordable.
•
Inadequate or non-indexed pensions, inflation, or the death of a spouse/partner can
cause financial hardship.
•
Some older adults begin to gamble in hopes of winning a jackpot. Debt incurred
through credit or loans from family/friends, or loan sharks creates more financial
problems.
ETHNO-CULTURAL GROUPS
•
11
While working with ethno-cultural groups, it is important to “consider factors such as
the “individual’s experience of oppression/discrimination, immigration status and
experience, degree and effects of acculturation, language and communication skills
and patterns, education/socioeconomic status, religion, age, gender, and family
structure.”12
Lemay, A. 2002. Problem Gambling and Older Adults: Results of Three Pilot Projects in Ontario. Toronto: Responsible
Gambling Council. Available at: responsiblegambling.org/newslink.
12
Van Wormer, K. and D.R. Davis, 2003. “Addiction Treatment: A Strengths Perspective. Pacific Grove, California:
Brooks/Cole Thomson Learning Inc. p. 313.
13
Ibid. p. 315.
14
•
It is important to determine “cultural-specific information such as attitudes and values,
how the problem is defined and identified, and cultural ways of seeking help.”13
•
Although people around the world share universal views about aging, there are
certain cultural variations in attitudes ranging from positive to negative.”14
•
“Many [older adults] live with or are cared for by adult children, who may be
approaching retirement themselves. Other caregivers may include grandchildren or
other relatives. Although extended families are a source of support, the close contact
can also spark new problems deriving from old family conflicts. There often exist wide
cultural gaps … These gaps can be a source of stress and conflict.”15
•
It is important for professionals working in the field of problem gambling to “rethink
their conceptualization of problem gambling in terms of the various subgroups within
the population at large, and not just the dominant culture.”16
•
In their resource kit New Beginnings: Problem Gambling Awareness for Newcomers in
Ethno-Cultural Communities (2005), COSTI Immigration Services and the Responsible
Gambling Council reports that newcomers to Canada have an increased risk of
developing a problem as a result of the various challenges they face upon their arrival.
They may perceive gambling as an attractive solution to their financial problems. At
the same time newcomers may not have access to the information they need to
understand the games (low probability rates of winning, for example).
GAY, LESBIAN, BISEXUAL AND TRANSGENDER (GLBT) GROUPS
•
“… most treatment centers do not address the special needs of the gay and lesbian
populations. …While many older gay people are open about their sexuality, a large
number have been in the closet for many years. They often keep their sexual
orientation secret, because they feel vulnerable and fear discrimination, abuse, or
social condemnation.”17
•
“As people were growing up in the 1930s ... society clearly said gay and lesbian people
should not exist. If people were gay or lesbian, they were not supposed to act on their
feelings. Many people who were lesbian, gay, or transgendered internalized these
societal feelings throughout the decades, leading to psychological conflict and
psychological stress.”18
•
Fears of discrimination, abuse, social condemnation, and homophobia may lead GLBT
older adults to seek excitement, power, control, and escape through gambling.
•
Unfortunately, the mental health and substance abuse fields have in the past been rife
with myths and misconceptions about gay, lesbian and bisexual people. Thus,
although lesbian, gay and bisexual people are frequent consumers of these services,
they are not always well and effectively served in many mental health and substance
abuse programs. Social workers [need to] understand that practice is informed by a
combination of knowledge, attitude and skill.19
14
Baker, F.M. and J. Takeshita, 2001. “The Ethnic Minority Elderly,” in W.S. Tseng and J. Streltzer (eds.), Culture and
Psychotherapy: A Guide to Clinical Practice. Washington: American Psychiatric Press, Inc.
15
Ibid.
16
Mark and Lesieur, 1992, as cited in van Wormer & Davis 2003, p. 561.
17
Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults: Alcohol Dependence and Misuse Among Older Gay
and Lesbian People at: www.agingincanada.ca/lgbt_older_adults.htm [accessed 6 March 2006].
18
Ibid.
19
Appleby, G.A. and J.W. Anastas, 1998. “Not Just a Passing Phase: Social Work with Gay, Lesbian, and Bisexual People.
New York: Columbia University Press, p. 299.
Chapter 2
15
•
“Until recently, old gays and lesbians have been invisible in the literature...This
invisibility of gays and lesbians in gerontology is striking since it is estimated that there
are 3.5 million gay men and lesbians over 60 in the United States [alone]. … [they] face
many structural obstacles to achieving an optimal adaptation at the end of the life
course.”20
OLDER WOMEN
•
“Gambling provides fun, excitement, and a way to pass the time and forget worries, as
well as the opportunity of winning money. Casinos appeal to women and older
women in particular, because they offer friendly service and a safe environment where
one feels comfortable going alone.”21
•
The National Advisory Council on Aging indicates that women living alone are
especially vulnerable.22
•
In a study of the link between caregiving responsibilities and compulsive gambling,
Schull indicates that many older women begin gambling as a means of reducing the
social isolation they feel. However, as the problem progresses, most women gamble
alone and further increase their isolation. Ironically, while gambling may start as a way
to assert autonomy, it eventually leads to increased loss of self.”23
•
“Many women gamble in search of a way to numb emotions, shut out the world, and
orchestrate a time out.”24
ABORIGINAL PEOPLE
•
In her prevalence study, Dreamchaser: Alberta Aboriginal Adult Gambling, Darlene Auger
states that 24% of Aboriginal problem gamblers are residential school survivors.
Findings suggest that problem gamblers have a lower level of education and income
however probable pathological gamblers had a higher income and were more likely
to live on a reserve. Reasons for gambling included to win, to get out of the house, to
forget problems and to be alone.25
•
In 1994 the National Advisory Council on Aging26 in Writings in Gerontology Aboriginal
Senior Issues (March 1994) indicated that Aboriginal people suffer from many more
health-related problems than does the general population because of inadequate
nutrition, sub-standard living conditions and low levels of education and poverty. They
further stated the elderly Aboriginal people often experience double alienation. Not
only are they outside the mainstream institutional structure, they are increasingly
marginalized by their own changing communities as a result of extensive social and
political change. Finally, the Council reports that access to leisure and other non-work
activities is also problematic for older aboriginal people. Several studies have found
20
Ibid., p. 246.
Brown, S. and L. Coventry, 1997. “Queen of Hearts: The Needs of Women with Gambling Problems.” Melbourne:
Financial and Consumers Rights Council.
22
Expressions, Spring 2000. Ottawa: National Advisory Council on Aging.
