Doctor of Philosophy, The Ohio State University, 1985, Graduate School

Doctor of Philosophy, The Ohio State University, 2011, Anthropology

The purpose of this study is to characterize the variable microstructure of the elderly human rib in an attempt to elucidate its contributions to biomechanical adaptive responses and fragility. Histological sections were made from Basic Fuchsin stained bilateral 6th ribs from 10 elderly post-mortem human subjects (PMHS). Percent Porosity Area (% Po.Ar), mean Osteon Area (On.Ar), mean Crack Length (Cr.Le), Crack Density (Cr.Dn), and Crack Surface Density (Cr.S.Dn) were successfully quantified and analyzed. ANOVA results indicate that all variables show significant inter-individual variation, but no significant bilateral variation within individuals. Subject variation could contribute to differential individual fragility. Paired t-tests revealed cortex differences for these variables (most are significant) between compressive and tensile cortices in a presumed cyclic bending loading pattern in the rib. These findings can contribute to interpretations about loading history and mechanical adaptation as well as bone behavior prior to failure. A methodological investigation into microfracture data collection showed significant differences between a “total” dataset and a “sampled” dataset. Therefore, it is recommended that only microfracture data collected from the entire rib cortex be utilized in future studies until a more representative sampling method can be developed. This study should prompt investigators to incorporate a histological perspective into interpretations as to why and how bone failure may occur and what contributes to fracture risk in the elderly rib in both modern and past populations.

Doctor of Philosophy, The Ohio State University, 2004, Educational Theory and Practice

An urgent need exists to reduce elderly women's risk for breast cancer by promoting a health behavior that could lower this threat. The knowledge of breast self-examination could represent a health behavior that leads to the detection of advanced breast cancer and could influence elderly women's self-rated health status. The focus of this study was to determine if the knowledge of breast self-examination (BSE) as an adaptive health behavior can influence the self-rated health status of elderly women. Additional factors were also considered for the extent of their potential influence on an elderly woman's estimate of health. The purpose of this research was to study the relationship of breast cancer risk, knowledge of BSE, environmental press, and individual competence factors on the self-rated health status of women, age 75 years and older, residing in a group of assisted living facilities. This study looked at whether BSE knowledge could be a significant contributor to these women's self-rated health status. This research was conducted with a quasi-experimental design and used random assignment to place assisted living facilities in either treatment or control groups. On the participant level, older women were provided with their risk of breast cancer prior to the intervention. In addition, the experimental group of older women received BSE instruction and then 8 weeks later were surveyed as to their health. Likewise, the control group provided the same data, except BSE instruction was withheld. A t-test was done to check for differences between the groups as well as a correlation to gauge relationships between the independent variables and the dependent variable for each of the groups. Finally, a step-wise linear regression was preformed to find which of the independent variables best explained the most variance in the dependent variable for each of the groups. BSE knowledge was shown to contribute statistically to the experimental older women's self rated mental (open full item for complete abstract)

PHD, Kent State University, 2022, College of Nursing

Despite a plethora of research examining fall risk, including numerous fall prevention strategies, falls remain the most common adverse event among the elderly. Frail older adults are at higher risk for falls. With the increase in the geriatric population and their risk for frailty, it is imperative to address the limitations of both diagnosis and treatment of frailty, and the concurrent fall risk for older adults in Saudi Arabia by examining self-perception of fall risk. In older Saudi Arabian adults, falls are a serious health issue affecting up to 49.9% of elderly people, often resulting in fractures, traumatic brain, and limb injuries. Each year an estimated 684,000 individuals die from falls globally and of particular concern 80% of these falls occur in countries considered low to middle income. This study expands the understanding of falls in the elderly by examining the relationship among individual perceptions of fall risk. Utilizing the Health Belief Model (HBM) as the framework, this study seeks to understand the relationships among individual perceptions related to risk for falling by examining perceived susceptibility, perceived severity, perceived benefits, perceived barriers, frailty, demographic variables, and fall risk level among older adult patients admitted in an acute care setting in King Salman Armed Forces Hospital (KSFAH) in Saudi Arabia. A descriptive correlational, cross-sectional research design was used to examine the relationships among the variables. Measurement tools included the Health Belief Model (HBM) scale, demographic data, Part B of the Tilburg Frailty Indicator, and the Morse Fall Scale. Mean scores of individual perceptions were reported significantly higher in the No Fall of risk participants over High risk fall patients (p < 0.05). The mean scores for “No Fall risk” are significantly higher than “High Fall Risk” in all four HBM domains, both individually and in the overall HBM (p < 0.05). Also in this study, age and frai (open full item for complete abstract)

