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A Caregiver’s Quick Guide To PAC Dementia Care Training

by Melissa Bell
7 minutes read

Dementia is the seventh leading cause of death globally. It is the general term for the impairedness of a person’s cognitive function, affecting memory, attention, reasoning, communication, judgment, and making decisions.

In the United States, there are 5.8 million people affected by the disease as of 2014, 97% of them aged 65 years and older. About 200,000 people have early-onset dementia and are under 65. Sadly, in 2060, this number is expected to rise to 14 million.

Contrary to what many people believe, dementia doesn’t come with age. Many people get old without suffering from it. The most common type of dementia is Alzheimer’s disease, wherein a person suffers from memory loss, communication, and personality changes. The other types of dementia are the following:

  • Vascular dementia – is caused by a stroke or a series of strokes.
  • Lewy body dementia – is abnormal microscopic protein deposits that form in the brain, causing a person to blank out and sometimes hallucinate.
  • Frontotemporal dementia – its symptoms may include a sudden lack of inhibitions in personal and social situations.
  • Parkinson’s disease dementia – Lewy bodies form in the brain resulting in problems with movement like trembling.
  • Creutzfeldt-Jakob Disease – a type of dementia where symptoms happen suddenly and progress very quickly.
  • Huntington’s disease – is a genetic condition where symptoms show up as early as 30.
  • Normal-pressure hydrocephalus – is caused by a build-up of cerebrospinal fluid in the brain.
  • Wernicke-Korsakoff syndrome – is dementia caused by a severe shortage of thiamine in the body because of alcoholism.
  • Mixed dementia – is a combination of two types of dementia.

Currently, there is no cure for dementia. The only way to help those who suffer from it is to manage their symptoms and care for them compassionately.

Senior woman

Dementia symptoms vary from the stages a person is in the disease and what type of dementia they have, but the most common symptoms of dementia are the following:

  • Memory loss
  • Getting lost in a familiar place
  • Difficulty with planning and organizing
  • Unable to solve problems and reason
  • Disorientation and confusion
  • Depression
  • Paranoia
  • Inappropriate behavior
  • Hallucinations
  • Anxiety

These symptoms affect a person’s ability to live normally and could have emotional, mental, and psychological implications for their families.

PAC or positive approach to care is a popular method applied in caring for patients with dementia. It is devised by Teepa Snow, a multi-disciplinary specialist and leading educator on dementia care. She has 40 years of clinical practice experience as an occupational therapist and made it her life mission to support and engage people in caring for dementia most compassionately and positively.

Her dementia care training includes incorporating meaningful activities that make a person with dementia feel valued and appreciated.

To give you an overview, here’s a quick guide to a positive approach to care for people with dementia:

1. Apply The Gem Categories

PAC categorizes patients based on their remaining abilities instead of their lost abilities because of the disease. The gem categories are the following:

  • Sapphire – are patients with a healthy brain that can still work optimally but may need support.
  • Diamond – patients who have a clear cognitive presence and can shine when supported but can be sharp when distressed.
  • Emerald – patients focused on their needs but with a positive approach can be competent with some tasks in time.
  • Amber – are ultra-sensitive patients who quickly get distressed and may need more focused care and an individualized approach.
  • Ruby – are patients with minimal fine motor skills and may need their day planned out, including detailed personal care.
  • Pearl – are patients who are near the end of their life. They may need more care and connection.

As a caregiver, treating a person with dementia like you would a precious gem would make them feel valued, and in time, with the proper care, some of their original traits may shine and be visible.

2. Understand The Patient’s Boundaries

People with dementia are often sensitive to their personal and intimate space. Caregivers must know spatial boundaries and respect this in approaching the patient. A carer needs to connect first or acquire permission to interact before physically intruding on their personal space.

What’s critical in this care is to put themselves in the patient’s shoes and internalize how someone with a cognitive impairment feels when abruptly interrupted or touched.

3. Practice HUH Or Hand Under Hand Approach

HUH is a positive physical approach that is a step up from the traditional handshake. It’s a gentle type of physical connection that assists patients in a friendly and comforting way without being intrusive and overbearing.

HUH is a compelling approach that makes dementia patients feel comfortable and encourages them to communicate as the touch may trigger some pleasant memories and unlock hidden motor activities they used to have.

HUH seems to help rewire the brain because touch can make recall travel to the brain and ignite memories that may have been temporarily locked away.

Performing HUH while crouched low and below the eye level of the patient can help the caregiver take control of any unfavorable situation that may arise without looking aggressive and assertive.

senior and young holding hands.

4. Fill Their Day With Meaning

A day in the life of someone with dementia could be very long and listless. There may be lots of times when they feel worthless and invaluable. That’s why it’s essential to make them feel valued, appreciated, and happy.

Doing worthwhile and engaging activities can help stimulate brain activity and improve their quality of life. The activities can also make them feel productive and allow them to interact with others and socialize.

Activities can range from productivity tasks like baking, folding clothes, and simple sewing. Patients could also engage in passive and active leisure activities like board games, dancing, and arts.

Self-care activities are also essential to include in their daily activities to help them remember their hygiene with assistance. Rest and restoration are things dementia patients may neglect since their brains may get overwhelmed often. It is necessary to cue their nap and sleep times to recharge and function better the next day.

5. Connect Through Music

Music is a powerful tool to connect with patients. It is ideal for dementia patients to engage in activities with music at least twice a day. You may incorporate music with leisure activities like a musical crossword puzzle where you associate words with familiar lyrics and tunes that they might recognize.

It’s also essential to use music to get active physically without straining their body with rigorous exercise. Start with soft upper body movements while seated so they can participate slowly and step up to move to other parts of the body like the hips and the feet, eventually standing up.


The remaining days of a patient with dementia should be full of positivity. Family members must ensure that they at least look for people who can do this compassionately because caring for people with dementia can be stressful and challenging. As a caregiver, you must be trained in PCA to give only the best care and attention to patients with dementia.

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