23
Schull, N.D. 2002. “Escape Mechanism: Women, Caregiving, and Compulsive Machine Gambling,” Working Paper
No. 41. Berkeley: University of California, Center for Working Families.
24
Boughton, R. and J. Brewster, 2002. Voices of Women Who Gamble in Ontario: A Survey of Women’s Gambling, Barriers
to Treatment, and Treatment Service Needs. Toronto: Ontario Problem Gambling Research Centre.
25
Auger, D., 2000. Dreamchaser: Alberta Aboriginal Adult Gambling. Prevalence Study. Edmonton: Nechi Training
Research and Health Promotion Institute.
26
Writings in Gerontology (15) 1994. “Aboriginal Seniors’ Issues. Ottawa: National Advisory Council on Aging.
21
16
that nearly half the senior native population almost never leaves home for more than
one hour a day.
•
Health Canada has reported that, “in 2000, life expectancy at birth for the Registered
Indian population was estimated at 68.9 years for males and 76.6 years for females. This
reflects differences of 7.4 years and 5.2 years, respectively, from the Canadian
population’s life expectancies.”27
•
In a 2000 study titled “Aboriginal Population: Gambling, and Grief,” the Ontario
Federation of Indian Friendship Centres found that those who were identified as
problem or pathological gamblers had grief scores of 41% and 45% respectively.
•
Piotrowski and Lemay indicate that there is a link between cultural loss and
[substance] dependence or addiction. They indicate that unreconciled losses in the
Aboriginal Canadian experience include, but are not limited to, loss of land, language,
spirituality, sense of belonging, autonomy, rights, self-sufficiency, traditional social
structure, connection to land, culture and tradition, identity, sovereignty, history,
control, cultural pride, community, trust, and loss of life.28
27
A Statistical Profile on the Health of First Nations in Canada for the Year 2000. Ottawa: Health Canada. 2000, at: http://
www.hc-sc.gc.ca/fnih-spni/pubs/gen/stats_profil_e.html [accessed 6 March 2006].
28
Piotrowski, L. and A. Lemay, 2004. “The Reconciliation ModelÓ: A New Treatment Approach for the Native
Community.” Child and Family. Journal of the Notre Dame Child and Family Institute, Vol. 7, no. 3 (Fall 2004), pp. 5–
14.
17
Chapter 3
Developing a
Skill Set
The goal of this chapter is to provide service providers with creative resources, older adult
specific screening tools and strategies for addressing and facilitating referrals to address
gambling related problems with their clients.
This chapter focuses on three areas:
•
Public Awareness
•
Screening
•
Harm Reduction
18
Public Awareness
With the growth of the gambling industry in Canada, service providers began to develop
and provide prevention education to older adults. Initial problem gambling prevention
education was developed based on existing substance abuse models. However, this
approach was not effective in reaching the targeted population. Education and public
awareness programs are vital in addressing problem gambling among older adults. A
2001 study, Project Weathervane, found that 65% of older adults had never heard of the
term “responsible gambling.” The study further found that among those who reported to
gamble responsibly, most were unable to clearly define the term in response to an openended question. Upon reviewing their approach, service providers identified three major
barriers to be considered when developing effective public awareness programs:
BARRIERS TO SUCCESSFUL PROBLEM GAMBLING PREVENTION
EDUCATION WITH OLDER ADULTS:
· S tigma: To address their problem with gambling, older adults must inevitably discuss
their financial issues openly with service providers. This can be a tremendous barrier for
members of a generation unaccustomed to discussing money issues in “public.”
· Focus on pr
oblem and tr
ea
tmen
problem
trea
eatmen
tmentt : Early materials aimed at older adults emphasized the
problems related to gambling, however, the target population was not receptive to this
angle.
· Institutional rresistanc
esistanc
e: Many institutions that serve the older adult population are
esistance:
frequently unaware of problem gambling issues or they underestimate the impact of the
problem. Banks and other businesses, for example, can be reluctant to help promote
awareness by distributing prevention material in their public places. Similarly, members of
the medical community are hesitant to address such issues with clients who may present
with early symptoms of an addiction.
lder A
dults: A P
ambling
These lessons led to the development of B etting on O
Older
Adults:
Prr oblem G
Gambling
eness KKit
it
areness
it, which is designed for use by community service providers and allied
A war
professionals as a primary prevention tool to educate older adults about responsible and
problem gambling. The kit contains four areas of educational focus:
1. Misconceptions of problem gambling and older adults
2. Warning signs of problem gambling for older adults
3. Realistic expectation of winning and losing
4. Where to go for help if experiencing problems
Comment from a service provider
Betting on Older Adults has proven effective in
using
the kit for first time with older adults:
increasing awareness of low-risk gambling and
warning signs of a problem. The kit includes a
“I did my first Bingo presentation yesterday and it was
video on problem gambling prevention, a
awesome. You have created an amazing resource and I am
facilitator’s guide and the interactive Bingo©
thrilled to be able to use it in the community. We had a great
and Gamble Scramble© games. It teaches
discussion prior to the game and the game itself was a big hit.
service providers how to engage people in
There was lots of laughter but at the end, everyone said that
non-threatening and non-judgmental
they learned a lot. I used the game the way it is
discussion, a particular challenge with the older
presented in the kit and it worked beautifully.
adult population. Finally, the kit can be adapted
I can’t wait for the next one.”
to meet the needs of various groups or
populations.
Developing a Skill Set
Chapter 3
19
Screening
Signs that older adults may be at a low to moderate risk for developing gambling
problems are often not immediately recognized by family members or service providers.
Service providers must feel comfortable discussing the topic of responsible and problem
gambling and possess the tools and resources necessary to engage older adults in such
discussion. Three effective tools are available as handouts.
Handout #1
LEISURE WELLNESS SCREENING QUESTIONS
If you think an older adult may be experience gambling related difficulties, you may want
to start a conversation by asking the following questions:
1. What do you do for fun?
2. What do you do to relax and wind down?
3. What do you do for social activities?
4. How do you spend your leisure time?
5. What types of gambling do you do? (Note: you may need to list all types of gambling,
as some individuals don’t see activities such as bingo as gambling).
6. How many times a week do you gamble? (Note: explore all activities including lottery
tickets, Nevada tickets, bingo and casino).
