Age-Friendly Built Environments for Older People in Viet Nam: From Accessibility Requirements to Safe, Usable Healthcare and Long-Term Care Facilities

Age-Friendly Built Environments for Older People in Viet Nam: From Accessibility Requirements to Safe, Usable Healthcare and Long-Term Care Facilities

An entrance ramp may meet the required design specifications but become difficult to use when parked vehicles or delivery equipment obstruct the approach. An accessible toilet may have properly installed grab bars, yet its layout may not provide enough space for an older person to transfer or receive assistance. A healthcare facility may display directional signs throughout the building, but an older visitor may still struggle to find the correct consultation room.

These situations illustrate an important distinction: a building can meet applicable accessibility design requirements and still present practical barriers to the people who use it.

For older people, accessing healthcare or residential long-term care involves much more than entering a building. It means being able to move from the arrival point to reception, locate the appropriate service, reach consultation or care rooms, use toilets, access shared spaces and leave safely. In residential settings, these activities are part of everyday life rather than occasional visits.

The usability of these spaces becomes particularly important when people have reduced mobility, use walking aids or wheelchairs, require assistance with daily activities, or experience changes in their abilities during illness and recovery. Older people are not a uniform group, and an environment that works well for one person may create unnecessary difficulties for another.

For healthcare and long-term care organizations in Viet Nam, the challenge is therefore not simply to incorporate accessibility requirements into building design. It is to translate those requirements into an environment that older people can safely, comfortably and reliably use throughout the delivery of care.

Why Accessibility Compliance Does Not Always Mean Practical Usability

Building accessibility requirements provide an essential foundation for inclusive healthcare and long-term care facilities. They establish technical expectations for features such as entrances, ramps, doors, circulation routes, elevators, reception areas, sanitary facilities, signage and provisions related to safe access and evacuation.

Compliance with applicable regulations is a legal and technical responsibility. It cannot be replaced by informal assistance arrangements, and an organization's commitment to person-centered care does not remove its obligations under construction and safety regulations.

However, compliance assessments and everyday usability assessments address different questions.

A design review may establish that a corridor has the required dimensions, but it may not reveal that cleaning carts or medical equipment regularly obstruct the route. An accessible reception counter may have been installed correctly but become unavailable because it is used for storage. An elevator may meet the relevant technical specifications but remain out of service without adequate arrangements for people who depend on it to reach care.

There is also a difference between reaching a space and being able to use it for its intended purpose. A wheelchair user may enter a consultation room but have difficulty approaching the examination area. An older resident may reach a dining room but be unable to position a mobility aid comfortably beside the table.

These examples suggest three practical questions that organizations should consider when evaluating their facilities: Can older people reach the space? Can they use it for its intended purpose? Will it remain usable when they need it?

The answers depend on more than building dimensions and installed equipment. Furniture placement, maintenance practices, service organization and the activities performed within each space can all affect usability.

An age-friendly facility should support as much independence as possible while recognizing that some older people will continue to need assistance. Independence does not mean expecting every person to perform every activity without help. Instead, the built environment should avoid creating unnecessary dependence and make appropriate assistance practical, safe and respectful.

This understanding is consistent with the World Health Organization's approach to healthy aging, which recognizes that functional ability depends on a person's intrinsic capacity, the surrounding environment and the interaction between them.

For healthcare and long-term care organizations, accessibility should therefore be considered not only as a technical characteristic of a building but also as part of the everyday experience of receiving care.

The Legal and Technical Context in Viet Nam

Viet Nam has an established legal framework addressing building accessibility, the rights of older people and persons with disabilities, construction quality, building maintenance and the safe use of facilities.

The Law on the Elderly No. 39/2009/QH12, as amended and reflected in Consolidated Document No. 23/VBHN-VPQH of February 26, 2026, provides an important legal foundation concerning older people's rights, care and participation in society.

The Law on Persons with Disabilities No. 51/2010/QH12, as amended and reflected in Consolidated Document No. 24/VBHN-VPQH of February 26, 2026, addresses accessibility and the rights of persons with disabilities. Its provisions are particularly relevant where older people also have disabilities, although older age itself should not automatically be equated with disability.

A central technical reference is QCVN 10:2024/BXD, the National Technical Regulation on Constructions Accessibility, issued under Circular No. 06/2024/TT-BXD of the Ministry of Construction.

