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FTJ Memory Care Team Trained in Teepa Snow’s Positive Approach to Care (PAC)

By Heidi White, FTJ Life Enrichment Director

As dementia becomes more common in the aging population, it is apparent that the typical and traditional ways of dealing with dementia are not enough. As the brain changes during the progression of dementia and its disease process, the ways that we interact with people living with dementia must also change. Knowing this, FTJ is changing how their team members interact with people living with dementia through Teepa Snow’s Positive Approach to Care (PAC) training.

In April this year Vivienne Campbell, Memory Care Resident Care Manager, Patricia Moore, Activity Coordinator and Heidi White, Director of Life Enrichment participated in a training course from the Teepa Snow Foundation to become PAC Certified Independent Coaches. With their Coach certification they can train staff in the best ways to approach, interact with and assist people living with dementia.

What is Teepa Snow’s Positive Approach to Care (PAC) method? The Positive Approach to Care involves several steps and aspects. It begins with the Positive Physical Approach (PPA), which involves Positive Personal Connection (PPC) and Positive Action Starter (PAS). And finally, as needed, Hand Under Hand (HuH) to assist in doing physical actions. These steps, when used properly, allow a caregiver to use as many of the retained skills of the person living with dementia as possible. It makes it possible to “Do With” a person living with dementia rather than “Do To” them.

The Positive Physical Approach (PPA)

This is a 6-9 step method used to approach and connect with a person living with dementia. When done correctly it results in a reduced chance of agitation and a greater mutual understanding and comfort on the part of the person living with dementia. PPA was developed based on the knowledge that a person living with dementia experiences their environment differently than a person with a healthy brain. PPA allows care partners to engage in a dynamic assessment of the other person’s willingness, current comfort level and their current ability to engage and interact. Care partners learn how to change their own actions according to the responses of the person living with dementia. They also learn how to use an improved personal connection to encourage participation in various care tasks or situations that arise.

Some of the benefits of PPA include:

• Establishing a mutually welcoming connection
• Reducing the risk of surprising and agitating the person living with dementia.
• Opening opportunities for continued connection for easier task completion
• It functions as a dynamic assessment of the other person’s willingness, comfort and ability to interact while reducing the risk of surprising negative reactions from the person living with dementia.

What are Positive Personal Connections (PPC)? 

PPC is an approach developed by Teepa Snow.  It consists of five phrases that help a care partner connect with the person living with dementia before jumping into a task.

1. Greeting someone
2. Complementing them
3. Noticing something positive in the environment
4. Sharing something
5. Seeking a possible unmet need.

Doing any one of these five things puts the relationship first and as a result, interactions are more likely to result in positive outcomes.

What are Positive Action Starters (PAS)?

PAS is an approach developed by Teepa Snow. It consists of five phrases that help care partners receive less resistance and refusals when getting started with a care task.

1. Asking for help
2. Asking to try something
3. Offering a choice
4. Giving one piece of information at a time
5. Going step by step.

Any of these action starters allow the person living with dementia to feel they have a choice and are part of the solution. The result is that they are more likely to respond positively with less resistance and refusals to the actions requested by the care partner.

Some of the benefits of PPCs and PASs

Some benefits include that a genuine connection is made with the person living with dementia. They put the relationship front and center and strengthen the bond between the care partner and the person living with dementia, resulting in reduced agitation. They help the person living with dementia feel seen and respected, rather than being a task to get done.

What is Hand Under Hand (HuH)?

HuH is an evidence-based technique to support and assist a person living with dementia with daily tasks like eating, drinking, bathing, getting dressed and more. HuH places pressure to the palm of the hand, NOT around the top of the hand, the sides or the base of thumbs or fingers. By changing the placement of the hand during a care task it protects both the care giver and the person living with dementia from injury.  HuH requires that the care partner is on the dominate side of the person living with dementia and supporting the hand they are most comfortable manipulating objects with. HuH is a vital part of “doing with” rather than “doing to” someone living with dementia. HuH allows the person living with dementia to be a participant in their own care rather than the object being done to.

Some of the benefits of HuH

• It lets the person living with dementia maintain a feeling of control and independence
• It utilizes remaining muscle memory to help the brain process the situation
• It increases food and drink intake
• It reduces resistant behaviors to care tasks

As staff and care partners are trained in and become more familiar and comfortable with the Positive Approach to Care their interactions with people living with dementia improve. By focusing on new and better ways to interact with someone living with dementia the overall quality of life for that person increases.

FTJ is continually looking for ways to improve the quality of care for people living with dementia and the Positive Approach to Care is one of the many adaptations we’ve made to improve the quality of life for residents at FTJ. As Teepa Snow says, “Until there is a cure, there is care.”  

~ Much of the information for this article came from the Teepa Snow website. Additional information can be found at  https://teepasnow.com/