7. Do you ever go to the casino or other gambling locations?
8. How much time do you spend on these activities?
9. How much money to you allocate to gambling?
Handout #2
THE WINDSOR PROBLEM GAMBLING SCREEN FOR OLDER ADULTS
The answers to the above questions may lead you to determine that you need more information. Although it has
not yet been validated,29 The Windsor Problem Gambling Screen provides a well-researched structure for more indepth discussion and exploration of your client’s gambling behaviour.
1. Since you started gambling, have you felt more depressed, either after gambling or in general?
2. Does gambling give you a sense of excitement or a ‘high,’ which makes you feel more alive?
3. When you lose money gambling do you return to try and win it back?
4. Have you ever been surprised by the amount of time that has passed when you’ve finished gambling?
5. Have you ever spent more money than planned when gambling?
6. Have you ever hidden your gambling activities, for example, where you were or how much you won or lost?
7. Each time you go gambling, do you believe that you could win big?
8. When you’re feeling “bad” does gambling make you feel better?
9. Has gambling filled a void in your life and helped you feel less lonely?
1
29
The Windsor Screen was developed by Frisch and Govoni. A research project is planned to validate the screen in clinical and community
samples of older adults.
Handout #3
“E.I.G.H.T.” Gambling Screen 30
The results of an in-depth discussion with your client may lead you to determine that you need to administer a
screening tool to ascertain the level of problematic gambling. The Early Intervention Gambling Health Test
(E.I.G.H.T.) Screen will assist you in determining next steps.
“E.I.G.H.T.” GAMBLING SCREEN
SCORING GUIDE:
To help us to check your gambling behaviour, please
answer the questions below as truthfully as you are
able from your own experience.
If you answer yes to 4 or more questions gambling may
be causing you problems in your life.
1. Sometimes I’ve felt depressed or anxious after a
session of gambling.
Y es
es, that’s true.
tion:
A ppr
opr
ppropr
oprii aatt e In
Intt er
ervv en
ention:
•
Determine level of clients’ concern about their
gambling. If there is concern, make a referral to a
problem gambling counsellor. If there is little or no
concern, offer information on responsible gambling
tips and signs of problem gambling.
•
Frame gambling as a health issue to reduce
resistance. “Planting the seed” as a possible health
matter may prevent progression of gambling
behaviour even if help is refused at this time.
•
Offer support and normalize reaching out for help.
Feelings of guilt and shame can prevent people
from discussing their problem with others.
N o , I haven’t.
2. Sometimes I’ve felt guilty about the way I gamble.
Y es
es, that’s so.
N o , that isn’t so.
3. When I think about it, gambling has sometimes
caused me problems.
Y es
es, that’s so.
4. Sometimes I’ve found it better not to tell others,
especially my family, about the amount of time or
money I spend gambling.
Y es
es, that’s true.
N o , I haven’t.
G uidelines ffor
or help in A
dminist
er
ing Scr
een:
Administ
dminister
ering
Screen:
•
When offering the screen, emphasize that gambling
is a common leisure activity that can sometimes
cause social or health problems. In so doing, the
focus is on health rather than an inquiry into lifestyle.
•
The screen is not diagnostic and errors can occur. It
is important to determine how clients feel gambling
affects their lives and the screen results can help
them to identify these effects.
•
It is effective to suggest that gambling is causing
problems that may be affecting your client’s health
or well-being. Such an approach allows for
discussion of an external (health) problem without
labelling, focusing on personal behaviour or eliciting
feelings of guilt that may cause defensiveness.
5. I often find that when I stop gambling I’ve run out
of money.
Y es
es, that’s so.
6. Often I get the urge to return to gambling to win
back losses from a past session.
Y es
es, that’s so.
7. Yes, I have received criticism about my gambling in
the past.
Y es
es, that’s true.
N o , I haven’t.
8. Yes, I have tried to win money to pay debts.
Y es
es, that’s true.
N o , I haven’t.
30
Early Intervention Gambling Health Test (E.I.G.H.T.) was developed by
Sean Sullivan at Auckland Medical School. Permission granted for use
and photocopying.
Developing a Skill Set
Chapter 3
23
Harm Reduction
According to Dennis Saleebey (1997), it is extremely difficult for an older person to ask for
help. He further states that people are better able to accept help if they are “given the
authority to make decisions about the nature of the help needed and how it should be
provided”. He stresses that “the more older persons feel in control of their lives by solving
their own problems, the less the likelihood of unnecessary dependency and learned
helplessness – two outcomes that are too often the fate of older citizens”.31
WHAT IS HARM REDUCTION?
H a rrm
m rreduc
educ
tion:
eduction:
31
•
Entails a set of practical strategies to help people help themselves to reduce
harm associated with gambling behaviours;
•
“… gives service providers a way to begin establishing and maintaining a
relationship with an older adult who has a [gambling] problem. It gives them
strategies on how to offer assistance, even where the older adult feels ‘it’s
impossible to stop right now.’”; 32
•
Supports a non-confrontational and non-judgmental approach;
•
Focuses on most immediate needs and issues;
•
Provides practical and immediate action;
•
Focuses on promoting healthy lifestyles and on reducing problems that the
client defines as important rather than on the [gambling misuse] per se, many
clients can be reached who would otherwise stay away.33
Saleebey, D. 1997. The Strengths Perspective in Social Work Practice. New York: Longman Publishers. pp. 120-21.
Seeking Solutions Project. (2004). Best Practices: Using Harm Reduction. Canada: Third in a Series of Best Practices
Sheets developed by the Seeking Solutions Project at: www.agingincanada.ca. [accessed 21 Feb. 2006]
33
van Wormer and Davis, p. 27.
32
Handout #4
“Seven Steps”
There are seven steps to follow when working with older adults using harm reduction guidelines.
1 . E stablish rrapp
app
or
appor
ortt :
a. Build trust and be non-judgmental: This may take
some time. Be patient and recognize the shame
and stigma a person may be experiencing
associated with their gambling behaviour;
b. Ask questions in a non-invasive manner;
c. Listen and empathize;
d. Acknowledge the person’s experience and
perception of the situation or problem;
e. Create a safe environment: Make every effort to
bring services to your clients so they feel safe in
their environments;
f. Use the following resources to help develop a
conversation to explore the older adult’s
relationship with gambling:
• Leisure Wellness Screening Questions
• The Windsor Gambling Screen for Older Adults
d. Address the areas or issues of immediate concern;
e. Use the Stage-Related Changes of Older Adults and
Gambling to help determine level of gambling and
helpful resources that will inform your work;
f. Explore whether your client would keep a
Gambling Diary.
