Aged Care Workforce Research Articles

"Time is a Big Factor": Aged-Care Workforce Perspectives on Communication Partner Training for Working With Residents With Dementia.

Many individuals who reside in permanent residential aged care (RAC) have a diagnosis of dementia, with the majority experiencing a communication disorder. Existing literature has placed an emphasis on the need for staff to undertake communication partner training. This study aimed to investigate the preferences of RAC staff, and their perceived barriers and facilitators to workplace training. Through an exploratory cross-sectional online survey, a sample of RAC workers in Australia were recruited (n = 104). Descriptive statistics revealed that the majority of participants preferred training to be delivered face to face and being paid for participation. Through content analysis of open-ended questions, seven categories were identified regarding perceived barriers and facilitators for communication partner training in the workplace. These included staff shortages, time pressures, remuneration and training delivery method, and quality of the educators. Additionally, management attitudes were pertinent. These findings may inform the development and outcomes of future communication partner training in RAC.

Reform and reverberation: Australian aged care policy changes and the unintended consequences for allied health.

Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care. Data from the four available Quarterly Financial Reports from the 2022-2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy. The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6minutes per person per day in the first quarter, reported allied health minutes fell to 4.6minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3minutes per person per day. This is just over half the Australian average of 8minutes reported to the RCACQS in 2019. Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced.

Registered nurses’ confidence related to undertaking a leadership role in residential aged care: A clinical leadership self-assessment survey

BackgroundThe Australian Royal Commission emphasizes the importance of registered nurse leadership in providing safe, high-quality care to older adults in Residential aged care. Nurse leadership has important ramifications for effective multidisciplinary care as well as recruitment and retention of the aged care workforce. Registered nurse leadership plays a crucial role in enhancing resident outcomes in Residential aged care, however there are limited studies examining self-perceptions of confidence and competence of nurses running Residential aged care, particularly after hours. AimTo examine registered nurse leadership via self-reported confidence and competence in Residential aged care. MethodsA cross-sectional research design with ten facilities in Western Australia was used, including a survey tool that relied on the Clinical Leadership Competency Framework. Cronbach's alpha test was used to ascertain internal reliability and replicability. The Strengthening the Reporting of Observational studies in Epidemiology guidelines was used to guide the study. Inferential statistics were used for data analysis. Data collection occurred over a six-month period, involving registered nurses employed by a single Residential aged care provider in Perth, Western Australia. Participants rated their leadership confidence on a 5-point Likert-type scale ranging from 1 (never) to 5 (all the time). FindingsFrom a sample of 100 registered nurses working in aged care after-hours, 90% reported high levels of self-confidence. The survey results showed that those who have more than 10 years of experience reported highest confidence in managing services. Registered nurses over 50 years old self-reported highest confidence in personal qualities, managing, and improving service domains. DiscussionRegistered nurses run residential aged care, and this time of aged care reform provides an opportunity to examine associations between registered nurse leadership and resident outcomes and provide avenues for improvements in working environments and resident experiences. ConclusionThe findings have important implications for Residential aged care providers in establishing effective leadership mentoring programs to support registered nurses in improving their confidence and ability.

Factors impacting clinical data and documentation quality in Australian aged care and disability services: a user-centred perspective

BackgroundResearch has highlighted a need to improve the quality of clinical documentation and data within aged care and disability services in Australia to support improved regulatory reporting and ensure quality and safety of services. However, the specific causes of data quality issues within aged care and disability services and solutions for optimisation are not well understood.ObjectivesThis study explored aged care and disability workforce (referred to as ‘data-users’) experiences and perceived root causes of clinical data quality issues at a large aged care and disability services provider in Western Australia, to inform optimisation solutions.MethodsA purposive sample of n = 135 aged care and disability staff (including community-based and residential-based) in clinical, care, administrative and/or management roles participated in semi-structured interviews and web-based surveys. Data were analysed using an inductive thematic analysis method, where themes and subthemes were derived.ResultsEight overarching causes of data and documentation quality issues were identified: (1) staff-related challenges, (2) education and training, (3) external barriers, (4) operational guidelines and procedures, (5) organisational practices and culture, (6) technological infrastructure, (7) systems design limitations, and (8) systems configuration-related challenges.ConclusionThe quality of clinical data and documentation within aged care and disability services is influenced by a complex interplay of internal and external factors. Coordinated and collaborative effort is required between service providers and the wider sector to identify behavioural and technical optimisation solutions to support safe and high-quality care and improved regulatory reporting.