Doctor of Philosophy, Case Western Reserve University, 2022, Systems Biology and Bioinformatics

Delirium has the highest occurrence rate of any complication in hospitalized adults over the age of 65. The study objective was to determine healthcare providers' current issues and challenges in delirium prevention to be used in the development of the Automated Delirium Assessment and Management System (ADAMS). We used a mixed-methods approach to collect valuable information and evaluate the knowledge and practices of healthcare providers. Ninety-seven healthcare professionals from medical and surgical wards were surveyed to determine their beliefs and perceptions. The majority of providers affirmed that current delirium protocols are helpful; however, existing screening instruments and methods for documentation are cumbersome, resulting in incomplete or limited documentation of episodes. These barriers lead to an understatement of the evidence available for continuous improvement of the patient management process. Subsequently, focus groups were conducted with 10 healthcare providers to derive a deeper understanding of the phenomenon, gauge interest, and discuss further current challenges and assessments. Thematic analysis revealed the following four main themes: (1) Factors impacting pharmacological and non-pharmacological delirium interventions, (2) Electronic medical record (EMR) experiences and concerns, (3) Delirium patients' experiences; and (4) Healthcare providers' perceptions of technology. Our focus group discussions revealed the importance of a more streamlined approach to assessing and managing delirium in critically ill elderly patients. Education of healthcare providers must take a more inter-professional approach, emphasizing the importance of sharing personal stories as well as the importance of documenting delirium assessments to enhance communication. The overall conceptual framework of our intervention (ADAMS) was based on the Donabedian quality assurance approach that takes into consideration three dimensions of quality care: structure, proces (open full item for complete abstract)

PhD, University of Cincinnati, 2022, Engineering and Applied Science: Computer Science and Engineering

The constantly increasing global elderly population is associated with a wide range of needs due to the varying degrees of decline in behavioral, social, emotional, mental, psychological, and motor abilities. Falls, highly common in the elderly, on account of such declining abilities and environmental factors, can limit their abilities to perform Activities of Daily Living (ADLs), as well as cause multiple health related complications including death. Therefore, it is essential that the future of intelligent living spaces, such as Smart Homes, are equipped with adaptable, pervasive, and ubiquitous systems that can anticipate and respond to these diverse needs of the elderly, while being able to track their dynamic indoor location, to provide solutions as and where such needs arise. The interdisciplinary work presented in this dissertation, aims to address these challenges and makes ten scientific contributions to these fields. First, it presents a methodology that investigates the many modalities of user interactions to deduce a user's indoor location in a particular "activity-based zone" during ADLs. Next, it presents a context-independent solution to determine the "zone-based" indoor position of a user in any indoor environment. These two approaches achieved performance accuracies of 81.36% and 81.13%, respectively, when tested on a dataset. Third, it presents a methodology for detecting a user's location in an indoor environment in terms of the X and Y coordinate information. This methodology outperformed all prior works in this field when evaluated using the Root Mean Squared Error (RMSE)-based performance evaluation metrics as per ISO/IEC18305:2016—an international standard for testing Localization and Tracking Systems. Fourth, it presents the findings from a comparison study of multiple learning approaches that were developed, implemented, and evaluated to address the challenge of determining the best machine learning method for Indoor Localization. The findin (open full item for complete abstract)

Doctor of Philosophy, Case Western Reserve University, 2022, EECS - Electrical Engineering