2 . Clar
ify and pr
ovide ffeedback:
eedback:
larify
pro
a. Describe your perception of the situation, which
likely differs from that of your client;
b. Give concrete examples such as: “When you told
me that you haven’t been feeling well lately, you
also mentioned that you had been spending
longer amounts of time playing bingo or the slots
at the casino. Do you think your physical health
could be affected by the long hours of gambling?”
5 . Identify and build on strengths
a. Learn how the person has coped with difficulties in
the past;
b. Explore the older person’s values, experiences and
interests;
c. Explore instances where your client has
successfully employed harm-reduction strategies
(e.g., leaving credit or debit cards behind, limiting
time spent gambling);
d. Encourage your clients to identify the strategies
that worked best to help them maintain the
boundaries that they had set for themselves;
e. Work with your clients to envision the kind of life
they desire;
f. Focus on your client’s personal and environmental
strengths;
g. Help identify strengths with questions such as,
“What is going well in your life right now?”“What
has worked well for you in the past?”“Who and
what is important to you in your life today?”
maliz
e their e
xp
er
ienc
e:
3 . R educ
e stigma and nor
malize
exp
xper
erienc
ience:
educe
normaliz
a. Describe how other older adults have had similar
problems;
b. Describe how they sought out and received help;
c. Provide hope and help to reduce stigma and
shame by explaining how those individuals have
developed healthy alternatives to gambling and
improved their lives;
d. Where appropriate, provide a testimonial handout
for them to read.
essible
6 . B e fle
xible and acc
flexible
accessible
a. Whether the service provider approves, clients
ultimately set their own goals;
b. Offer timely access to other support services such
as mental health and financial counselling;
c. Establish alternative recreational activities that
don’t involve gambling activities;
d. When possible offer to meet clients where they are
most comfortable (e.g., office, home, by telephone
or in hospital).
4 . B egin w
or
e the clien
wor
orkk wher
where
clientt is:
a. Listen to your clients to ascertain their
understanding of their relationship with gambling
and how they believe it is affecting their lives;
b. Where they have defined a problem, collaborate
with them to consider a broad range of solutions;
c. Gather and locate resources to meet your client’s
individual needs;
7 . O f ffer
er supp
or
e tha
v ailable
suppor
ortt or assur
assure
thatt it is aav
a. Determine what community resources are available
to help your client;
b. Offer help to remove any practical barriers (e.g.,
transportation) to your client’s seeking help;
c. Offer emotional support through encouragement
and by expressing confidence in your client’s ability
to change.
Handout #5
Stage-Related Changes in Older Adults
and Gambling
The following chart provides a tool for engaging older adults in discussion about their gambling. Review the chart
together and ask your clients to choose which stage pertains to them. Suggested resource tools for each stage are
provided for the service provider to work with individuals or groups.
Handout #5
Stage-Related Changes in Older Adults
and Gambling (cont)
Handout #6
Tips to Keep Gambling Fun
HARM REDUCTION STRATEGIES:
•
Set limits on amount of time and number of days you gamble per month;
•
Do not borrow;
•
Gamble only what you can afford for entertainment;
•
Do not gamble to cope, solve or avoid problems;
•
Avoid magical thinking or belief in a “System of Winning”;
•
Take only the cash you plan to spend;
•
Leave all bank cards at home;
•
Keep a healthy balance in your leisure activities;
•
Make plans to protect yourself from staying too long; arrange a social outing with someone at a specific
time to avoid gambling longer than intended;
•
Avoid on-site cash machines at the gaming venue;
•
Decide on a spending limit ahead of time and adhere to it.
Handout #7
Gambling Diary
A Gambling Diary will help you keep a record of your gambling. There are four points to remember:
1. It is important to record every gambling session that you have. Try to record them after each session.
2. When you make your entry, ensure that you record all the details for each column.
3. In the ‘Details of Session’ column, make an honest judgement about whether or not the session caused you
problems.
4. Use all the pages provided; do not give up. A complete diary will give you valuable insight.
Keep your diary in a prominent spot where you are likely to see it (a fridge door, for example). Ask yourself the
following questions about your gambling behaviour:
a. Am I sticking to my limits of time and money?
b. Am I gambling more often than I planned?
c. Are there times when I’m gambling out of habit or to cope?
d. Am I gambling alone more often?
Gambling Diary
(cont)
Handout #8
Testimonial
TAILS YOU LOSE
34
My name is Eileen Chitruk and I am 79 years old.
In the fall and winter I go to school and hope to
graduate next year with a BA. My major is
French. My status is divorced so my gambling
did not affect anyone in the home except
myself. After school in order to have a change
from a lecture, I would stop in at a bingo hall
and stay for one round. Normally all I would
spend is $10.00 a day. But this grew to be a daily
habit and since my pension cheques amounted
to about $1,500.00 monthly, an expenditure of
$300.00 a month was excessive. In addition I
bought lottery tickets every Wednesday, Friday
and Saturday, which amounted to
approximately $100.00 a month.
Once I won $1,250.00 at bingo. I kept the
$1,000.00, gave my son $125.00 and my best
friend the same amount. I was so happy to
share my good fortune with the people closest
to me. From then on very little kept me from
playing bingo every day. If I was visiting a friend,
I would keep one eye on my watch and when it
was ten minutes to four, I would say I had to go
home to study but I really went to the closest
bingo. It is so easy to play bingo. There is a
game every hour on the hour. I just had to drive
to wherever a bingo game was starting up on
the even hours or the odd hours. It was not
necessary to make an appointment and I didn’t
need to go with anybody else. As a matter of
fact, another person would be distracting and
also I would have to share my winnings if I were
lucky enough to win.
I own my own home and have to keep my car
in good shape so after a few years things got a
little rough speaking financially. To make ends
meet I was reduced to living on potatoes and
carrots. In addition I did not buy myself
anything new in the way of clothes. New
furniture or repairs to the house just had to wait
a little longer until I hit the “big one.”
My cheques only come in at the end of the
month and sometimes I would run out of
money so I would borrow for a week or two
from my sister’s bank account. I have power of
attorney for my sister who is 90 years old and
living in a nursing home with dementia. She
would never have done that to me because in
the first place she would never squander her
money on gambling.
Finally I had enough and decided to call
Gamblers Anonymous but kept putting if off
from day-to-day and from week-to-week and
from month-to-month. But eventually I looked
up the number in the phone book and all I
could find was Problem Gambling Services. I
made that call and a counsellor gave me an
appointment for the following Tuesday.