Debate: Tackling the aged care workforce

Debate: Tackling the aged care workforce

Dietetics student contribution to addressing malnutrition in residential aged care facilities.

To test a model of malnutrition screening and assessment conducted by dietetics students on placement in residential aged care facilities. The secondary aim was to identify possible facilitators and barriers to the implementation of the model. The type 1 hybrid effectiveness-implementation trial study design and reporting outcomes were developed using the Consolidated Framework for Implementation Research. An innovative placement model was developed, where students on voluntary placement visited three residential aged care facilities to identify residents at risk of malnutrition using currently available screening tools for older people. Students completed malnutrition assessments for all residents using the subjective global assessment tool. Thirty-two students participated; 31 completed all three sessions, with malnutrition screening completed for 207 residents and malnutrition assessment for 187 residents (July and September 2022). Based on the subjective global assessment, 31% (n = 57) of residents were mildly/moderately malnourished, and 3% (n = 5) were severely malnourished. The Innovation Domain of the Framework was the most important consideration before implementation. Whilst previous research documented student learning opportunities in residential aged care facilities, this study provides the first available evidence of the direct contribution students can make to the health of aged care residents through malnutrition screening and assessment. The model enables students to conduct malnutrition screening and assessment feasibly and efficiently in facilities that do not routinely collate and act on these data. With a limited nursing aged care workforce to undertake this vital task, the potential role of student dietitians to fulfil this role must be considered.

'Can a relative override a patient's Advance Care Directive?': end-of-life legal worries of general practitioners and nurses working in aged care.

This paper aimed to describe the legal worries of Australian general practitioners (GPs) and nurses regarding end-of-life care provided in the aged care setting. An analysis of responses to the final, open-ended question of a cross-sectional online survey of GPs and nurses practising in aged care settings in Queensland, New South Wales and Victoria was undertaken. Of the 162 GPs and 61 nurses who gave valid responses to the survey, 92% (151 GPs and 55 nurses) responded to the open-ended question. Participants identified concerns across all relevant areas of end-of-life law. The most common concerns were substitute decision-makers or family member(s) wanting to overrule an Advance Care Directive, requests for futile or non-beneficial treatment and conflict about end-of-life decision-making. Participants often also identified concerns about their lack of legal knowledge and their fear of law or risk related to both end-of-life care generally and providing medication that may hasten death. Australian GPs and nurses working in aged care have broad-ranging legal concerns about providing end-of-life care. Legal concerns and knowledge gaps identified here highlight priority areas for future training of the aged care workforce.

Migrant healthcare assistants’ decision to work in long-term care

In high-income countries, population ageing has a significant impact on the labour force and care demands. As a result, the tendency is to rely on migrant workers to meet workforce and care demands. Drawing on insights from Bronfenbrenner’s ecological systems theory, this study focused on unskilled migrant healthcare assistants in Norway’s long-term care. The objectives were to explore factors influencing the decision of unskilled migrant healthcare assistants to work in elderly care, sources of knowledge about work in elderly care, and challenges encountered in elderly care work. The key research questions were as follows: a) What factors influence the decision of migrant healthcare assistants to work in elderly care? b) What are the sources of knowledge/information about work in elderly care for migrant healthcare assistants? c) What are some of the challenges of working in elderly care for migrant healthcare assistants? Qualitative research and purposive sampling were used to recruit 20 participants: 13 unskilled migrant healthcare assistants and seven managers of long-term care facilities in South-Eastern and Northern Norway. Data were collected using in-depth individual interviews, focus group discussions and participant observation, and thematically analysed. Findings indicated that factors influencing unskilled migrant healthcare assistants' decision to work in the elderly care sector included cultural norms and values of caring for older people, nonrecognition of overseas qualifications and economic considerations. State-organized language learning programmes, Norwegian Labour and Welfare Administration (NAV) offices, as well as migrant family and community networks, provided crucial information about work in elderly care. Challenges regarding lack of career progression, temporary working contracts, low status and poor wages emerged. In conclusion, meaningful employment outcome through better opportunities for career progression are essential for unskilled migrant healthcare assistants’ well-being and care for older people. It would be useful for long-term care policymakers and stakeholders to address the challenges faced by its aged care workforce.

