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

While helping arrange her dad's medical care, Gina obtained power of attorney to manage his finances during his hospitalization and recovery. Gina's full name is not being used to protect her father's privacy.

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

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

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

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

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

"He just fluffs it off."

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

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

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

'The new senior centers'

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

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

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

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

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

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

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

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

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

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

No refunds are allowed

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

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

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

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

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

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

"But the next time, and the time after that, it doesn't work."

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

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

That's what happened with Gina's father.

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

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

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

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

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

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

No cash means no gambling

At Jewish Family Services, which provides addiction treatment, counselors see many people who, like Gina's father, are in denial.

The initial call for help often comes from a concerned family member, according to gambling treatment counselor Mary E. McConnell.

"I tell the family, the first thing you need to do is get control of their money, because if they don't have money, they can't gamble," McConnell said. "In New York State, you cannot gamble without cash. You cannot buy a scratch-off card or numbers ticket with a credit card; you can't play in a casino without cash."

That can be easier said than done. Without the incentive of major health problems, like those that gave Gina the legal power to help her father, many adults resent being told what they can do with their money.

Cutting off their access to gambling is only the first step, McConnell said.

The dopamine high fueled by a slot machine is psychologically and physically addictive, and chemically resembles that produced by cocaine, "lighting up" the same parts of the brain as the drug. The rush is stimulating and helps relieve one of the chief problems facing the isolated elderly: boredom.

"You're in your own little world, it's just you and the machine. You get in the zone, you're focused on the game, everything in your life recedes into the background," Wert said. "The players feel numb. They aren't feeling the pain of their losses -- the kids being out of the house, the loss of their spouse and maybe their friends.

"It even can be the loss of their own health and the ability to do things they enjoyed. It's an escape."

And escape they do.

Researchers play catch-up

Gambling often is the first or second choice of seniors who are asked about their favorite forms of recreation, and the boom in casinos has outrun the research on it.

Social scientists continue to play catch-up in understanding gambling's lasting effects. They know that getting out with others can be good for lonely seniors, while losing the rent money is obviously bad. In between, a huge gray area looms.

"People in the general population who look in casinos see lots of older people, especially in the daytime, and they think this has to be a bad thing, they must have a problem," said Dr. Rachel A. Volberg, president of Gemini Research, a company that studies problem gambling. However, she added, "there is surprisingly little empirical research" on the subject of seniors and gambling.

For one thing, researchers have not settled on exactly what constitutes "responsible" gambling and what is reckless.

Does a gambler have to be disgusted about his or her losses, or in despair, before it's a problem?

"It's also true that many assisted-living facilities and senior centers take their clients to casinos themselves to get them out and for a change of scene," Volberg said. "There's certainly an argument to be made that gambling in this way can be social and stimulating, and help older adults maintain cognitive function."

Volberg is doing her research in Massachusetts, which, like New York, is planning to expand its number of casino venues.

"In a few years, we should have a better idea of the impacts," she said.

Field trips to casinos

Talk to any of the many seniors who gamble recreationally, and they happily acknowledge that winning is a long shot. Maybe that is why it is also a thrill.

Mostly they view it as an entertainment expense, on par with going to the theater or out to dinner, and consider a casino outing good value for the money. There is good food and frequently live entertainment geared toward an older audience.

At the Cheektowaga Senior Center, as at many others just like it, casino bus excursions are part of a wide mix of activities, along with pizza parties, movie nights and the popular afternoon pinochle sessions.

Most of the travelers gathering for an overnight excursion to the Seneca Allegany Casino and Hotel earlier this year had already set their betting budgets. The most conservative gamble only with the "free play" vouchers that come with their bus tickets, and when that's gone, they head to the spa or buffet.

One woman, Sally, said she likes the slots, but only as long as the machine cooperates with a rewarding give and take.

"You can tell if it's going OK, or you quit," she said. "We'll have a nice dinner tonight and come home tomorrow. I like it best when there's a show."

Jerome, who was going with his wife and some other couples, also had a level-headed approach.

"You can only gamble so much. It's more or less a party," Jerome said. "We'll do a little swimming, get in the Jacuzzi. Then the guys will play some cards. It's a good deal."

"The key," he said, "is not to take more than you want to lose."

But with convenient ATMs nearby, that key can get lost all too quickly. More than half of the people who go to casinos spend more than they planned, studies show, something Gina and her father learned in the hardest way possible.

"I found this long yellow receipt from the casino, showing he had won $2,200 back in November," Gina said. "Mind you, he had $18 in the bank in January. I asked him what happened to the $2,200 and he kind of waved his hand at me and said, 'I put it back in. I put it back in.'"

These days, Gina is looking for a permanent health care facility for her father and signing him up for Medicaid; he's eligible now that he has lost his house. She's trying to put aside her frustration and get him settled as best she can.

"I don't have the answers. I don't know when it started," she said. "All I know is he had no savings. He spent all his money, and he doesn't want to talk about it. I don't know. Maybe he thought he was going to die and it didn't matter."

Melinda Miller wrote this article with support from the MetLife Foundation Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America. email: mmiller@buffnews.com

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