Building Resident Participation into Residential Long-Term Care Governance in Viet Nam: Inclusive Consultation, Shared Priorities and Accountable Follow-Through

Building Resident Participation into Residential Long-Term Care Governance in Viet Nam: Inclusive Consultation, Shared Priorities and Accountable Follow-Through

A residential care facility decides to change its dining arrangements. Management believes that serving dinner earlier will make staffing more efficient and allow residents to settle into their evening routines sooner. The new schedule is introduced with good intentions.

Several residents are unhappy. One has always preferred a later meal. Another enjoys spending time with friends in the dining room after afternoon activities. A third finds the new schedule inconvenient because it conflicts with regular calls with family members.

The facility has a system for receiving feedback, and residents are welcome to raise concerns. But nobody asked them about the proposed change before the decision was made.

When management eventually organizes a meeting, residents explain what matters to them and offer practical suggestions. Yet they receive little information about whether those suggestions will influence the final arrangement.

The facility has listened, but has it meaningfully involved residents in the decision?

This distinction matters in residential long-term care. Older people may be consulted about personal preferences, invited to complete satisfaction surveys, or encouraged to submit complaints. These are valuable practices, but they do not necessarily give residents a meaningful voice in how the organization is managed.

Decisions about daily routines, shared spaces, services, activities, communication, and organizational priorities can affect the lives of everyone residing in a facility. For residential long-term care providers in Viet Nam, meaningful resident participation offers a way to connect person-centered care with organizational governance.

It can help managers understand what residents value, identify priorities that might otherwise be overlooked, and demonstrate how residents' perspectives influence decisions and service improvement.

The purpose is not to transfer every management responsibility to residents. It is to establish reliable ways for people receiving care to contribute to decisions that affect their lives, understand how their views have been considered, and see whether agreed improvements are carried through.

Resident Participation Goes Beyond Collecting Feedback

Residential care organizations commonly gather feedback through satisfaction surveys, informal conversations, family meetings, and complaints procedures. These methods help identify problems and provide useful information about service quality, but collecting feedback and involving residents in governance are not the same.

A satisfaction survey usually asks people to evaluate a service that has already been designed or delivered. A complaints process allows individuals to raise concerns about something they believe has gone wrong.

Participation in governance goes further. It creates opportunities for residents to influence how priorities are identified, how services are planned, which improvements are considered, and how the organization evaluates whether changes are working.

Residents might help identify whether a facility should prioritize quieter communal spaces, more flexible meal arrangements, improved access to outdoor areas, or clearer communication about planned changes. They may also contribute to discussions about how new residents are welcomed, how shared environments are used, or which aspects of everyday life deserve greater management attention.

These are organizational questions rather than simply individual service requests.

Participation can occur at different levels. Residents may receive information about a proposed decision, be consulted while options remain open, help develop possible solutions, or contribute through an ongoing advisory process.

The appropriate level depends on the issue, residents' preferences, applicable requirements, and the responsibilities of the organization.

Facilities should describe these arrangements accurately. Informing residents about a decision already made is not the same as involving them in making it. Similarly, asking for opinions does not necessarily mean that decision-making authority has been shared.

Meaningful participation requires clarity about what residents can influence, who makes the final decision, and how their contributions will be considered.

Why Participation Matters in a Place People Call Home

A residential long-term care facility is both an organization providing services and a place where people live.

Residents may depend on employees for essential assistance, but they continue to have personal preferences, relationships, experiences, and views about how their living environment should function.

Management decisions influence many aspects of everyday life. Meal schedules, visiting arrangements, maintenance activities, communal spaces, recreational programs, and communication procedures all affect residents' comfort, independence, and sense of control.

Some decisions involve professional, safety, or legal requirements. Others allow considerable flexibility.

When residents have limited opportunities to influence these arrangements, an organization may unintentionally prioritize operational convenience over the experiences of the people receiving care.

A schedule may work well for employees while creating difficulties for residents. A redesigned communal area may look attractive to management but be inconvenient for people using wheelchairs or living with sensory impairments.

Consultation can reveal these differences before changes are introduced. Residents may also identify concerns that are difficult to recognize through incident reports, financial indicators, clinical records, or routine operational monitoring.

Their perspectives provide information that can help management understand whether services work as intended in daily life.