CARING SELF-EFFICACY AND BEHAVIORS OF MIGRANT NURSING ASSISTANTS WORKING IN RESIDENTIAL AGED CARE FACILITIES

Abstract Data show a significant proportion of nursing assistants from migrant backgrounds in the Australian aged care industry. However, compared to locally-born counterparts, they are more likely to be employed as casual staff and offered shorter shifts, irregular hours, and lower pay, often without employment benefits. Previous studies have shown that the working environment of an organization influences employees’ self-efficacy, affecting their performance. This study hypothesized that migrant nursing assistants from non-English-speaking countries have lower confidence in caring for older residents and, thus, execute less-satisfactory caring behaviors than their local, English-speaking colleagues. The caring self-efficacy was quantitatively measured from the perspective of nursing assistants in residential aged care facilities (N = 280), and caring behaviors were explored from older residents’ perspective (N = 13). Results showed that nursing assistants whose first language was not English had lower levels of caring self-efficacy than native English speakers. However, older residents found that they frequently met residents’ individual needs and were more competent, emotionally present, respectful, and amiable, despite communication issues. Older residents insisted that the personalities of nursing assistants have a greater impact on their job performance than their backgrounds. These findings suggest that although migrant nursing assistants from non-English-speaking countries had low self-efficacy to carry out their job, their performance was appreciated by older residents. This study supports the Australian government’s strategy of using immigration to prevent or respond to an aged care workforce crisis, but it also advocates for improved working conditions, organizational resources and benefits for those with non-English-speaking backgrounds.

Workforce training through massive open online courses: can education generate collective hope for better dementia care?

AbstractThe personal care workforce is generally poorly paid, often unregulated, minimally trained and unprepared for the challenges of working with people with dementia. When it comes to accredited healthcare degrees, established programs have little space to accommodate emerging health priorities, such as dementia, in an already crowded curriculum. This creates the perfect storm of a significantly unprepared healthcare workforce as we look towards an expected 139 million cases of dementia worldwide by 2050 (www.alzint.org).Could freely available, online, evidence‐based dementia care education be a solution, offering hope, knowledge and skills to carers across the globe? In 2013, the University of Tasmania launched an Understanding Dementia Massive Open Online Course (MOOC). Over 7 weeks participants increase their knowledge of dementia: its causes, symptoms and ways of responding to the needs of people living with the condition. This award‐winning MOOC has world‐leading completion rates, been rated amongst the top MOOCs of all time (Class Central), and reached over 330,000 people around the globe. As well as offering free MOOCS, there are low or no‐cost university level education options in a Diploma and Bachelor of Dementia Care. Targeted to the Australian Aged Care workforce, but open to any student, these fully online programs attract personal care workers, health professionals and family members of people living with dementia. Thousands of students have enrolled, primarily for professional and practice development reasons and to provide better care for family members or friends with dementia. These programs were created specifically for learners of all ages and from culturally and linguistically diverse backgrounds, and designed to facilitate success and progress. They are scalable and are being translated into a number of languages and cultures. With this approach, one click at a time, we offer hope through accessible education for those that need it most. In this sense, education is considered an intervention ‐ improving dementia care and awareness, decreasing stigma, and in driving a public health approach for dementia prevention.

Factors Impacting Retention of Aged Care Workers: A Systematic Review.

Retention of care support workers in residential aged care facilities and home-based, domiciliary aged care is a global challenge, with rapid turnover, low job satisfaction, and poorly defined career pathways. A mixed-methods systematic review of the workforce literature was conducted to understand the factors that attract and retain care staff across the aged care workforce. The search yielded 49 studies. Three studies tested education and training interventions with the aim of boosting workforce retention and the remaining 46 studies explored opinions and experiences of care workers in 20 quantitative, four mixed-methods and 22 qualitative studies. A range of factors impacted retention of aged care staff. Two broad themes emerged from the analysis: individual and organisational factors facilitating retention. Individual factors related to personal satisfaction with the role, positive relationships with other staff, families, and residents, and a cooperative workplace culture. Organisational factors included opportunities for on-the-job training and career development, appropriate wages, policies to prevent workplace injuries, and job stability. Understaffing was often cited as a factor associated with turnover, together with heavy workloads, stress, and low job satisfaction. With global concerns about the safety and quality of aged care services, this study presents the data associated with best practice for retaining aged care workers.