Effective from February 1, 2025, QCVN 10:2024/BXD replaced QCVN 10:2014/BXD, subject to its transitional provisions. The regulation establishes mandatory technical requirements for new construction and renovation within its specified scope, including healthcare buildings and other relevant categories of construction works.

Importantly, the regulation expressly recognizes older people with age-related functional limitations among those who may experience difficulties accessing buildings. It addresses accessible parking and arrival areas, entrances, internal circulation, doors, elevators, reception facilities, examination and patient-care rooms, sanitary facilities, wayfinding and evacuation-related accessibility.

The regulation includes specific provisions for accessible examination and patient-care rooms in different categories of healthcare facilities, with requirements varying according to the type of establishment. It also specifies accessibility features for sanitary facilities, including emergency assistance alarms in accessible toilets.

These requirements demonstrate that accessibility involves more than providing a ramp at the main entrance. However, the precise obligations must be determined according to the applicable building classification and regulatory provisions, rather than assuming that every room in every facility is subject to identical requirements.

The regulation also contains transitional provisions for certain construction projects that had reached specified approval or appraisal stages before its effective date. Depending on the circumstances set out in those provisions, some projects may continue to apply QCVN 10:2014/BXD.

For protected heritage buildings and older buildings that cannot be renovated to meet the relevant accessibility requirements, the regulation also addresses the provision of assistance measures for people experiencing access difficulties.

These provisions should not be interpreted as a general exemption for existing facilities. Equally, the introduction of a new technical regulation does not automatically require every existing building to undergo complete reconstruction. The applicable requirements depend on the building's legal status, approved use, project history, proposed alterations and relevant transitional provisions.

The Construction Law No. 135/2025/QH15, which generally took effect on July 1, 2026, provides the broader framework for construction activities and building management. Decree No. 207/2026/ND-CP, effective on the same date, establishes further provisions concerning construction quality, construction activities and building maintenance.

Where medical examination and treatment services are provided, the Law on Medical Examination and Treatment No. 15/2023/QH15 and applicable implementing regulations must also be considered. Fire safety and rescue arrangements are governed by their respective requirements, including the Law on Fire Prevention, Firefighting and Rescue No. 55/2024/QH15 and relevant technical regulations.

Residential long-term care facilities may operate under different legal and organizational arrangements depending on their approved functions and the services they provide. A hospital, rehabilitation center, residential care facility and mixed-use building should therefore not automatically be treated as belonging to the same regulatory category.

Internationally, ISO 21542:2021, Building Construction — Accessibility and Usability of the Built Environment, provides a relevant technical reference for accessibility and usability in building design. The World Health Organization's healthy aging framework and Australia's National Aged Care Design Principles and Guidelines (2024) offer additional perspectives on environments that support independence, dignity and participation in everyday life.

These international references can inform planning, design review and quality improvement. They do not automatically constitute mandatory requirements in Viet Nam or replace applicable Vietnamese regulations.

For organizations, the practical starting point is to establish the correct legal and technical baseline before assessing how well the building functions in everyday use.

An Age-Friendly Facility Accessibility and Usability Framework

A useful facility assessment should begin with what older people need to do in the building, rather than treating accessibility as an inventory of installed features.

The proposed Age-Friendly Facility Accessibility and Usability Framework brings together five complementary dimensions: regulatory compliance, connected accessibility, task-level usability, operational reliability and safe assistance.

Regulatory compliance provides the mandatory foundation. Organizations need to understand the building's approved function, applicable construction requirements, relevant transitional provisions and any outstanding compliance concerns. Matters requiring architectural, engineering or regulatory expertise should be assessed by appropriately qualified professionals.

Connected accessibility considers whether individual building features form a continuous usable route. An accessible entrance offers limited practical value if an older person cannot reach the reception desk, a designated accessible consultation room, a toilet or another necessary destination without encountering significant barriers.

Task-level usability examines what happens once a person reaches a particular space. An accessible doorway does not necessarily mean that a consultation room can accommodate the person, their mobility aid and the activities required during care. Similarly, the presence of grab bars does not establish that a toilet can be used comfortably or with appropriate assistance.

Operational reliability focuses on whether accessible spaces and features remain available during normal activities. Cleaning, equipment movement, temporary storage, maintenance work and changes in service arrangements can all affect usability. A feature that works during a scheduled inspection may not remain available throughout the day.