Obstacle detection and warning can help elderly people enhance their mobility as well as their safety, especially in enclosed spaces (indoor environments). As people age, falling poses a significant risk, therefore providing mechanisms to prevent falls is vital to improve the safety and wellness of the elderly people population. Every year, millions of individuals in the United States are treated in emergency departments for fall-related injuries, which result in fractures, loss of independence, and even death. As a result, this issue must be addressed promptly. Fall prevention has been a focus of research for more than a decade, to enhance people's lives through the use of technology. This is primarily motivated by the impact that falls have in terms of mortality, morbidity, and social expense, which puts them on par with road traffic injuries in terms of mortality, morbidity, and social costs. Falls detection for elderly people can be essential to diminish the mortality rate and limit the associated health impacts. Technological solutions designed to automatically detect and inform a fall may be categorized into wearable and non-wearable solutions. Fall prevention systems take advantage of external sensors and wearable sensors where different motion characteristics are extracted from the collected data and are used to estimate the likelihood of a fall and alert the user in real-time. This work proposes an obstacle detection system to inhibit falls in the indoor environment. When obstacles are detected, the system will provide alarm messages to grab the user's attention. Because the elderly people spend a lot of their time at home, the proposed detection system is designed mainly for indoor applications. For this, firstly, obstacles are detected and localized, and then the information about the obstacles will be sent to the walker using an audio alert. In this dissertation, we present an assistive system for elderly people (open full item for complete abstract)

Doctor of Nursing Practice Degree Program in Population Health Leadership DNP, Xavier University, 2021, Nursing

Time banditry is defined as the misuse of time doing non-task related activities during paid work; this is also considered to be "stealing time" (Martin et al., 2010). Notably, time banditry may happen in all employment sectors and in various forms. Each time bandit steals time for a marginally diverse reason. Although the motives may be different between individuals, the concept is the same. This DNP project implemented an Electronic Visit Verification (EVV) system to replace the existing time management methods used by organizations. The goal was to facilitate consistency in the duties of CNAs who cared for homebound elderly residents and reduce time banditry. EVV is a computer-based software that enables real-time touchscreen smartphone contact between workers (CNAs) and the managers (nursing supervisor). EVV functions as a medium to monitor home care workers' attendance, current client situation, data entry, and care plan coordinating. CNAs log-in at the time of arrival at the work location indicating the start of work and log out at end of work – completing task. The clients are expected to countersign with the CNAs to confirm agreement with time entry. Findings from the outcome of patient surveys suggests that customers verbalize satisfaction with the EVV use because CNAs are arriving to work on time, staying for the entire scheduled shift, and completing task. Stakeholders state that billing is more accurate and organizational growth becomes promising.

MARCH, University of Cincinnati, 2021, Design, Architecture, Art and Planning: Architecture

Due to medical and caretaking needs, many seniors face displacement from their homes and a sense of isolation from their community. An increasing percentage of senior citizens are choosing at-home assistance instead of nursing home relocation. For these seniors to continue living in their own homes, accessible design retrofits are often necessary. These retrofits adapt homes to meet the specific needs of the residents aging in place. Despite the comfort of living in their own homes, the decision to age in place can still result in seniors becoming isolated from their community through issues of independence and mobility.

Bachelor of Science, Walsh University, 2021, Honors

This research study compared the effectiveness of music therapy in reducing pain levels in the pediatric, adult, and older adult populations. In addition, this study compared different types of music therapy and their effectiveness in reducing pain levels in comparison to pediatric, adult, and older adult populations. The research design is a content analysis to study the relationships between the effectiveness of music therapy in reducing pain levels in various populations with different types of music therapy. This study included peer-reviewed scholarly journals that included human participants that researched the effect of music therapy implemented by a licensed music therapist on pain levels using valid and reliable pain measurement tools in the pediatric, adult, and elderly populations. Music therapy is a growing field and is effective in providing non-pharmacological pain relief in individuals of all ages. The results of this research study can assist in guiding future research by identifying the varying effectiveness of music therapy in different populations.

Master of Science, The Ohio State University, 2021, Mechanical Engineering

Automotive crashes are a leading cause of death in the US, with side-impacts being the most fatal. Thoracic injuries are among the leading causes of such fatalities in small, elderly females. Thus, a series of six realistic side-impact post-mortem human surrogate (PMHS) sled tests were conducted. Results showed serious thoracic injuries in all PMHS, despite current side-impact anthropomorphic test devices (ATDs) predicting a <10% probability of such injuries. While this is partially due to the inaccuracy of injury risk scaling, it is hypothesized that combined thoracic loading, anteriorly-posteriorly (A/P) from the seatbelt pretensioner and laterally from the side airbag, increased rib fractures despite less-than-expected lateral chest deflection. The objectives of this study were to investigate the following in small, elderly female PMHS: 1) discrepancies between existing injury risk assessment tools and actual injury outcomes; 2) the effects of seatbelt pretensioners on thoracic injury; and 3) the effect of combined loading from the seatbelt pretensioner and side airbag on thoracic injury in side-impact. Prior to PMHS testing, SID-IIs ATD tests were run to match conditions to the previous study. A foam-padded pneumatic lateral impactor was used as a repeatable airbag surrogate. Three PMHS were tested, each under three different loading conditions: 1) A/P-only (seatbelt pretensioner), 2) lateral-only (airbag surrogate), and 3) combined loading (both). Anterior and posterior aspects of right and left ribs were instrumented with strain gages to detect potential fractures and fracture timing. Chest deflection was measured by axillary- and xiphoid process- level chestbands. Seatbelt load and spine motion were also measured. An anatomical dissection was completed after each test series to document all injuries. Each PMHS first underwent an A/P-only test, resulting in A/P chest compressions of 7-12% and no rib fractures. While the goal was to conduct one (open full item for complete abstract)