Exploring Australian dietitians' experiences and preparedness for working in residential aged care facilities.

Dietitians are increasingly working in residential aged care facilities (RACF). As such, supportingthe RACF dietetic workforce is imperative. This qualitative study explored dietitians' experiences and preparedness for working in RACFs. A qualitative descriptive approach from a non-singular reality relational position was used. Recruitment occurred through convenience and snowball sampling, including contacting a list of dietitians who had previously consented to be contacted for research. The interviews included a semi-structured approach. Data were analysed using constant comparison and reflexive thematic analysis. Thirty-one dietitians (n = 29 female; median age, 39 years) with a range of career experience participated in an interview. Interviews ranged from 25 to 68 min (mean duration, 41 min). Five themes and 14 subthemes were identified. Themes were: (1) joining the aged care workforce was not initially considered a career option, (2) difficulty sustaining satisfaction working in aged care, (3) navigating practical challenges working with residents while prioritising quality care, (4) poor acknowledgement of the dietitian role by staff and (5) grappling with a moral desire to improve the aged care sector. Dietitians face many challenges in fulfilling their role in RACFs, including RACF staff's poor understanding of dietitians' scope and a lack of procedural support for their daily activities. Dietitians report that genuine improvements in their job satisfaction and experiences of older adultsrequire structural reform within the government, beyond their locus of control.

Strategies that support cultural safety for First Nations people in aged care in Australia: An integrative literature review.

The 2019 Royal Commission into Aged Care Quality and Safety highlighted the need for First Nations peoples to have improved, culturally safe care. This paper is a call to action for First Nations peoples to be involved in developing culturally safe care and services to be embedded within Australian aged care services. The first screening examined the Australian literature (peer-reviewed articles published since 2010 in English) detailing key aspects relevant to Cultural Safety for First Nations peoples supported by aged care services in Australia. The second screening assessed whether the findings of these studies aligned with the key aspects of Cultural Safety of First Nations peoples in aged care. The initial literature search yielded 198 papers, of which 13 met the inclusion criteria for the final review. Topics that required further interrogation included barriers to communication, racism and discrimination, impacts on health outcomes, health-care workforce education needs and the importance of cultural connections to Country and kin. These topics influenced the perception of First Nations peoples feeling culturally safe when supported by aged care services. The literature identified a need to recruit more First Nations peoples into the aged care workforce, involve more First Nations family and community members in aged care and retain a consistent workforce overall. Together these strategies were seen to address the barriers that continue to affect aged care provision for First Nations peoples.

Baseline data from the Australian PITCH study: Characteristics of home care workers providing dementia care

AbstractBackgroundPeople living with dementia increasingly prefer to live in their own home as their care needs progress. Home care workers (HCWs) are essential for supporting independent living, and need training and support on how to deliver evidence‐based and best‐practice dementia care. The home care workforce is diverse, and in Australia, the number of workers who identify as culturally and linguistically diverse (CALD) in 2020 represented 21% of the total direct‐care workforce.The Promoting Independence Through quality Care at Home (PITCH) project aims to improve outcomes for people living with dementia and their paid and family carers by co‐designing and testing an evidence‐based specialist training program for dementia care. A pragmatic stepped‐wedge cluster RCT is being conducted to evaluate the program. To date, 227 HCWs from seven home care providers across Australia have completed baseline measures.MethodHCWs completed the Strain in Dementia Care Scale (SDCS), Sense of Competence In Dementia Care – Staff (SCIDS), Dementia Attitudes Scale (DAS) and Dementia Knowledge Assessment Scale (DKAS). Associations between these measures was assessed using Pearson correlations. HCWs were grouped into CALD/non‐CALD groups based on self‐reported cultural background. ANOVAs examined group differences by CALD status.ResultFor the whole sample, SCIDS was correlated with DAS (r = 0.599, p<0.005) and DKAS (r = 0.257, p<0.005). DAS and DKAS were moderately correlated (r = 0.334, p<0.005). Nearly 30% of HCWs in our sample identified as CALD. The CALD group showed lower DAS, DKAS and SCIDS compared to the non‐CALD group (p’s<0.001). No differences were observed on SDCS (p = 0.58).ConclusionHCWs who were more knowledgeable about dementia had more positive attitudes toward dementia and a higher sense of competence in dementia care. HCWs who did not identify as CALD showed greater dementia knowledge, more positive dementia attitudes, and higher sense of competence in dementia care. Findings suggest that better dementia literacy supports more positive attitudes to dementia and sense of competence, and highlights that more targeted and specialized support may be beneficial for staff from CALD backgrounds (who comprise a high proportion of the Australian aged care workforce). Findings have implications for clinicians, researchers, policy‐makers, educators, and providers of dementia services.