Safe assistance addresses the relationship between physical space and the practical delivery of support. Where older people need help moving, positioning themselves or using facilities, the environment should provide suitable space and arrangements for that assistance. The objective is to support care without creating unnecessary difficulty or compromising dignity.

These dimensions are interconnected. A facility may perform well in one area while presenting significant barriers in another. An accessible entrance cannot compensate for an unusable toilet, just as a well-designed patient room cannot overcome an inaccessible route to that room.

The framework is intended as an operational quality improvement approach. It is not a separate legal standard, building certification scheme or substitute for formal technical compliance assessment.

Following the Older Person's Journey Through the Facility

One practical way to identify usability problems is to follow the journey that an older person actually makes through the facility.

Instead of reviewing each architectural feature separately, this approach examines whether people can complete a sequence of activities without encountering avoidable barriers.

The journey will differ between an outpatient clinic, a hospital and a residential long-term care facility, but several areas deserve particular attention.

Arrival, Drop-Off and Building Entrance

The experience begins where an older person arrives, whether by private vehicle, taxi, patient transport or another means of transportation.

The route from the arrival point to the intended entrance should be examined as a continuous journey. The assessment should consider changes in level, walking surfaces, ramps, available maneuvering space, doorway operation and the possibility of obstruction by vehicles or equipment.

An accessible entrance may exist but be difficult to locate. It may also require a complicated detour that places additional demands on someone with limited mobility.

Organizations should therefore examine whether designated routes remain available during normal operating periods, including when vehicles arrive, deliveries are made or maintenance activities are taking place.

A building entrance that meets the applicable design requirements but is routinely obstructed may fail to provide the accessibility expected during everyday use.

Reception, Registration and Waiting Areas

Reception is often the first place where older visitors need to understand how a facility operates.

An accessible reception counter should remain available for its intended purpose. Appropriate clearances and usable space should not be occupied by paperwork, storage boxes or equipment. Registration activities should be organized so that older people can approach the counter, complete necessary procedures and obtain assistance without unnecessary difficulty.

Waiting areas also need to function for people with different mobility needs. Seating arrangements, wheelchair spaces and circulation routes should work together without creating obstacles or unnecessarily separating people from accompanying family members.

The physical layout should make it reasonably easy to identify where registration, consultation, payment and other relevant services take place.

Staff assistance can be helpful, particularly for someone visiting an unfamiliar facility. However, assistance should not become the only practical solution to a confusing or poorly organized environment.

A reception area may have several directional signs but remain difficult to navigate if department names are inconsistent or the signs are not positioned where people need to make decisions.

The objective is not simply to display information. It is to help people understand where they need to go and how to reach that destination.

Corridors, Elevators and Internal Wayfinding

Internal circulation should be assessed as a connected route between the spaces people need to use.

A corridor may provide sufficient space when empty but become difficult to navigate when medical equipment, cleaning carts or temporary furniture are placed along the route. A doorway may satisfy dimensional requirements but become difficult to use because of its operating mechanism or surrounding furniture.

Many of these barriers arise after a building has been completed and occupied.

For facilities with multiple floors, elevator availability can be particularly important. Where older people depend on an elevator to reach consultation, diagnostic, treatment or residential areas, organizations should understand which services become difficult or impossible to access during an outage.

Maintenance arrangements should address fault reporting and timely corrective action. Operational contingency arrangements should also identify how affected users and services will be managed when an essential accessible route is temporarily unavailable.

Wayfinding should be evaluated at the points where people need to make decisions. A directory at the main entrance may be helpful, but users also need consistent directional information at corridor intersections, elevator exits and entrances to service areas.

Signs should clearly identify destinations, use consistent terminology and be positioned in accordance with applicable accessibility requirements. Their practical effectiveness should be considered from the perspective of the people expected to use them.

The objective is not to increase the number of signs indiscriminately. It is to make the building understandable and navigable.

Consultation, Treatment and Patient Rooms

Reaching a consultation or care room is only part of the experience. The room must also support the activities performed there.

Furniture placement, examination equipment, storage arrangements and the position of doors can influence whether older people can enter, approach the intended care area, position mobility aids and leave without unnecessary difficulty.

A consultation room that appears accessible when empty may become difficult to use once examination equipment and furniture are arranged for daily operations.

In inpatient settings, the assessment should consider whether patients can reach the intended facilities and whether the available space supports the assistance that staff are expected to provide.

