Using the PAC Coaching Cycle as a Care Partner or Supervisor

The PAC coaching cycle is a structured, supportive process that helps care partners and supervisors build dementia care skills through observation, feedback, and guided practice. It’s not about criticism—it’s about growing together, step by step. Whether you’re a family member learning to adapt or a supervisor mentoring staff, this cycle turns everyday challenges into learning moments. You’ll find concrete steps, real phrases to use, and ways to tailor the approach to your unique situation.

Key points

The PAC coaching cycle is a supportive, non-judgmental loop of observe, give feedback, practice, and repeat.
Start with one small challenge and one small change—don’t try to fix everything at once.
Use concrete tools like the ‘One Small Shift’ card and the observation checklist to keep feedback focused.
Supervisors: build coaching into your regular schedule, not just during crises.
Family care partners: find a trusted friend or support group member to be your coach—no certification needed.
Always frame feedback around what went well first, then offer one gentle suggestion.
The cycle works for all roles: care partners, staff, supervisors, and even people with early-stage dementia.

What the PAC Coaching Cycle Is and Why It Matters

The PAC coaching cycle is a method from Teepa Snow’s Positive Approach to Care that pairs a coach (someone skilled in PAC techniques) with a care partner or staff member to improve how they interact with someone living with dementia. Unlike a one-time training, this cycle is ongoing: you observe, you practice, you get feedback, and you try again. It’s built on the idea that learning happens best when you can see what you’re doing, hear how it lands, and adjust in real time. For supervisors, it’s a way to support staff without making them feel judged—because the focus is always on the person with dementia, not on ‘fixing’ the caregiver.

How the Cycle Works in Practice

The cycle typically has three phases: first, the coach observes a care interaction (like helping with bathing or redirecting during agitation). Second, the coach and care partner meet to discuss what went well and what could shift—using PAC language like ‘hand-under-hand’ or ‘positive physical approach.’ Third, the care partner tries the new approach, and the coach observes again. This loop repeats until the skill feels natural. For a supervisor, this means scheduling short, regular check-ins—not just annual reviews. For a care partner, it might mean asking a PAC-certified mentor to watch you during a difficult moment and give you one or two small tweaks to try next time. The goal is always to build confidence, not to overwhelm.

Why It Works for Different Roles

Care partners often feel isolated, especially when they’re family members. The coaching cycle gives them a trusted ally who can say, ‘I see you struggling with that—here’s a different way to hold the spoon.’ Supervisors benefit because coaching reduces turnover: staff who feel supported are less likely to burn out. And for the person with dementia, the cycle means more consistent, compassionate care because everyone is learning the same PAC approach. As one PAC-certified coach put it, ‘If I teach something, I learn it’—so the coach grows too. The cycle isn’t a hierarchy; it’s a partnership.

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

Step-by-step

Step 1: Identify a specific care challenge you want to work on—for example, getting dressed without resistance or responding to repetitive questions. Write it down in one sentence.
Step 2: Find a PAC-certified coach or mentor. This could be a supervisor who has PAC training, a colleague who’s been through certification, or even a family member who’s learned the approach. If you’re a supervisor, designate a staff member with PAC skills to act as a coach for others.
Step 3: Schedule a 15-minute observation session. The coach watches you interact with the person with dementia during the chosen challenge. They take notes on what you say, how you move, and how the person responds.
Step 4: Right after the observation, hold a 10-minute feedback conversation. Start with what went well—‘I noticed you used a calm voice and waited for a response.’ Then offer one small change: ‘Next time, try approaching from the front and offering your hand palm-up instead of reaching from behind.’
Step 5: Practice the new technique within the next 24 hours. If possible, have the coach observe again, or record yourself (with permission) to review later.
Step 6: Meet again for a 5-minute check-in. Ask: ‘How did that feel? What did you notice about the person’s reaction?’ Adjust as needed. Repeat the cycle weekly until the skill feels automatic.
Step 7: For supervisors: set up a coaching schedule for your team. Rotate who coaches and who is coached so everyone builds skills. Use part of team meetings to share what’s working.

What not to do

Don’t turn the coaching session into a performance review. If you focus on ‘you did this wrong,’ the care partner will shut down. Instead, frame it as ‘let’s find what works better together.’
Don’t skip the observation step. Trying to coach without watching first leads to generic advice that may not fit the situation. Always see the interaction firsthand.
Don’t give more than one or two suggestions per session. Overloading the care partner with changes makes them feel overwhelmed and less likely to try anything. Pick the most impactful tweak.
Don’t assume the coach knows everything. Even a PAC-certified coach is still learning. Encourage the coach to say, ‘I’m not sure—let’s look that up together.’ This models humility and growth.
Don’t use the coaching cycle only when there’s a crisis. Regular, low-stress coaching builds trust and skill. If you only coach after a meltdown, it feels punitive.

Practical tools

The ‘One Small Shift’ Feedback Card
A simple index card you keep in your pocket. On one side, write ‘What went well:’ and on the other, ‘One thing to try next time.’ After observing, fill it out together with the care partner. This keeps feedback positive and focused. Example: ‘What went well: You used a soft tone. One thing to try: Offer a choice between two shirts instead of asking ‘What do you want to wear?’
The PAC Observation Checklist
A short list of PAC skills to watch for during an observation: positive physical approach (approach from front, at eye level), hand-under-hand technique, using simple positive words, waiting for a response, and redirecting with a preferred activity. The coach checks off what they see and notes one area to develop. This makes feedback concrete.
The ‘Try It Twice’ Commitment
After a coaching session, the care partner agrees to try the new approach at least two times before the next check-in. This reduces the pressure to get it perfect the first time. The coach says, ‘Just try it twice—even if it feels awkward. Then we’ll talk about what happened.’
The Weekly Coaching Log
A shared notebook or digital document where the coach and care partner jot down one win and one challenge from the week. Example: ‘Win: Used hand-under-hand during toothbrushing—no resistance. Challenge: Still struggling with bath refusal.’ This builds a record of progress and helps spot patterns.

Discuss with your clinician

If the care partner or person with dementia has a history of trauma or anxiety, discuss with a therapist or social worker before starting coaching—feedback, even positive, can feel triggering.

If the care partner is experiencing significant burnout or depression, coaching may need to be paused until they have more emotional support. Talk to a doctor or counselor.

If the person with dementia has a condition like Lewy body dementia with frequent hallucinations, coaching techniques may need to be adjusted. Ask the neurologist or geriatrician for guidance on safe approaches.

Related guides

Sources

Teepa Snow's Positive Approach to Care