The complexities of employee voice within a multiculturally diverse aged care workforce setting

The study of employee voice has primarily focused on mainstream settings (the public sector, manufacturing and larger organisations) within Western countries, where the design of employee voice mechanisms occurs within the context of standard employees (e.g. white, Anglo‐Saxon and heterosexual persons) (Greene 2015, Finding a Voice at Work? New Perspectives on Employee Relations, 67–91). This article explores the challenges of managing voice within a residential aged care setting in Australia and seeks to understand how a multiculturally diverse workforce, characterised by culturally and linguistically diverse (CALD) individuals, interprets a range of voice mechanisms provided by management and the factors that influence their use. We present qualitative data from 21 semi‐structured interviews conducted with employees, management and key support staff. We show that managers tend to emphasise downward communication more than voice and that all workers, regardless of their cultural background, perceived barriers to speaking up. Despite general support for voice within the organisation from all stakeholders, our research shows that organisational factors such as budgetary constraints shrunk the voice agenda and created a culture in which employees feared raising issues and concerns. Furthermore, we found that cultural, language and literacy issues associated with such a workforce added a degree of complexity to employee voice and that voice could be muted due to these factors. Our research provides an opportunity to rethink the voice literature by drawing on the diversity literature in the context of multiculturally diverse workforce settings, highlighting missed opportunities for inclusive voice practices.

Community aged care in Australia: the need for innovative programmes to boost workforce capacity

Across Western nations, ‘ageing in place’ policies rely on having a sufficient and skilled aged care workforce. In Australia, due to the impact of successive policy reforms, this workforce including the sector that provides community-based services has declined in number and skills. At the same time the need to upskill and sustain this workforce has intensified as the frailty and health needs of consumers have increased. This paper reports on an integrative literature review undertaken during 2021 to describe workforce needs and peer reviewed reports of programs instituted in aged care settings that aimed to address these needs. The review sought to examine programs implemented in both long-term and community care settings and to draw from these elements that may be utilised in future program design across the sector. It focussed primarily on workforce deficits in the community aged care sector and on the capacity of rurally-based services to meet and respond to growing consumer demand. The findings emphasise current workforce deficits while they also reveal a paucity of peer-reviewed reports of implemented programs across the sector as a whole. Nevertheless, the few programs examined in this review provide examples of the capacity and willingness of workers and providers to trial measures that aim to increase the recruitment, retention, skill and job-satisfaction of direct care workers. We propose that the key elements of the programs identified in this paper provide the foundation for the development of strategically designed programs that address particular workforce needs such as those shaped by rural contexts.

Staff perspectives on end-of-life care for people living with dementia in residential aged care homes: qualitative study.

People living with dementia in care homes can benefit from palliative approaches to care; however, not all will require specialist palliative care. The generalist aged care workforce is well placed to provide most of this care with adequate training and support systems in place, but little is known about their experiences. To describe staff perspectives on providing quality end-of-life care for people living with dementia in residential care and their families. Focus groups and semi-structured interviews were conducted with residential aged care managerial and frontline staff in Australia who were caring for residents living with dementia and end-of life needs. A comprehensive, then snowballing sampling strategy was used in participating care homes. Transcripts were analyzed using reflexive thematic analysis. Fifteen semi-structured interviews and six focus groups were undertaken with 56 participants across 14 sites across two Australian states. Five themes were identified: putting the resident at the center (creating homes not hospitals, knowing the individual, a case management approach); articulating goals to grant wishes (initiating the conversation, broadening death literacy, avoiding hospitalization); a collective call to action (staffing the home, recognizing deterioration and escalating issues, communication channels and engaging GPs, managing medications, psychosocial supports); educating to empower staff (governance and guidance, mentoring juniors, self-care); and facilitating family acceptance (setting expectations, partnering in care, access at all hours). Aged care staff are committed to providing person-centered palliative and end-of-life care for people living with dementia, recognizing the intrinsic value of each resident, regardless of their declining state. Frontline and managerial staff consider advance care planning, collectively working as part of a multidisciplinary team, access to targeted palliative and end-of-life education and training, and engaging families as key priorities to providing high quality care in care homes.