Residential long-term care rooms require additional attention because they serve as personal living spaces as well as places where assistance may be delivered.

The arrangement of beds, furniture, personal belongings and circulation space should support daily routines while allowing necessary care activities to take place.

The aim is not to prescribe one standardized layout for every room or resident. Different facilities and individuals have different needs. Instead, the physical arrangement should be appropriate for the room's intended function and the services provided.

Organizations should also recognize the distinction between technical compliance and the usability of a fully furnished, occupied space. Both perspectives are necessary when assessing whether the environment supports care.

Toilets, Bathing Areas and Personal-Care Spaces

Sanitary facilities provide a particularly clear example of the difference between installed accessibility features and practical usability.

A toilet may have an appropriately designed doorway and grab bars, yet its usefulness may be reduced when equipment or other objects occupy the designated maneuvering space.

The relationship between the toilet, washbasin, grab bars, door and available space affects how a person can use the facility. Where assisted use is anticipated, the layout should be evaluated against the type of support that the organization is equipped and expected to provide.

Accessible toilets should retain their designated function. They should not become storage areas or be made unavailable through routine operational practices.

Emergency assistance arrangements also deserve attention. QCVN 10:2024/BXD includes requirements for emergency assistance alarms in accessible toilets. Beyond correct installation, organizations need to ensure that such systems remain usable, functional and connected to an appropriate response process.

In residential long-term care settings, bathing and other personal-care spaces may require additional consideration because some residents need regular physical assistance.

Their design and operation should reflect residents' needs, the facility's approved functions and the capabilities of the care team.

These considerations concern the usability of the physical environment. They do not replace individualized care assessment or professional procedures for providing personal assistance.

Dining, Activity and Shared Living Spaces

In residential long-term care, an age-friendly environment extends beyond bedrooms and personal-care areas.

Dining rooms, shared lounges, activity spaces and family visiting areas are part of everyday life. Their usability can influence whether residents can maintain familiar routines, participate in activities and spend time with others.

A resident may be able to enter a dining room but find it difficult to approach a table because of furniture placement. A shared activity space may be accessible in principle but become difficult to use when seating arrangements reduce circulation space.

These issues matter because residents experience the facility as a place to live, not simply as a location where care is provided.

Where on-site gardens, courtyards or other outdoor spaces are available, organizations should also consider how residents reach and use them. The assessment should remain focused on the facility and its immediate premises rather than extending into wider urban planning.

Australia's National Aged Care Design Principles and Guidelines provides a relevant perspective through four principles: Enable the Person, Cultivate a Home, Access the Outdoors and Connect with Community.

For organizations in Viet Nam, these principles offer useful considerations for improving the everyday usability of residential care environments, without replacing applicable local requirements.

Ordinary Exit Routes and Emergency Arrangements

The journey through a facility also includes leaving the building safely.

Ordinary exit routes should remain understandable and usable during normal operations. Their accessibility may be affected by doors, changes in level, equipment placement or alterations to circulation arrangements.

Emergency conditions require additional assessment, particularly where residents or patients cannot move without assistance.

Emergency access and evacuation provisions must comply with applicable fire safety, accessibility and rescue requirements. The appropriate arrangements depend on the building's approved design, occupancy, fire protection systems and the needs of its users.

Organizations should not improvise alternative evacuation arrangements or assume that a routine accessibility measure automatically provides an acceptable emergency solution.

Accessibility walkthroughs may identify concerns requiring further review, but formal evacuation arrangements and related technical measures must be assessed by competent professionals under the applicable legal framework.

Assessing and Improving Existing Facilities

Many healthcare and long-term care organizations in Viet Nam operate in buildings developed before current accessibility requirements were introduced.

Some facilities have been expanded or modified over time. Others operate in leased buildings that were originally intended for different purposes.

In these circumstances, a structured assessment can help distinguish between immediate operational barriers, maintenance deficiencies and building limitations requiring more substantial intervention.

Some problems can be corrected without major reconstruction. An obstructed accessible route may be restored by changing storage arrangements. A reception area may become easier to use after furniture is reorganized. Damaged fittings, confusing directional signs or poorly functioning doors may be addressed through maintenance and relatively limited improvements.

Other barriers may require architectural or engineering work. An unsuitable entrance, insufficient circulation space or a sanitary facility that cannot accommodate its intended users may require redesign or renovation.

