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Controversial casino-style gaming a hit with the elderly at adult day care centers

A group of elderly people enjoy playing cards on a table used for baccarat while another group in the back plays on a mahjong table at "Las Vegas Adachi Branch" in Tokyo's Adachi Ward on May 15, 2018. (Mainichi/Akira Iida)

TOKYO -- As the government is preparing to introduce casinos to increase tax revenues and shore up the economy, some adult day care centers in Tokyo and other parts of Japan are already offering such gaming facilities in a bid to stem dementia among elderly users.

But casino-type nursing care is apparently a double-edged sword as it carries the risk of producing elderly gambling addicts, and some local governments have begun to regulate such moves.

Decks of cards were spread out besides a stack of chips on a table used for playing baccarat on one recent weekday afternoon. "Can you give me one (a card) too," an elderly player said to a day care worker acting as a dealer. Other senior players stared eagerly at the card as it was handed out.

"Las Vegas Adachi Branch" is one such casino-style adult day care center based in Tokyo's Adachi Ward. The facility, which opened in 2013, has everything from pachinko machines to mahjong tables. The male-to-female ratio is seven to three and the average age of users here is over 80, with more than half of them having mild dementia.

Users are given a pseudo currency called "Vegas." Most of them enjoy playing casino games and mahjong, even though there are options for normal rehabilitation. Although Vegas cannot be turned into actual money, the person who is the biggest winner receives a commendation. A 78-year-old male user who visits once every week smiled and said, "It's fun to win and lose. I even want a revision of my nursing care level, so that I can come here more often."

ACA Next Inc. based in Tokyo's Minato Ward has started operating 20 casino-type adult day care centers, including the Adachi Branch, in seven prefectures such as Tokyo, Kanagawa and Aichi and it aims to establish 100 branches by 2020. Chief Executive Officer Kaoru Mori, who decided to introduce such a concept after visiting overseas casinos, stated, "We have not identified any users that showed addiction. We will continue to provide such a service as a choice for elderly people."

Kikunori Shinohara, a Suwa University of Science professor in the field of neuroscience with detailed knowledge on training the cognitive function of seniors, pointed out, "Parts of the brain associated with cognitive functions and motivation are likely to increase activity when playing mahjong, pachinko, casino games, etc. It may help maintain the elderly's motivation if incorporated into their rehabilitation."

There are other companies that run similar facilities. However, some local governments have begun to regulate such moves, considering the purpose of nursing care insurance which usually uses public funds to cover 90 percent of the service fees. Hyogo Prefecture and its capital city Kobe established ordinances in 2015 to prohibit facilities that offer mainly games like pachinko and mahjong as preventative care from being official government-designated centers. Rules restricting those facilities, such as prohibiting the use of pseudo money so it does not encourage gambling, are included in regulations introduced by the Hyogo Prefecture city of Amagasaki in November 2016 and Tokyo's Arakawa Ward last March.

A Hyogo Prefectural Government official in charge said that taxpayers will not accept spending their money on care services focused solely on casino games. "You cannot justify seniors becoming gambling addicts by letting them spend over half of their time playing games at a care facility," the official said.

A health ministry official handling nursing care for the elderly said the central government is aware of some local governments taking steps to regulate such facilities. "But we haven't made a decision as a government on whether casino-type adult day care services should be allowed or not."

(Japanese original by Akira Iida, City News Department)

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