Residential Aged Care and Homelike Environments: A scoping literature review of views of the aged care workforce

Evidence exists of the benefits of homelike environments for residents of residential aged care facil-ities (RACF). To date, most research has focused on the perceptions, experiences, and quality-of-life outcomes of homelike environments from residents’ perspectives. The views of the aged care workforce (ACW) about homelike environment in RACF is under-researched. A scoping review was conducted of the Pubmed, Medline, PsychInfo, Cinahl, and Scopus databases in April 2021. Search terms included: homelike environment; residential aged care; staff. Perspectives of ACW were synthesized using Rijnaard’s framework, encompassing three key categories. Of 1597 papers identified, 21 articles published from 1990 to 2021 met the eligibility criteria for review. The scop-ing review provided insights from nursing staff, facility managers, administrators, and also activity coordinators, laundry, and catering staff. Eight key elements of homelike environments were identi-fied, further classified into three key categories: (1) built environment (indoor and outdoor spaces); (2) psychological elements (residents’ choices and control, maintaining residents’ beliefs and habits); (3) social elements (relationships with residents, families, and staff, communal environments and maintaining contact with community). No important differences in themes across ACW groups were evident. Homelike environments were associated with higher job satisfaction, lower burnout, lower staff turnover and did not contribute to staff distress nor perceptions of reduced safety. Homelike environments are potentially beneficial for ACW. Review findings can inform planning, implemen-tation, and evaluation of homelike environments, to ultimately enhance outcomes for ACW and res-idents in RACFs.

Migrant Care Workers' Perceptions of Their Working Conditions in Australian Residential Aged Care Facilities.

Staff shortages and retention are the major challenges in residential aged care facilities (RACFs). This study aimed to explore migrant care workers' perceptions of job demands, their coping strategies, and employment intentions to leave or stay in the sector. Using a descriptive qualitative research design, semi-structured interviews were conducted with n = 20, RACF migrant care workers from Filipino, Indian, and Nigerian backgrounds in Perth, Western Australia, from April to December 2019. Data were thematically analyzed. Motivating factors included the availability of care work in RACFs, and positive cultural norms associated with caring for older family members. Participants experienced a combination of resettlement and workplace challenges specifically, limited support network, communication challenges, and racial discrimination. Work challenges that are compounded by post-migration stressors should be recognized and addressed in the design and implementation of the aged care workforce reforms to attract and retain migrant care workers.

Effectiveness of clinical mentorship program for students of long-term aged care: A mixed-methods study

BackgroundInternationally, the population is rapidly aging with a strong demand for aged care services. In Taiwan, both recruiting and retaining staff to aged care poses difficulties. Good clinical role models can positively impact students' confidence and professional development and influence their willingness to enter the long-term aged care workforce. ObjectivesTo clarify clinical mentors' roles and competencies and assess the effectiveness of a mentorship program for improving students' professional commitment and self-efficacy in long-term aged care. DesignA mixed-methods study with a quasi-experimental research design and qualitative interviews. SettingsPurposive sampling was used to recruit long-term aged care professional clinical mentors with preceptor qualifications and nursing and aged care students enrolled in a two-year technical program in a Taiwanese university's gerontology care department. ParticipantsFourteen mentors and 48 students participated. The student control group received regular education; the experimental group received mentorship guidance. MethodsThis study included three phases. Phase one involved qualitative interviews to identify clinical mentors' roles and competencies. Phase two involved expert panel meetings to establish the clinical mentorship program's content and implementation. Phase three involved the program's evaluation. Quantitative questionnaires were administered before the program and subsequently at 6, 12, and 18 months to assess mentors' effectiveness and students' professional commitment and self-efficacy in long-term aged care. Qualitative focus groups solicited participants' feelings and suggestions for the program. ResultsClinical mentors' roles and competencies centered on two themes: professional role model and establishing good rapport. Quantitative analysis showed that mentoring effectiveness initially recorded a decline, followed by a subsequent increase. Both groups' professional self-efficacy and commitment followed an increasing trend. While the experimental group's professional commitment score was significantly higher than the control groups, their professional self-efficacy scores did not differ significantly. ConclusionsThe clinical mentorship program improved students' long-term aged care professional commitment and self-efficacy.