These interventions should be assessed against the building's classification, approved use, existing conditions and applicable construction requirements. Changes involving regulated building elements, structural components or fire safety systems require appropriate professional assessment and any necessary approvals.

Improvement priorities should distinguish legal noncompliance, significant safety concerns and operational barriers that unnecessarily restrict access.

Issues involving mandatory technical requirements or serious safety risks need appropriate priority. Other improvements can be scheduled according to their effect on essential services, the number and characteristics of affected users, available resources and practical feasibility.

The frequency of a problem is relevant but should not be the only consideration. A barrier affecting relatively few people may still have serious consequences if it prevents someone from accessing essential care.

For older buildings where significant alterations are difficult, organizations should examine the applicable regulatory provisions and feasible improvement options rather than assume that no action is possible.

Interim operational arrangements may sometimes be necessary while permanent solutions are being developed. Such measures should be documented and reviewed, particularly where they restrict access to services or depend heavily on staff availability.

However, operational assistance should not automatically be treated as a substitute for mandatory construction or accessibility requirements. Any alternative arrangement must be considered within the applicable legal framework.

The objective is to improve present usability while developing a realistic plan for addressing more substantial building limitations.

Clarifying Responsibility Between Building Owners, Facility Managers and Care Providers

The ongoing usability of a healthcare or long-term care facility depends on coordination between those responsible for the building and those delivering care within it.

Under Article 65 of the Construction Law No. 135/2025/QH15, the building owner or the party responsible for managing and using the building is responsible for its maintenance, as applicable. Maintenance must follow the approved maintenance plan and procedures.

Decree No. 207/2026/ND-CP further addresses maintenance planning, inspection, maintenance activities and associated documentation.

These statutory responsibilities should be distinguished from the additional operational usability activities proposed in this article.

Building owners and legally responsible building managers may have obligations concerning the condition of the building, technical systems, maintenance arrangements and authorized alterations.

Facility management teams often coordinate repairs, maintain circulation areas, respond to building defects and arrange technical assessments.

Healthcare and long-term care providers have a complementary responsibility arising from their delivery of services. They are particularly well positioned to observe how the environment affects patients, residents, caregivers and staff.

For example, a technical inspection may establish that an accessible toilet is functional, while care staff may recognize difficulties that arise when a resident needs assistance within that space.

Similarly, maintenance personnel may find a corridor unobstructed during an inspection, while frontline staff may report that equipment frequently blocks it during busy service periods.

Both perspectives are necessary.

When the building owner, operator and care provider are separate organizations, their respective responsibilities should be documented through applicable legal arrangements, contracts and operating procedures.

Such arrangements should clarify who receives reports of accessibility barriers, who can authorize immediate corrections, who is responsible for arranging technical work and how unresolved concerns are escalated.

The allocation of tasks through contracts or internal procedures must remain consistent with statutory obligations. A healthcare or care provider should also address foreseeable risks arising during its own services, even where it does not own the building.

In practical terms, organizations need a clear process for identifying a barrier, assigning responsibility, taking corrective action and confirming that the problem has been resolved.

Turning the Framework Into Practical Improvement

Healthcare and long-term care organizations can begin improving facility usability through structured observation and documented follow-up.

Three complementary tools can support this process: the Facility Accessibility and Usability Walkthrough, the Operational Barrier Register, and the Accessibility Improvement and Maintenance Plan.

These are proposed implementation resources intended to support quality improvement. They do not replace statutory inspections, required building maintenance documentation or professional compliance assessments.

Facility Accessibility and Usability Walkthrough

A Facility Accessibility and Usability Walkthrough examines how a building functions during actual service delivery.

For an outpatient clinic, the review might follow an older visitor from arrival through registration, consultation, diagnostic services, payment and departure.

For a residential long-term care facility, it might examine the routes between bedrooms, sanitary facilities, dining areas and shared activity spaces.

The assessment should consider different patterns of use, including older people who walk independently, use mobility aids or wheelchairs, or require assistance from staff.

Facility management personnel and care staff should participate, with appropriate involvement from older users or their representatives. Architectural, engineering, accessibility, occupational therapy or rehabilitation expertise may be particularly valuable when specialized assessment is needed.

Observations should focus on actual operating conditions rather than only on how the building appears when prepared for inspection.

Where appropriate, the review may take place during different service periods or room configurations, particularly when equipment movement, occupancy or staffing arrangements affect usability.

