The Program of All-Inclusive Care for the Elderly (PACE) was designed to serve individuals with complex medical, functional, and social needs. As dementia prevalence continues to rise, PACE programs are increasingly caring for participants whose cognitive impairment impacts nearly every aspect of care delivery.
As we approach 2026, PACE organizations face a convergence of challenges:
- Rising dementia prevalence
- Increasing participant acuity
- Direct care workforce shortages
- Heightened CMS oversight and quality expectations
In this environment, dementia training is no longer optional—it is core infrastructure.
Dementia Is Central to the PACE Population
Many PACE programs report that 30–50% or more of participants live with dementia or cognitive impairment. Dementia affects:
- Safety and falls
- Medication management
- Behavioral symptoms
- Caregiver stress
- Day center engagement
- Hospitalization risk
- Staff confidence and retention
Because PACE operates under a capitated model, unmanaged dementia-related crises directly impact both quality outcomes and financial sustainability.
CMS Expectations Are Rising—Even Without New Dementia Rules
While CMS has not issued dementia-specific PACE regulations, surveys and audits increasingly examine outcomes heavily
influenced by dementia care quality, including:
- Avoidable hospitalizations
- Psychotropic medication use
- Behavioral health documentation
- Participant and caregiver experience
- Interdisciplinary team (IDT) coordination
Programs lacking dementia-capable staff are more exposed to risk, even when care intent is positive.
CMS PACE Program Overview:
https://www.cms.gov/medicare/health-safety-standards/pace
National PACE Association:
https://www.npaonline.org
Workforce Pressure Amplifies the Risk
PACE programs are navigating:
- Persistent staffing shortages
- Staff confidence and retention
- Staff burnout and fatigue
- Increasing participant complexity
Without dementia training, staff often experience:
- Fear or frustration when behaviors arise
- Misinterpretation of distress as non-compliance
- Reliance on task-based care instead of relationship-based care
- Faster burnout and disengagement
This creates a cycle of turnover, instability, and compromised care.
Effective dementia education equips staff across all roles—not just clinicians—to:
- Understand the “why” behind behaviors
- Use non-pharmacological de-escalation strategies
- Communicate with empathy and clarity
- Build trust with participants and caregivers
- Reduce crisis events and staff stress
Importantly, dementia training supports PACE’s greatest strength: the interdisciplinary team model.
When all team members share a common understanding of dementia, care planning becomes more realistic,
coordinated, and effective.
Dementia-Capable PACE Programs Perform Better
Organizations that invest in dementia education often see:
- Improved staff confidence and retention
- Reduced behavioral incidents
- Better caregiver engagement
- Stronger survey performance
- Enhanced quality of life for participants
In a competitive workforce environment, supporting staff competence is supporting staff well-being.
Preparing PACE for 2026 and Beyond
PACE programs positioned for success will:
- Treat dementia training as essential infrastructure
- Provide education for all staff roles
- Emphasize non-pharmacological, person-centered care
- Support caregivers as partners
- Align workforce development with CMS priorities
Dementia is not a side issue in PACE—it is central to mission fulfillment, quality outcomes, and long-term sustainability.
Learn more about how AGE-u-cate Training Institute’s innovative dementia training programs are helping over 2.5 million people to elevate empathy, a deeper understanding and practical skill-building tools.