Master of Education, Cleveland State University, 2019, College of Education and Human Services

Purpose: The purpose of this study was to examine the impact of gender on acute exercise induced BDNF and cognitive function among older individuals. The hypothesis was that exercise would increase BDNF levels and enhance cognitive processing time post exercise followed by a drop in BDNF and return cognitive processing time to baseline post-30 minutes. It was also hypothesized that women would have higher BDNF values compared to men. Methods: The subjects consisted of 18 active males (n = 9) and females (n = 9). The subjects took part in an exercise trial and a control trial. The exercise trial entailed riding either a recumbent or upright bike at 75% of their age predicted max heart rate for 30 minutes. The control trial consisted of reading. A Stroop Test was given, and blood samples were obtained before, after, and 30 minutes after exercise and control. Serum was analyzed for BDNF, testosterone, and estrogen using commercially available ELISA kits. Results: Results showed that there was a significant effect of time in Stroop testing across all subjects. There was a trend (p = 0.068) for a decrease in Stroop time from pre to immediate-post timepoints, and a significant decrease (p = 0.004) in Stroop time from pre to post-30 timepoints. There was a significant main effect of exercise on BDNF levels, (p = 0.05) and females were found to have significantly higher BDNF than males (p = 0.055). Conclusion: There was statistical evidence that acute exercise affects BDNF production in both genders, but not cognitive processing speed among an older active population. Cognitive processing speed continued to improve across all timepoints. As well, women were found to have overall higher BDNF.

Doctor of Philosophy, Case Western Reserve University, 2019, Nursing

Currently, the global prevalence of dementia is an estimated 35.6 million people and is expected to rise up to 65.7 million by 2030. Caring for people with dementia can easily lead to a negative feeling such as compassion fatigue and depression, but these could be reduced by cognitive and behavioral skills that constitute resourcefulness. This study examined the current living situation for Thai caregivers of elders with dementia and relationships among contextual factors, resourcefulness, compassion fatigue, and depressive symptoms. Research Questions: 1) What are characteristics of Thai caregivers of elders with dementia, and their perceptions of characteristics of care recipients and their caregiving situation? 2) How do contextual factors impact resourcefulness, compassion fatigue, and depressive symptoms? 3) How are resourcefulness, compassion fatigue, and depressive symptoms related? This study was guided by the Resourcefulness Theory Model by Zauszniewski. A descriptive, correlational, cross-sectional design was used in this study. Study participants were 140 Thai caregivers of elders with dementia from the Prasat Neurological Institute in Thailand. Data were collected using a Demographic Questionnaire, the Compassion Fatigue Scale, and Thai translations of the Resourcefulness Scale and the Center for Epidemiological Studies Depression Scale. Results: The average score of compassion fatigue was 36.76 (SD = 7.43), indicating low compassion fatigue. The average score of resourcefulness was 91.69 (SD = 18.78), indicating use of a moderate level of resourcefulness skills, while the average score on depressive symptoms was 32.40 (SD = 7.88), indicating moderate depressive symptomatology. Caregiving hours had a significant positive impact on resourcefulness. Caregiver burden had a significant positive impact on depressive symptoms. However, marital status and age of care recipient had a significant negative impact on depressive symptoms. Only the age of the care re (open full item for complete abstract)

Master of Arts, Case Western Reserve University, 2019, Psychology

Older adults are at high risk for suicide compared to younger adults and differential risk factors may also exist across older adulthood. This study aimed to understand key risk factors for young-old (65-75 years old) and old-old (75+ years old) adults by testing a biopsychosocial framework using a psychological autopsy method. Correlational results indicated that hopelessness, depression, and negative attitude about physical health directly contributed to elderly suicide. While a more objective assessment of physical illness was associated with advanced age, it did not increase suicide risk. Advanced age was also associated with social isolation, which was significantly related with hopelessness, depression, and negative attitude about health. Multivariate analyses suggested that hopelessness fully mediates the relationships between isolation, negative attitude about health, depression, and suicide. Hopelessness and depression greatly contribute to suicide. Negative health attitudes may be an elderly-specific risk factor, while social isolation may increase risk for old-old adults.