Older people should be invited to share their experiences and priorities. Participation should be voluntary, respectful and safe. No one should be asked to attempt an unsafe activity simply to demonstrate the existence of a barrier.

The objective is to understand where a journey becomes difficult, why the difficulty occurs and what change would make the intended activity more accessible and usable.

Operational Barrier Register

A walkthrough becomes more useful when its findings lead to documented action.

An Operational Barrier Register records problems affecting the accessibility or usability of specific areas.

Each entry should identify the location, the affected activity, the observed barrier and its consequences for people using the facility.

For example, the register might document an entrance repeatedly obstructed during deliveries, an accessible reception counter unavailable during busy periods or furniture preventing a wheelchair user from approaching a designated service area.

The record should distinguish potential regulatory issues from maintenance defects, operational obstructions and broader limitations in the physical design.

An appropriate priority and responsible person should be assigned, together with the proposed action, target completion date and method of verifying that the problem has been resolved.

Where immediate correction is not possible, the organization should document necessary interim measures and any unresolved risks.

Photographs or other supporting evidence may be useful, provided they are collected and managed in accordance with applicable privacy, consent and personal data protection requirements.

The value of the register lies not simply in recording individual defects but in identifying recurring patterns.

If a corridor is repeatedly obstructed, for example, the underlying problem may concern equipment storage or internal workflow rather than a series of unrelated housekeeping failures.

A documented register can help management recognize those patterns and address their causes.

Accessibility Improvement and Maintenance Plan

The Accessibility Improvement and Maintenance Plan translates assessment findings into coordinated corrective action.

The plan should distinguish improvements that can be made immediately from those requiring technical assessment, building modifications, capital investment or coordination with the property owner.

High-priority actions may include restoring obstructed accessible routes, repairing essential accessibility features and addressing conditions that prevent older people from reaching necessary services.

More substantial improvements may need to be incorporated into renovation plans or future facility investment decisions.

Accessibility should also be considered whenever an organization changes its physical layout, relocates services, introduces large equipment or modifies rooms for another purpose.

A space that was previously usable may become difficult to access after apparently minor changes.

The improvement plan should therefore be connected to routine inspections, fault reporting, maintenance activities and relevant building management procedures.

Where statutory maintenance plans and procedures are required, accessibility-related actions should be coordinated with those existing obligations rather than treated as a separate replacement system.

Organizations should also verify whether completed improvements have worked.

Removing an obstruction may resolve an immediate problem, but additional changes may be necessary if the obstruction repeatedly returns. Reorganizing a consultation room may create more usable space, but the revised arrangement should be checked against the activities actually performed there.

Together, the three tools create a practical improvement process. The walkthrough identifies barriers, the register establishes accountability, and the improvement and maintenance plan supports corrective action and continued usability.

Measuring Whether Usability Has Improved

Installing additional ramps, signs or accessible toilets does not necessarily demonstrate that older people are experiencing better access to services.

Organizations should also examine whether previously identified barriers have been reduced and whether improvements remain effective.

Useful measures may include the frequency of obstruction along designated accessible routes, the availability of essential accessibility features, the time required to resolve reported problems and the proportion of corrective actions verified as effective.

Feedback from older patients, residents and caregivers can help identify difficulties that routine technical inspections may not detect.

For example, users may report that a particular route remains confusing, an accessible facility is frequently unavailable or a room is still difficult to use despite recent modifications.

Organizations may also examine whether environmental barriers contribute to delayed access to services, interrupted activities or unnecessary requests for assistance.

These findings require careful interpretation. Some older people will appropriately require assistance regardless of the quality of the built environment. The objective is not to eliminate necessary support but to reduce avoidable difficulties created by the facility itself.

Measures should be selected according to the organization's function, population and resources. They should not be treated as universal performance thresholds or substitutes for formal technical compliance assessments.

Where feasible, completed improvements should be verified through direct observation and feedback from the people affected.

Closing a maintenance request does not necessarily mean that the original usability problem has been resolved.

The most meaningful evidence of progress is that people can complete necessary activities with fewer avoidable barriers and that improvements remain effective during routine service delivery.

Making Accessibility Part of Everyday Facility Governance

A building's usability can deteriorate without any major construction changes.

Movable furniture may gradually occupy circulation space. Storage practices may change. Equipment may be relocated. Repairs may be delayed, or a designated accessible area may be assigned an unintended function.