So far I have been through a twelve-week
treatment program, followed by twelve weeks
of aftercare. A month after starting the program,
I began to attend Gamblers Anonymous on
Monday evenings and I am still going there
faithfully. At this point I have completed oneon-one with my counsellor and I have no desire
to gamble again or to buy any lottery tickets.
The casino did not tempt me because it is too
smoky and too noisy and my $10.00 a day could
be all gone in ten minutes or less.
Life is much better for me now as I can buy
whatever food I desire. Today I paid to have my
nails done and next week I will get my hair
dyed and a haircut. I no longer give cheap
birthday and Christmas gifts. I like to think I was
smart enough some to pick up the phone and
call Problem Gambling Services before the hole
I was digging got too deep. This Illness is
insidious.
34
The Chase: Report on Problem Gambling Vol. 1, Summer 2001.
Reprinted with permission.
Handout #8
Testimonial
HEADS I WIN…35
Tom Hunter has a wicked sense of humour and
most days it’s probably what keeps the
recovering gambling addict sane. At 65, the
retired teacher and school superintendent is
battling Parkinson’s Disease and the call of the
gambling siren. He’s a private man who agreed
to share his addiction story to help others - in
the hope it will prevent seniors from recklessly
betting their pensions, or at the very least, be a
warning that seniors are not immune to the
ravages of problem gambling.
Until 1994 Tom’s only indulgence was the odd
lottery ticket or taking part in the office pool. A
visit from a relative changed that. On his first
visit to Casino Windsor, Tom became
acquainted with blackjack. “It fascinated me but
I didn’t play that first time and watched as a
man put down $200 and in 10 minutes was up
$200,” said Tom. “I went home and got tapes
and books on how to win.” His first experience
playing was in August 1994. It wasn’t significant.
In December, he won big. He started with $600,
playing at the $25 table. As he started winning
he upped his bets to $500 a hand. He was soon
$23,000 ahead, and his fate was sealed. His wife
sent their son to get him out of the casino. “I
gave him a hard time and he was amazed to
see 40 chips in front of me worth $500 each. He
called another son and daughter to come
down and I played a $500 hand for each and
won all three,” Tom said. “Of course I only tell
stories about the wins because you don’t want
to remember the losses.”
As the months passed he would win big,
$42,000 at one 14 hour sitting, before losing it
all back. Other huge loses of $20,000 were also
recalled. He was also getting a reputation at
work as a gambler and he revelled in it. He also
began to suspect he had a problem. Yet he
loved the social aspect of gambling, the
fleeting friendships made around the blackjack
table, playing the big spender – once handing
a $500 chip to a couple who was losing.
His life slowly spiralled out of control. While
away on holiday, he would instruct his son
how to juggle money from one account to
another when his pension cheque arrived. He
ran up credit card debt and ran through their
chequing accounts. Life wasn’t pretty and he
wasn’t having fun any longer.
Desperate, he told his wife what was
happening and handed over all control of the
household money to her. Tom signed a selfexclusion letter, banning himself from the
casino. He had lost a total of $115,000. He also
found Problem Gambling Services. With best
intentions, support from his family and
professional help, Tom is still fighting his
addiction battle, but one that is getting easier.
“It feels good this way. I can be trusted with
money now and I’m at peace with the world.
I’m grateful I still have enough money to live
on,” said Tom, and joked “I have $25 in my
wallet. It’s been a long time since I was allowed
that much.” When Parkinson’s isn’t waging a
war in his body, Tom likes to spend time
improving his computer skills. “Once you
decide the casino is not for you, start doing
other things, think about other things, seek out
someone who understands and who can
support you,” said Tom. “My counsellor is my
conscience. But you can’t do it yourself. I hope
if there’s someone reading this he or she can
recognize themselves and ask for help.”
35
Ibid. Reprinted with permission.
Handout #8
Testimonial
WHEN THE STAKES GET TOO HIGH!!36
Billie Goetz, an intelligent 57-year-old is
sharing her gambling story in order to prevent
another woman from experiencing the pain
she suffered. Billie Goetz started out as a small
time gambler occasionally playing bingo and
making an odd trip to Las Vegas. But as her
family grew up and even though she worked
outside the home, she found herself with
more time on her hands with gambling filling
the void very nicely. Bingo was where a
“respectable” woman could go alone and
when the casino came to town she found it a
place she could go on her own, without being
stigmatized. Billie’s downfall began with a $10
bet that turned into $1,000, and an investment
of six quarters, which won her $10,000.”That
was the hook. I gave some of the money to my
husband and sister-in-law. It was too easy,” said
Billie. But the losses also began to pile up. Billie
quickly ran through $45,000 on lines of credit,
racked up $15,000 on a credit card and
gambled $3,000 she had allotted for laser eye
surgery. The world began closing in and Billie
hit the wall the night she took her last $2,000
and, after 16 hours at the casino, had lost it all.
“My husband was coming home from a
business trip and I wrote him a letter telling
him everything. It blew him away. He’s a man
who has a hard time forgiving and I was really
scared,” said Billie. But he took me in his arms,
said we would work it out and then we told
my daughter.
Billie arranged to meet a counsellor at
Problem Gambling Services and describes
that first session as though the weight of the
world was lifted from her shoulders. After
twelve weeks of individual and group
treatment, she vowed she would never again
want to experience the horror of feeling like
“the lowest of the low, a betrayer.” One year
later Billie returned to PGS requesting the 12week aftercare group for additional support
and says she’s never looked back.
“I don’t have that gut-wrenching dread in the
pit of my stomach. I was at the end of my rope
but I couldn’t even cry because I was afraid of
losing it.” Even simple things are important
now, like not being afraid to let my husband
check the mail,” said Billie. “I want to warn other
people to realize that when you can’t drive by
a bingo hall or casino or some other gambling
place without yearning to be in there, you’ve
got a problem, and you need help. Get it
before it goes too far.”
36
Ibid. Reprinted with permission.
33
Chapter 4
Transition to
Retirement
Lifestyle
This chapter aims to help service providers increase their knowledge about retirement
wellness and balanced living for persons 55+
This chapter will focus on four areas:
•
Planning for Retirement
•
Retirement Wellness
•
Leisure Wellness
•
Shifting Focus in the Life Cycle
34
Planning For Retirement
The Centre for Addiction and Mental Health indicates that in 2002, adults aged 65 and
up comprised almost 13% of the Canadian population. By 2026, this figure is expected
to climb to about 21%, an increase of nearly 50%. Older adults have roughly 7.7 hours
of free time each day. 37 While most people plan their careers, few plan their
retirements.