Doctor of Philosophy, Case Western Reserve University, 2019, Anthropology

This dissertation examines how a matrilineal Tibetan society has reacted to the political, economic, and socio-cultural changes in China. The Zhaba region of Ganzi Tibetan Autonomous Prefecture in Sichuan province was chosen as the overall field site because of its matrilineal kinship system and "visiting marriage" tradition, in which partners live in their natal matrilineal households while children belong to the mothers' family. Based on eleven months of anthropological fieldwork, this dissertation is the first ethnography on marriage, family, and intergenerational relations among matrilineal Tibetans in Southwestern China. This dissertation discusses how the changing ideals of marriage and family formations influence people of different generations. A major argument of this dissertation is that the interplay of state policies including birth planning policy, household registration policy, marriage certification rules, and socio-economic developments over the past few decades, have contributed to changes in the "visiting marriage" tradition and family ideals among the matrilineal Zhaba Tibetans. This has led to the sense of exclusiveness between the visiting partners, an increase of the father's contribution in childrearing, and the emergence of neolocal nuclear families. However, this dissertation shows that there has been a revival of the traditional "visiting marriage" among the majority of young people in their twenties (63.64%) who still chose to practice "visiting marriage" and live with their natal matrilineal households. Using ethnographic data, this dissertation brings to the forefront how a matrilineal society in the cultural context of China, structures the life course of different generations and affects the well-being of the elderly. Moreover, this in-depth, on-the-ground ethnography of Tibetans residing in Sichuan province, demonstrates the diverse manner that ethnic Tibetans are adapting to change and development in China. By comparing family ch (open full item for complete abstract)

Master of Sciences, Case Western Reserve University, 2018, Clinical Research

Background: Vision impairment (VI) and cataract are common causes of disability in U.S. adults age 65 and older, but are especially, highly prevalent in institutionalized elderly. Objective: To estimate prevalence of VI and cataract in both populations and compare prevalence trends since 1985. Method: A meta-analysis included studies containing both nursing home and community elderly populations. A secondary (synthetic) meta-analysis also included studies containing only one of the two populations, pooled by 10-year cohorts. Results: The meta-analytic pooled prevalence estimates for VI and cataract in nursing home elderly are .50 and .48. In community elderly, these estimates are .04 and .17 respectively. Both meta-analyses indicate significantly higher odds (p<.001) of VI in nursing home elderly (OR1=26.123, OR2=31.097) and cataract (OR1=8.868, OR2=6.378). VI trends in both groups are remaining stable. While community studies are showing a rise in cataract prevalence, nursing home studies indicate a declining trend since mid-1990's.

Master of Fine Arts, The Ohio State University, 2018, Design

Physical therapy is a common form of muscle and joint treatment focused on increasing a person's mobility. Physical therapy is especially important for seniors where injuries from falls and joint replacement surgeries can greatly limit a person's ability to socialize, maintain their independence and can negatively affect their overall quality of life. An important part of physical therapy is exercise treatment, where people are provided with a series of specific exercises to complete in their own time, at home. To benefit from physical therapy exercise treatment, people must regularly complete their exercises for many months or years. This thesis began with an investigation of why most people fail to adhere to their physical therapy home exercise program. Following an iterative primary research process, the research scope was narrowed to an investigation of how best to support the accurate performance of physical therapy home exercise programs by seniors. The final outcome from this investigation is a series of design criteria and a design framework, which can be used to guide the development of future technologies for seniors to assist with the accurate performance of physical therapy home exercise programs.