These problems often emerge through ordinary operational decisions rather than major design failures.

Preventing them requires more than occasional inspections. Accessibility should become part of the organization's arrangements for facility management, maintenance, service planning and quality improvement.

For healthcare facilities, this means ensuring that physical access supports the services patients are expected to use.

For residential long-term care facilities, the implications are broader. The environment should support not only access to care but also residents' ability to maintain daily routines, use shared spaces and participate in activities with appropriate independence and dignity.

Older people and their representatives can provide valuable insight because they experience the building in ways that may not be visible during technical assessments.

Their feedback should inform decisions about practical usability, while appropriately qualified professionals remain responsible for matters requiring formal technical or regulatory assessment.

An organization does not necessarily need to create a separate governance structure for accessibility. It can integrate these responsibilities into existing facility management, maintenance and quality improvement processes, provided that accountability remains clear.

The essential requirement is that accessibility concerns are identified, communicated, acted upon and reviewed.

Conclusion: An Accessible Building Must Also Be Usable

As Viet Nam responds to population aging, healthcare and long-term care organizations will increasingly need environments that accommodate people with diverse and changing abilities.

Building accessibility regulations provide a necessary technical foundation. Yet the experience of older people also depends on how those requirements are translated into functioning spaces and maintained throughout daily operations.

An accessible route should remain available when it is needed. A designated accessible consultation room should support the activities performed within it. A toilet designed for accessible use should remain usable. Shared living spaces should allow residents to participate in everyday activities rather than merely enter the room.

Achieving these outcomes requires attention to building design, actual use, maintenance and organizational responsibility.

The proposed Age-Friendly Facility Accessibility and Usability Framework offers a practical way to connect these considerations through regulatory compliance, connected accessibility, task-level usability, operational reliability and safe assistance.

Its value lies in helping organizations identify barriers, prioritize improvements, assign responsibility and verify that corrective actions remain effective.

An age-friendly facility is not defined only by the accessibility features it contains. It is defined by whether older people can reliably reach and use its spaces and services with appropriate independence, safety, comfort and dignity.

Professional and Regulatory References

Viet Nam

Law on the Elderly No. 39/2009/QH12, as amended, including Consolidated Document No. 23/VBHN-VPQH dated February 26, 2026.

Law on Persons with Disabilities No. 51/2010/QH12, as amended, including Consolidated Document No. 24/VBHN-VPQH dated February 26, 2026.

Ministry of Construction. QCVN 10:2024/BXD, National Technical Regulation on Constructions Accessibility, issued under Circular No. 06/2024/TT-BXD, effective February 1, 2025.

Construction Law No. 135/2025/QH15, generally effective July 1, 2026.

Government Decree No. 207/2026/ND-CP, detailing provisions of the Construction Law concerning construction quality management, construction activities and maintenance of construction works, effective July 1, 2026.

Law on Medical Examination and Treatment No. 15/2023/QH15.

Law on Fire Prevention, Firefighting and Rescue No. 55/2024/QH15.

International

World Health Organization. World Report on Ageing and Health (2015), together with subsequent WHO resources on healthy aging, functional ability and the UN Decade of Healthy Ageing (2021–2030).

International Organization for Standardization. ISO 21542:2021, Building Construction — Accessibility and Usability of the Built Environment.

United Nations. Convention on the Rights of Persons with Disabilities, particularly Article 9 on accessibility.

Australian Government Department of Health and Aged Care. National Aged Care Design Principles and Guidelines (2024).

About This Article

This article is published by Healthy Longevity Vietnam (HLVN) as an educational and quality improvement resource addressing the accessibility and practical usability of healthcare and long-term care facilities for older people in Viet Nam.

The proposed Age-Friendly Facility Accessibility and Usability Framework, together with the Facility Accessibility and Usability Walkthrough, Operational Barrier Register and Accessibility Improvement and Maintenance Plan, represents a practical approach to organizational assessment and improvement. These tools are not statutory technical standards, official regulatory assessment methods, accreditation requirements or certification schemes.

This article does not constitute legal advice, an architectural or engineering compliance assessment, a fire safety assessment or an evaluation of any individual facility. Its recommendations should be considered alongside applicable Vietnamese laws, technical regulations, professional requirements and facility-specific conditions. Building alterations and matters involving statutory compliance require assessment by appropriately qualified professionals.

Legal and professional context reviewed: October 2026.