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Rolling Out Positive Approach to Care (PAC) Training Across Your Senior Living Organization

Implementing PAC across an entire senior living organization can feel like a big lift, but it is absolutely doable with a thoughtful, step-by-step plan. This article walks you through exactly how to start small, build momentum, and make PAC a natural part of your culture — not just a one-time training. You will find concrete steps, common pitfalls to avoid, and tools to help every staff member, from housekeeping to leadership, feel confident using these skills. You are not alone in this; many organizations have successfully woven PAC into their daily practice, and you can too.

Key points

  • Start small: train a few champions first, then let the skills spread organically through practice and peer modeling.
  • Lead by example: if leaders do not use PAC skills, no one else will. Be the first to practice and share your successes and struggles.
  • Make practice regular and low-pressure: weekly 15-minute sessions are more effective than a single all-day workshop.
  • Celebrate small wins publicly to build momentum and show that PAC is valued.
  • Include all staff — not just direct care — in training and practice.
  • Partner with other organizations and use free resources to stretch your budget and build a wider learning community.

Why a Full Rollout Matters — and Why It Feels Hard

When you decide to bring Positive Approach to Care into your senior living community, you are not just adding a new training module. You are shifting the entire culture of how your team interacts with residents living with dementia. The challenge is that staff come from different backgrounds, have different comfort levels with change, and may already feel overwhelmed by their daily duties. Without a structured rollout, the training can feel like just another checkbox — something staff attend but quickly forget.

The key insight from organizations that have succeeded is that PAC is not something you teach once and expect to stick. It becomes part of who you are as a team. As one care partner who earned multiple PAC certifications put it, 'If I teach something, I learn it.' That is the heart of the rollout: you are not just delivering information; you are creating a community of learners who practice together, make mistakes together, and grow together. The goal is to make PAC skills so embedded that they become second nature — like a reflex when a resident is struggling.

The Power of Leading by Example and Building a Learning Community

One of the most effective ways to roll out PAC is to start with yourself and a small group of champions. As Teepa Snow emphasizes, you have to 'lead by example.' If managers and supervisors are not practicing the techniques in their own interactions — with residents, with staff, with families — then no amount of training will convince the rest of the team to adopt them. Staff watch what their leaders do far more than they listen to what they say.

From there, you create a 'mini university' within your organization. This might look like a weekly 'PAC Tuesday' or 'Teepa Thursday' where a small group gathers to practice one specific skill — like the hand-under-hand technique or a particular way of offering choices. Over time, this group becomes your internal experts. They can model the skills for others, answer questions in the moment, and help new hires get up to speed. The goal is to make learning PAC a continuous, social process rather than a one-and-done event.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Start with yourself and a small leadership team. Before you train anyone else, commit to learning and practicing PAC skills in your own daily work. Watch Teepa Snow's videos, attend a live workshop, or get certified through a program like Mental Health America's PAC certification. Use these skills when you interact with residents, families, and staff. Let people see you using the techniques — this models the behavior you want to see.

  2. Identify 2-3 'PAC champions' from different departments (e.g., a nurse, a care aide, an activities coordinator). These are people who are curious, open to learning, and respected by their peers. Offer them the opportunity to become PAC certified as trainers or coaches. As one care partner noted, getting certified through an organization like Mental Health America can be a powerful way to build expertise and credibility.

  3. Create a regular, low-pressure practice time. Call it 'PAC Practice Tuesdays' or 'Skills Share Thursdays' — whatever fits your schedule. For 15-20 minutes each week, gather a small group to practice one specific PAC skill. For example, practice the 'positive physical approach' — approaching from the front, at eye level, with a warm smile and a slow, open hand. Repeat it together. Talk about what felt awkward and what worked.

  4. Integrate PAC into existing meetings and huddles. During your morning stand-up or shift change, ask one person to share a PAC tip or a success story from the previous day. This keeps the skills top-of-mind and normalizes talking about them. For example, 'Yesterday, I used the hand-under-hand technique when helping Mrs. Jones with her meal, and she relaxed immediately.'

  5. Offer a formal PAC in-service or workshop for all staff, but make it interactive. Do not just lecture — have staff practice on each other. Use role-play scenarios that reflect real situations in your building, like a resident who is refusing care or a family member who is upset. After the workshop, give each person a simple one-page cheat sheet with the top 3-5 PAC skills to try that week.

  6. Pair new hires with a PAC-trained buddy during their first two weeks. This buddy models the skills in real time and gives gentle feedback. For example, if a new aide is rushing through a transfer, the buddy can say, 'Let's slow down together. Watch how I offer my hand first and wait for her to reach out.' This embeds PAC from day one.

  7. Create a visible 'PAC wall' or bulletin board in a staff-only area. Post a skill of the month, a photo of a staff member using the technique, and a short testimonial. For example, 'This month's skill: Offering choices. Try saying, "Would you like to sit in the blue chair or the green chair?" instead of "Sit down."' Update it monthly to keep it fresh.

  8. Celebrate small wins publicly. When a staff member uses a PAC skill well — especially in a tough moment — acknowledge it in a team meeting or via a quick note. For example, 'I saw how you used the 'ask, don't tell' approach with Mr. Smith this morning. He calmed down so quickly. Great job!' This reinforces that PAC is valued and noticed.