MFA, Kent State University, 2018, College of Communication and Information / School of Visual Communication Design

Human populations have been aging both in economically developed and developing countries, especially during the recent decades. According to the World Health Organization (2002), seniors over the age of 60 years will reach 1.2 billion in 2025, reaching 2 billion by 2050, which includes 80% in developing countries. The prevalence of aging populations is expected to reconstruct living conditions in several areas, including personal beliefs, culture, economy, education, and social welfare (Chui et al. 2010). As the aging population increases, some technology companies have begun to realize the significance of serving this demographic of users. Currently, the telecommunication industry tends to focus on young adults and middle-aged groups, while research targeting senior populations is still lacking. Aging populations encounter various problems associated with the use of mobile devices, although this modern technology is widely adopted in the world. Compared with the youth or middle-aged groups, the sensory capabilities of the senior users is deteriorated due to the aging process. The difficulties for aging populations in using model devices fall into several categories: cognition, auditory, haptic, visual, and motor-based troubles (Drew et al. 2013). As a result of these difficulties, designers need to consider user experiences in different situations. For instance, because of deterioration of aging brain cells, the visual acuity of the senior users will decline; in this regard, designers have to decide how to use the design to assist the elderly to understand visual items. Different living conditions also influence the usability of mobile devices. Even in the same city, senior groups will be different regarding their backgrounds, including, but not limited to, income, education, literacy levels, gender, etc. Designers must understand the needs of senior users in different contexts to develop designs to fit local conditions and culture. Many previou (open full item for complete abstract)

Master of Science in Occupational Health, University of Toledo, 2017, Occupational Health (Industrial Hygiene)

Indoor air quality (IAQ) is considered one of the top five environmental risks to the public's health. Older adults are more vulnerable to health complications associated with indoor air contaminants because of their decreased immune system and age-associated health problems, as well as the fact that they spend up to 95 percent of their time indoors. Area air sampling was conducted in the nursing home section of four long term care facilities, three days at each facility (12 days total). Particle concentrations (PM2.5, PM10, Total Particulate matter (TPM), Ultrafine Particles (UFP), temperature, and humidity were measured. Two minute samples were collected during seven Sampling Sessions. Up to nine indoor locations were sampled, representing the various occupied spaces in each nursing home, along with an outside location for comparison. Results of Analysis of Variance (ANOVA) by Facility demonstrated significant differences (p<0.001) in PM concentrations and UFP counts. One Facility had higher particulate concentrations at all Sampling Locations which may include contributions from geographic location, vehicular traffic, or resident clustering. ANOVA by Sampling Location demonstrated significant differences (p<0.001) in PM concentrations and UFP counts. In general, the highest UFP and PM concentrations were seen in the kitchen, satellite kitchen, and hair salon, especially at times when the staff and residents were active in these rooms. Significant differences were seen in UFP counts (Facilities 1 and 3) and PM2.5 (Facility 2) by Sampling Session. The highest concentrations were found for the Sampling Sessions in the mid-morning and mid-afternoon which were during peak times of activity for the residents. Although maximum temperature measurements exceeded ASHRAE winter guidelines, this may be appropriate for older residents who prefer a warmer temperature. While most median particle values were below ASHRAE guidelines, maximum values did exceed occasionally (open full item for complete abstract)

Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology

As the population of older adults continues to grow with time, the need for geropsychology clinicians also grows. Many barriers exist that contribute to why elderly individuals are not receiving adequate psychological treatment. This study explores why graduate psychology students are often disinterested in working with older adults and whether it is possible that student interest could increase with more geropsychology graduate coursework and practicum training opportunities. This study also explores the possible connection between quality of elderly relationships and interest in working with the elderly. The results of this study support that Clinical and Counseling Psychology graduate programs lack quality education for providing mental health services to the older adult population. This general lack of education includes the lacking availability of geropsychology courses, integration of the older adult population in academic courses, training in the assessment, diagnosis, and provision of psychotherapy for older adults, as well as building awareness of attitudes, responses, and biases toward this population. The results of this study also support that graduate programs lack the availability of practicum placements that allow students to work with the older adult population. Participants rated the age group of 65-years-old and beyond as least preferred and a majority felt “minimally competent” to provide psychological treatment to older adults, yet 31% of participants responded that they will likely work with older adults in the future. Correlational analyses showed that the likelihood of graduate students to work with older adults in the future increases as the quality of their clinical training for older adult service provision increases. Also, as the quality of education for older adult service provision increases, the quality of clinical training with older adults increases. No significant correlations were found between emotional closeness to an older adult (open full item for complete abstract)