DEMENTIA SERVICES FOR INDIVIDUALS AND ORGANISATIONS JULIE COLE OCCUPATIONAL THERAPIST

Casino Daycare: A Good Idea?

 

An article about an alternative to conventional day care  caught my eye.   The founder,  Kaoru Mori,  had an idea after seeing how enthusiastically older people  participated in gaming activities in Las Vegas.     So he’s set up a number of casino-type day centres in his home country of Japan, a nation where  gambling is usually frowned upon.    Although real money is not needed attendees enjoy games such as poker, mahjong and slot machines.  They  receive their daily kitty to play as an incentive for engaging in health checks and physical exercise at the start of each session.    If they fancy a break from the tables or perhaps when they have ‘lost their shirt’ for the day additional activities such as karaoke, massage,  movies and art are on offer.

I have to be honest and confess that my initial thoughts were not altogether approving.   Would being exposed to a casino-like environment on such a regular basis, albeit one where money is fake,  have the potential for harm?   Could it  lead to problem behaviours online or in high street betting shops in countries like the United Kingdom where gambling is legal and readily available ?  For the majority of day care attendees  this might not be an issue.  Many are not conversant with I.T. or may not enjoy unsupervised access to the community.    Even so,   a minority of vulnerable individuals including those with cognitive problems such as dementia,  lead less restricted lives.  Could being habitualised to gambling behaviours  lead to addiction and its associated problems?  Certainly some in Japan have concerns.  This type of daycare has been banned in some cities.

However I can also see obvious advantages too.  There’s no doubt that gaming  provides enjoyable cognitive and sensory stimulation and the activities can, to a degree, be graded according to a person’s ability.  By their practice of providing an incentive  for exercise and health checks, the centres in Japan  promote physical well-being too.   Going to a casino might also evoke a sense of occasion,  a time to dress up, thus giving a person a purpose to make an effort over their appearance.    The element of chance inherent in gaming brings spontaneity and surprise to lives which might otherwise be mundane    These are places  which offer  activities that are targeted at adults and cannot be viewed as regressive in nature.    They appeal to both sexes, a fact that cannot be lost on conventional daycare providers who sometimes struggle with finding activities that resonate with men.   It is also true that the  environment of a casino is by its very nature one that encourages  meaningful social interaction.  The fact that there is so much going on can break down barriers caused by shyness when being introduced to an unfamiliar environment.  They encourage an individual to focus outside themselves and onto what they are doing thus breaking down feelings of self consciousness.

In part these day centres owe their success to the generous subsidies available for care in Japan. Even if this cannot be replicated in other parts of the world for economic or other reasons there is much to be learnt from it.     The opportunity that these care settings  provide for intensive age appropriate activity  for both sexes that is engaging on so many different levels gives food for thought.    Can aspects of this model be taken to improve day care in other settings?   Is it a good idea to reward participation in physical activity to improve motivation?  What  features of the activities on offer make them so popular?  Might others that are easily accessible have the same wide appeal?    And could gaming with all its inherent benefits perhaps using tokens, fake money or even small change, be included occasionally into a balanced activty programme?

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