•
“The closer people got to retirement, they more likely they were to say they were
financially ready or on track for retirement … but they are not prepared for the
emotional changes that come with it.”38
•
Results of a recent poll suggest many Canadians are preparing their finances for
retirement, but few feel prepared for the emotional and social aspects of that next
stage of their life. While 31% said they were well prepared financially for retirement,
only 4% said they are well prepared for the transition to retirement lifestyle.39
•
“Baby Boomers, are the first generation of women to experience wide-scale
financial independence. ‘We’ve gotten caught in a time warp where our economic
realities have changed faster than our expectations and identities’”. Liz Perle author
of Money, A Memoir: Women, Emotions, and Cash writes, “Whereas men have a more
straightforward relationship with money...women are torn between two sets of
modern values. On the one hand, they want money and are expected to be able to
generate it. On the other, they’re still expected to care for their family’s needs first
and foremost. The push-and-pull of it all often leads to …’magical thinking’ – the
fantasy that a white knight will take care of all of her financial troubles. This isn’t
necessarily a regressive fantasy; the white knight is often not a man at all, but a
dream job or maybe a lottery.”40
•
One of the key characteristics of the Baby Boom cohort is diversity: diversity of
expectations, vision of retirement, and dreams.41
•
Tomorrow’s seniors will present a broad spectrum of abilities, interests and needs.
Although many will be healthier, wealthier and better educated than their parents,
some will be vulnerable to poverty, social isolation and their adverse impacts on
health and autonomy.42
•
“Problem gamblers are well educated, have decent incomes, ranging from $40,000–
$50,000, and have few problems with drugs or alcohol. …One of the most
interesting things from a Canadian perspective … is that these are people who
look like they might not be previously seen in an addiction setting”. 43
37
“Problem Gamblers: Seniors Specialty,” Toronto: Centre for Addiction and Mental Health, at: http://www.camh.net/
Care_Treatment/Program_Descriptions/Problem_Gambling/problem_gambling_seniors.html [accessed 9
March 2006].
38
Ibid.
39
“Retirees Not Emotionally Ready: Poll.” The Sault Star, February 2006.
40
“Women and Money: The Last Taboo.” Macleans, 13 February 2006.
41
AARP Baby Boomers Envision Retirement II – Key Findings, may 2004.
42
Expressions, Spring 2000, p. 7.
43
The Sault Star, 15 June 2003.
Transition to Retirement Lifestyle
Chapter 4
35
•
According to Lynn McDonald44 (Expressions 2000), the look of retirement continues to
change. What is now described as the “New” Retirement provides many different
approaches to retirement. Five key areas are emerging:
1. A
ge: the age at which older adults decide to retire today is much more varied;
Age:
out
es: how a person is directed towards retirement is more varied – buyouts,
2. R
Rout
outes:
layoffs, the need to care for an aging parent or sick spouse;
3 . In
v olun
tar
y rretir
etir
emen
Inv
oluntar
tary
etiremen
ementt : used to happen when people reached mandatory
retirement age, but now it’s more likely to result from job loss or caregiving;
etir
emen
etur
ning tto
o the w
or
or
ce): is a new trend (225,000 - 6% of
4. R
ev ersing rretir
etiremen
ementt (r
(retur
eturning
wor
orkk ffor
orc
Re
the senior population in 1998);
5. N
o rretir
etir
emen
No
etiremen
ementt : may be another new trend due to the need to supplement income.
In Healing Journey Through Retirement, the authors state that adjusting and
adapting to retirement is an immediate issue. 45 They list the common difficulties
experienced by persons in the transition to retirement:
____ Being alone more of the time
____ Feeling useless
____ Having less money
____ Free time
____ Boredom
____ Feeling disempowered
____ Having nothing to do
____ Not having a job to go to
____ Changes in relationship
with spouse
____ Having to do things I don’t
want to do
____ Lack of structure
every day
____ Not having clearly defined
identity
____ Getting used to being home all day
____ Sense of being disconnected
The authors further state that “people who develop interests outside of work
before they retire are likely to make the best transition from work to retirement.
On the other hand, those who have little time for anything else outside of their
job are likely to feel the greatest loss when the office door shuts behind them.”
•
“I was lonely, my life had no excitement, I was depressed and bored,” said Eve Trottier, a
widow of 28 years. “I wanted something to fill the gap. I guess I felt sorry for myself
after I retired.”46
As mentioned earlier, older adults – especially recent retirees – are beginning to form a
significant market for the gaming industry. A significant sub-group in this market could
be at risk for developing gambling-related problems. Hence it is important that
individuals assess how they plan to adjust for the next phase in their lives and learn to
plan how to use their newly available free time.
44
Expressions Spring 2000.
Rich, P., D. Madway Sampson, and D.S. Fetherling. 2000. Healing Journey Through Retirement. New York: John Wiley
& Sons, Inc.
46
“Seniors Gamble to Beat Loneliness, Study Shows,” The Sault Star, ˆ19 February 2004.
45
Handout #1
Retirement Wellness Chart
Healthy retirement whether early, planned or mandatory, requires planning. Without a sense of balanced living we
will encounter common difficulties such as social isolation, boredom, loss of sense of connection and loss of sense
of belonging, unhealthy changes in our relationships, and loss of structure and purpose. These losses and changes
can lead to unhealthy ways of coping and problem solving. It is important to regularly assess our wellness
throughout retirement to enhance our enjoyment of life and evaluate what we like, what we want to change, and
what we want to stop doing.
Evaluate your wellness in the Seven Life Areas. Be sure to interpret each Life Area as it fits your lifestyle, culture, and
understanding of the word. Some examples are provided below to help. Identify areas in which you are doing
well. Determine areas that you would like to improve or change and list action steps to meet your goal.
Scale: 1: lowest score indicating minimal satisfaction in this area
Scale 10: highest score indicating extremely satisfied with this life area
S ocial: exercise group, bowling, dances, parties, club meetings, film festivals, taking a course, attending concerts or
sporting events;
P hy sic
al: Tai Chi, walking, regular doctor’s appointments, yoga, swimming, golfing, skating, gardening, hiking,
sical:
fishing;
In
tual
tual: Reading, taking courses, joining a book club, learning a new language;
Intt ellec
ellectual
P ur
poseful: volunteering, teaching others a new skill, visiting;
urp
E motional: Stress reduction exercise, meditation, writing, listening to music, performing or playing an instrument,
painting, sculpting, writing poetry or prose;
S pir
itual: nature walks, creating art, church, attending spiritual events;
piritual:
L eisur
e: gardening, cycling, cross-country skiing, boating, photography, chess club, theatre, movie night, walking,
eisure:
cooking.
