A 2013 report by the Institute for American Values titled "Why Casinos Matter" looked at studies on the way slot machines are designed to get players to enter "the zone" for an almost trance-like journey as they are fed small rewards.
Those rewards, however, amount to less than the money being taken and can come in the form of points redeemable for a "free" lunch or an item in the gift shop. Eventually the machine does its job if it takes people to the end of their money — what industry parlance calls "playing to extinction."
"It is like getting high," Bernal with Stop Predatory Gambling says. "It is like taking a needle into your arm, but you are doing it through an electronic gambling machine."
Identifying the point where that "high" becomes addictive is difficult to quantify, but is key to how much revenue casinos make from their most addicted players and problem gamblers. The "Why Casinos Matter" report examines 11 scholarly studies on the subject and finds that anywhere from 35 percent to 55 percent of casino revenues come from problem gamblers. If you look at only gambling machines, the report says the percentage of profits coming from problem gamblers using the machines ranges from 42 percent to 74 percent.
The gaming industry, however, cites a poll commissioned by the American Gaming Association that found that 75 percent of seniors who visited a casino in the last year set a budget. Three-fourths (76 percent) of them set a budget of less than $200 and a majority (58 percent) set a budget of less than $100. The assumption is that seniors keep to the budgets they set — although the report makes no indication.
When Bilkey worked as a gerontologist in Palm Springs, California, he began seeing more and more older adults afflicted with compulsive gambling problems. "All kinds of horrible stuff," he says. "I thought, 'Wow, this is going to be a big problem because of the ever-increasing numbers of older adults.'"
Bilkey said he had clients who were diagnosed as bi-polar who would spend three days in a casino. "It is a haven (of) wonderful wait staff who serve you drinks, who are friendly and want to see you," he says. "It is a perfect setup for difficulty — especially if you have difficulties."
He is particularly worried about seniors who are beginning to experience any kind of cognitive decline or even dementia. "People are not going to be able to focus," he says. "They won't recognize the difference between a one-cent machine and a dollar machine. But even for people with that difficulty, there is nobody monitoring that."
At the same time, the Journal of Aging Studies found that seniors who gamble, in general, do better than the general population in money management and have fewer gambling problems.
Another study in the September 2004 issue of The American Journal of Psychiatry found that older problem gamblers were not motivated by the allure of winning like younger gamblers, but were there out of boredom or to pass the time.
Chris Moyer, a spokesman for the American Gaming Association, points to the National Center for Responsible Gaming, a gambling industry-sponsored organization that funds research into the causes and cures of addictive gambling. "The industry is certainly very concerned about this," he said. He also points out that the AGA's 2013 survey shows that only 28 percent of seniors age 65 and over visited a casino in the past year — compared to 39 percent of people age 21 to 35.
Ed Hogarty, 80, of Concord, California, didn't begin gambling until he retired in 1994.
"Early on I won $4,000," he says. "That inspired me to go again."
It also got him on a mailing list.
"Every time I want to go, there is a newsletter from the casino with a coupon for $20 free play," he says.