  9. After 3-6 months, survey staff on what is working and what is hard. Use the feedback to adjust your approach. For example, if staff say they are struggling with a specific technique, schedule a dedicated practice session on that skill. If they want more real-life examples, invite a PAC-certified coach to do a live demonstration with a resident (with consent).

  10. Expand your learning community beyond your organization. Partner with home health agencies, adult day programs, or other senior living communities in your area. Offer to host a joint PAC workshop or share resources. As one PAC-certified professional shared, they educated home health caregivers they partnered with, creating a wider network of support for families and residents.

What not to do

  • Do not try to train everyone at once in a single all-staff meeting. This overwhelms staff, and most will forget the content within days. Instead, use the 'mini university' approach — start with a small group and let the skills spread organically through practice and peer modeling.

  • Do not make PAC training a one-time event with no follow-up. Without ongoing practice and reinforcement, staff will revert to old habits. Instead, build in weekly practice sessions, monthly skill spotlights, and regular check-ins to keep the skills alive.

  • Do not expect staff to learn by watching a video alone. Passive learning does not change behavior. Instead, combine video watching with hands-on practice and real-time coaching. For example, watch a 2-minute clip of Teepa demonstrating a technique, then have staff pair up and try it on each other.

  • Do not punish staff for struggling with new skills. This creates fear and resistance. Instead, normalize mistakes as part of learning. Say, 'It is okay if this feels awkward at first. We are all learning together. Let's try it one more time.'

  • Do not assume that only direct care staff need PAC training. Housekeeping, dining, front desk, and maintenance staff also interact with residents. Include them in the training and practice. For example, a housekeeper can use the positive physical approach when entering a resident's room to clean.

  • Do not skip the step of getting buy-in from leadership. If the executive director or department heads are not visibly using PAC skills, staff will see it as optional. Instead, have leaders attend the same training and practice alongside everyone else. Let them be the first to share a success story.

Practical tools

  • The 'PAC Practice Tuesday' Template

    A simple 15-minute agenda for a weekly practice session: (1) Welcome and check-in (2 min) — 'What is one PAC skill you tried this week?' (2) Skill demonstration (3 min) — One person shows the skill, e.g., hand-under-hand. (3) Paired practice (5 min) — Everyone pairs up and tries the skill. (4) Group debrief (3 min) — 'What felt good? What was tricky?' (5) Challenge for the week (2 min) — 'This week, try using the skill with one resident each shift.' Print this template and post it in the break room.

  • The 'PAC Skill of the Month' Poster

    Create a simple poster with these elements: (1) The skill name (e.g., 'Positive Physical Approach'). (2) A photo or drawing of a staff member using the skill. (3) 3-4 bullet points on how to do it (e.g., 'Approach from the front, at eye level. Smile. Offer your open hand, palm up. Wait for the person to reach out.'). (4) A real-life example: 'When I used this with Mrs. Lee, she smiled and took my hand right away.' Post it in the break room, by the time clock, and in the staff bathroom.

  • The 'PAC Buddy' Checklist for New Hires

    A one-page checklist for the buddy to use during the first two weeks: (1) Day 1: Watch me use the positive physical approach with a resident. (2) Day 2: You try it with me watching. I will give you one tip. (3) Day 3: Practice offering two choices instead of telling. (4) Day 4: Use hand-under-hand during a meal. (5) Day 5: Debrief together — 'What is getting easier? What is still hard?' This turns onboarding into a PAC learning experience.

  • The 'PAC Success Story' Form

    A simple half-sheet form that staff can fill out in 2 minutes: (1) Your name. (2) Resident initials. (3) What was happening? (e.g., 'Resident was agitated at bath time.') (4) What PAC skill did you use? (e.g., 'I offered a choice: "Would you like to wash your face or your arms first?"') (5) What happened? (e.g., 'She chose arms, and the bath went smoothly.') Collect these forms weekly and read one aloud at a staff meeting. This builds a culture of sharing and celebration.

  • The 'PAC Quick Reference' Card

    A laminated card that fits in a pocket, with 5 key skills: (1) Positive Physical Approach — front, eye level, smile, open hand, wait. (2) Hand-under-hand — gently place your hand under theirs, palm up. (3) Offer choices — 'Would you like A or B?' (4) Validate feelings — 'I can see this is hard for you.' (5) Redirect with a task — 'Can you help me fold these towels?' Give one to every staff member. Encourage them to pull it out when they feel stuck.

Discuss with your clinician

If a resident has a history of falls or physical aggression, discuss with the clinical team how PAC techniques like the positive physical approach should be adapted for safety. For example, approaching from the front may need to be modified if the resident has a known trigger for certain movements.

If a resident is on medications that affect their cognition or movement (e.g., antipsychotics, sedatives), talk with the prescribing clinician about how these might interact with PAC strategies. For instance, a resident on a sedative may need even slower approaches and more time to respond.

If a resident has a known history of trauma (e.g., PTSD from military service or abuse), discuss with a social worker or psychologist how to adapt PAC techniques to avoid triggering. For example, the hand-under-hand technique may need to be introduced very slowly, or with verbal permission first.

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