Handout #2
Leisure Wellness Chart
To prevent gambling from becoming a problem in your life, it’s important to develop a balance in your leisure
activities. Older adult designed activities are available several places throughout your community. You may want
to call or drop in to your local seniors drop in centre, pick up a senior’s newspaper to review a calendar of events
and activities, or check your local college or YMCA to check out courses and activities.
Here are a few ideas to get you started:
What were some activities that were fun for you in the past?
What are some activities that you always wanted to try but didn’t have time?
What are some activities that will get you physically fit?
Handout #3
Throughout the life cycle, the focus of our time and energy shifts in accordance with our priorities at various
stages in our lives. As young people, we have opportunity to invest ourselves in playfulness. As adults, we invest
most of our time and energy in the responsibilities of career, home-making and raising a family. As we enter later
stages in life we become more contemplative, reflecting on our life goals and accomplishments. The following
provides an overview of the impact of these shifting priorities and the implications for living a balanced life.47
47
Adapted from conversations with Hugh Walker, M.Div. M.M.F.T. Director/Supervisor of Clinical Pastoral Education and Evelyn Bakich, RN CPGC, St.
Joseph’s Care Group, 2002.
Handout #3
(cont)
Handout #3
(cont)
DIVIDE THIS CIRCLE TO REPRESENT THE THREE AREAS: PLAYFULNESS, RESPONSIBILITY
AND CONTEMPLATION IN YOUR LIFE TODAY
•
As you complete your diagram what do you notice?
•
Has there been a shift in focus in your life?
•
What is going well in each of these areas?
•
Who and what is important to you in your life today?
•
Envision the kind of life you desire? What would the circle look like.
•
Identify steps to make changes or enhance your life.
41
Chapter 5
Resources
•
Educational Resources
•
National Resources
•
Useful Web Sites
•
Where to Find Help
•
References
42
Educational Resources
BETTING ON OLDER ADULTS: A PROBLEM GAMBLING
AWARENESS KIT
This primary prevention kit offers a variety of interactive tools that help to increase
awareness of low-risk gambling behaviours. Also includes a video on problem
gambling awareness and numerous resource materials including a Facilitator’s
Guide, an interactive Bingo© game and Gamble Scramble©. The kit is available to
problem gambling service providers throughout the province of Ontario at no
charge. Produced by The Ontario Resource Group on Problem Gambling & Older
Adults 55+ and the Responsible Gambling Council with generous support from the
Ministry of Health and Long-Term Care.
Cost: One complimentary kit is available to Ministry of Health-funded problem
gambling treatment agencies within the Province of Ontario. Other interested
parties contact:
1. Responsible Gambling Council
3080 Yonge Street, Suite 4070 Box 90
Toronto, Ontario, Canada M4N 3N1
Telephone: (416) 499-9800
Fax: (416) 499-8260
Internet: www.responsiblegambling.org/olderadults/
2. Evelyn Bakich, Sister Margaret Smith Centre-St. Joseph’s Care Group
35 Algoma Street N., P.O. Box 3251
Thunder Bay, Ontario P7B 5G7
Telephone: (807) 343-2425 ext. 2861
Fax: (807) 343-9447
Internet: www.mha.sjcg.net/as/gambling/
GAMBLING AWAY THE GOLDEN YEARSTM: SENIOR PROBLEM
GAMBLING EDUCATIONAL KIT
This educational resource examines the potential for gambling to turn from a
recreational activity to an addiction, especially during the retirement years. The
educational kit contains ten copies of the 18-page book Gambling Away the
Golden Years and a 10-minute video by the same name. The kit is designed for use
in treatment settings, public education presentations, senior citizen facilities, and for
the educating health care providers. Cost: US$110.00.
IN SEARCH OF BALANCETM: EDUCATIONAL KIT
This educational kit includes a 23-minute video and ten 25-page workbooks. The
video discusses such topics as How the Senior Gambler Feels, “Soft Signs” of a
Gambling Problem, and The Road to Recovery. The kit is directed at all levels of
helping professions and can be used in a variety of settings. Cost: US $165.00.
Resources
Chapter 5
43
COMPULSIVE GAMBLING AND SENIOR CITIZENS
A three-fold brochure provides general information on gambling addiction among older
adults. Cost: US$6.25 per pack of 25.
Contact: North America Training Institute
314 West Superior Street, Suite 508
Duluth, Minnesota, 55802
Telephone: 1-218-722-1503
Fax: 1-218-722-0346
Internet: www.nati.org/products/
RESPONDING TO OLDER ADULTS WITH SUBSTANCE USE, MENTAL
HEALTH AND GAMBLING CHALLENGES A GUIDE FOR WORKERS
AND VOLUNTEERS
This booklet describes problems with alcohol, anxiety, dementia, depression, gambling
and medications in older people, and identifies the signs of each problem. Tips on talking
with older adults with these problem are included, as well as pointers on when to seek
help.
For information or to place an order:
Centre for Addiction and Mental Health
Publication Services
Tel: 1-800-661-1111 or 1-416-595 6059 ( Toronto)
Email: [email protected]
Website: www.camh.net
Reproducible copy of this publication is available on the Internet at
www.camh.net/care_treatment/Resources_for_Professionals/Older_adults (English)
www.camh.net/fr/care_treatment/Resources_for_Professionals/Older_adults (French)
44
National Resources
FIRST NATIONS AND INUIT HEALTH BRANCH
Health Canada
1921 Tunney’s Pasture, 21st Floor
Ottawa, Ontario K1A 0K9
Telephone: 1-613-957-2991
Internet: www.hc-sc.gc.ca
English/French
DEPARTMENT OF INDIAN AFFAIRS
AND NORTHERN DEVELOPMENT
Terrasses de la Chaudiere
10 Wellington, North Tower
Hull, Quebec
Ottawa, Ontario K1A 0H4
Telephone: 1-819-997-0380
Internet: www.ainc-inac.gc.ca
English/French
CANADIAN CENTRE FOR ACTIVITY AND AGING (CCAA)
The University of Western Ontario
1490 Richmond Street
London, Ontario N6G 2M3
Telephone: 1-519-661-1603
Fax: 1-519-661-1612
Internet: www.uwo.ca/actage
English
ACTIVE LIVING COALITION FOR OLDER ADULTS
33 Laird Drive
Toronto, Ontario M4G 3S8
Telephone: 1-416-423-2163
Fax: 1-416-423-2112
Toll Free: 1-800-549-9799
Internet: www.alcoa.ca
English/French
Resources
Chapter 5
45
INSTITUTE FOR LIFE COURSE AND AGING,
UNIVERSITY OF TORONTO
222 College Street, Suite 106
Toronto, Ontario M5T 3J1
Telephone: 1-416-978-0377
Fax: 1-416-978-4771
Internet: www.utoronto.ca/lifecourse/
English
THE ONTARIO GERONTOLOGY ASSOCIATION
351 Christie Street, Suite C216
Toronto, Ontario M6G 3C3
Telephone: 1-416-535-6034
Fax: 1-416-535-6907
Internet: www.ontgerontology.on.ca
English
Useful Web Sites
A ging in C
anada: www.agingincanada.ca/site.htm
Canada:
On
tar
io P
ambling R
esear
ch C
en
e: www.gamblingresearch.org
Ontar
tario
Prr oblem G
Gambling
Resear
esearch
Cen
entt rre:
ouncil: www.responsiblegambling.org
R esp
onsible G
ambling C
esponsible
Gambling
Council:
Canadian C
en
e on SSubstanc
ubstanc
eA
buse: www.ccsa.ca
Cen
entt rre
ubstance
Abuse:
Cen
e ffor
or A
ddic
tion and M
en
tal H
ealth: www.camh.net/Care_Treatment/
entt rre
Addic
ddiction
Men
ental
Health:
Program_Descriptions/Problem_Gambling/gambling.html
eH
arb
or C
ompulsiv
eG
ambling Hub: www.sfcghub.com/index.html
S a ffe
Harb
arbor
Compulsiv
ompulsive
Gambling
G am-A
non and G
am-A-T
een: www.gam-anon.org
am-Anon
Gam-A-T
am-A-Teen:
G ambling A
non
ymous: www.gamblersanonymous.org
Anon
nonymous:
J our
nal of G
ambling IIssues:
ssues: www.camh.net/egambling
ournal
Gambling
N or
th A
mer
ic
a T r aining Institut
e: www.nati.org
orth
Amer
meric
ica
Institute:
T he Institut
e ffor
or P
ambling: www.gamblingproblem.org
Gambling:
Institute
Prr oblem G
46
Where to Find Help
To find out more information on preventing problem gambling, contact one of the
agencies listed in the Ontario Resource Group on Problem Gambling and Older Adults
55+ at the front of this manual.
COMMUNITY LEGAL EDUCATION ONTARIO
1-416-408-4420
www.cleo.on.ca
English/French
GAM-ANON AND GAM-A-TEEN
1-416-366-7613
www.gam-anon.org
GAMBLERS ANONYMOUS
1-416-366-7613
www.gamblersanonymous.org
GAMBLERS ANONYMOUS, ONTARIO LOCATIONS
Toronto Hotline:
Windsor Hotline:
Niagara Falls Hotline:
Ottawa Hotline:
Internet:
(416) 366-7613
(519) 971-5215
(905) 351-1616
(613) 567-3271
www.gamblersanonymous.org
LEGAL AID ONTARIO
1-800-668-8258
www.legalaid.on.ca
English/French
ONTARIO PROBLEM GAMBLING HELPLINE
1-888-230-3505
www.opgh.on.ca
ONTARIO ASSOCIATION OF CREDIT COUNSELLING SERVICES
1-905-945-5644
To find the nearest registered OACCS agency go to: www.oaccs.com
Resources
Chapter 5
47
References
“Aboriginal Seniors’ Issues,” in Writings in Gerontology (15), Ottawa: National Advisory
Council on Aging, 1994.
Addictions Research Foundation, Lifestyle Enrichment for Senior Adults at Centretown
Community Health Centre and Community Older Persons Alcohol Program. 1993.
Alternatives: Prevention and Intervention for Alcohol and Drug Problems in Seniors.
Toronto: Addiction Research Foundation.
Addictions Treatment Clinic: Sault Area Hospitals, Lifestyle Enrichment for Senior Adults at
Centretown Community Health Centre, Sister Margaret Smith Centre at St. Joseph’s
Care Group and Responsible Council, 2005. Betting on Older Adults: A Problem
Gambling Awareness Kit. Toronto: Responsible Gambling Council. Available at:
www.responsiblegambling.org.
Aging in Canada. 2006. “Lesbian, Gay, Bisexual and Transgender (LGBT ) Older Adults:
Alcohol Dependence and Misuse Among Older Gay and Lesbian People.” Available
at: www.agingincanada.ca/lgbt_older_adults.htm. [accessed 22 February 2006].
Appleby, G.A. and J.W. Anastas. 1998. Not Just a Passing Phase: Social Work with Gay, Lesbian,
and Bisexual People. New York: Columbia University Press.
Auger, D. 2000. Dreamchaser: Alberta Aboriginal Adult Gambling. Prevalence Study.
Edmonton: Nechi Training Research & Health Promotion Institute.
Baker, F.M. and J. Takeshita. 2001. “The Ethnic Minority Elderly,” in W.S. Tseng & J. Streltzer
(eds.), Culture and Psychotherapy: A Guide to Clinical Practice. Washington: American
Psychiatric Press, Inc.
Berman, L. 1992. Behind the 8-Ball: A Guide for Families of Gamblers. New York: Fireside Press,
Simon & Schuster.
Boughton, R., and J. Brewster. 2002. Voices of Women Who Gamble in Ontario: A Survey of
Women’s Gambling, Barriers to Treatment, and Treatment Service Needs. Toronto: Ontario
Problem Gambling Research Centre. Available at: www.gamblingresearch.org/
download.sz/voicesofwomen%20Boughton%20(1).pdf?docid=1524 [accessed 2
March 2006].
Brown, S. and L. Coventry. 1997. Queen of Hearts: The Needs of Women with Gambling
Problems. Melbourne: Financial and Consumers Rights Council, 2006. Available at:
http://home.vicnet.net.au/~fcrc/research/queen.htm. [accessed 21 February 2006].
Canadian Journal of Psychiatry. Sault Ste. Marie: The Sault Star, June 15, 2003.
Centre for Addiction and Mental Health: Problem Gambling Project. 2005. Problem
Gambling: A Guide for Helping Professionals. Toronto: Centre for Addiction and Mental
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Betting on Older Adults: A Problem Gambling

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