However, participation should not be presented as a guarantee of better outcomes. Its value depends on whether people can contribute meaningfully, whether management considers their views seriously, and whether the process influences actual decisions.

A meeting that produces no response or follow-up may do little to strengthen confidence in the organization. Participation becomes valuable when residents' experiences are connected to decisions and accountable action.

What the Research Tells Us About Resident Engagement

International research increasingly recognizes resident engagement as an important element of long-term care governance. However, evidence about how to implement it effectively and measure its impact remains incomplete.

A scoping review by Hutchinson and colleagues, published in the Canadian Journal on Aging in 2025, examined resident engagement in the organizational design and governance of long-term care homes.

The review included 62 articles covering 59 studies. Residents' councils were the most frequently described approach, appearing in 38 studies.

Relatively few studies addressed the inclusion of residents from diverse backgrounds or those living with dementia and other cognitive impairments. Only ten studies reported quantitative evaluations of resident engagement, and just four included outcomes reported directly by residents.

These findings highlight an important gap between establishing participation arrangements and demonstrating that those arrangements work. Residents' councils have been described extensively, but their existence does not automatically mean that residents influence organizational decisions or experience better care.

Another study by Staempfli and colleagues, published in 2025, examined factors influencing the effectiveness of resident and family councils in long-term care homes.

Drawing on focus groups and interviews in British Columbia, the researchers identified factors that organizations could potentially improve, including communication, council structure, recruitment and engagement, leadership, organizational culture, and available resources.

They also identified challenges associated with residents' medical complexity and shorter lengths of stay, which can affect participation and the continuity of council membership.

A separate scoping review by Westworth and colleagues, published in September 2025 in the Journal of Public Health, examined how co-design processes involving residents and informal caregivers were evaluated in residential aged care research.

Of 22 included studies, only six evaluated their co-design process. None used predefined criteria to measure whether the process had meaningfully involved residents or their informal caregivers.

The researchers concluded that evaluation of co-design in residential aged care remains limited and inconsistent.

Although research co-design and ongoing organizational governance are not identical activities, these findings raise a relevant question: how can organizations determine whether participation is genuine rather than merely procedural?

The evidence supports a cautious approach. Resident involvement is consistent with person-centered governance, but facilities should not assume that establishing a committee, conducting workshops, or collecting more feedback necessarily improves care outcomes.

Participation arrangements need to be designed carefully, supported by management, and evaluated for whether they give residents meaningful opportunities to influence decisions.

Choosing Participation Methods That Fit the Facility

Meaningful participation does not require every residential care organization to adopt the same structure.

A larger provider may establish a residents' advisory group that meets regularly and has a defined relationship with senior management or the organization's quality committee. A smaller facility may use facilitated discussions, consultations on proposed changes, individual conversations, or periodic meetings with a designated manager.

Other approaches may include accessible written feedback, small-group discussions, resident representatives, or participation in specific quality improvement projects.

The method should reflect the purpose of the consultation.

For example, a proposed change to dining arrangements may benefit from discussions with residents who use the dining room at different times. A review of accessibility should include people with different mobility, sensory, and communication needs.

A wider discussion about organizational priorities may benefit from an ongoing advisory arrangement that allows residents to become familiar with how the facility makes decisions.

Not every issue requires a formal meeting. Some residents may find individual conversations more comfortable or productive, particularly when the subject is personal or they need additional time to express their views.

Participation should also remain voluntary. A resident should not be expected to join a committee or attend regular meetings simply to demonstrate engagement with the facility.

The organization needs several appropriate ways for people to contribute. The starting point should be a clear understanding of the issue being considered, which decisions remain open, and how residents' views may affect the outcome.

Residents' Advisory Groups Need a Clear Purpose

A residents' advisory group can provide a structured way for people to raise shared concerns, discuss proposals, and communicate priorities to management. It may also create continuity between occasional consultations and longer-term organizational decisions.

However, its effectiveness depends on how the arrangement operates.

A group that meets regularly but has no clear relationship with decision-makers can become largely symbolic. Residents may offer thoughtful suggestions without knowing whether anyone with authority has considered them.

Likewise, a group whose agenda is controlled entirely by management may have limited opportunities to raise independent concerns.

A useful advisory arrangement should have a clearly explained purpose, accessible procedures, and a defined pathway for communicating recommendations to the people responsible for making decisions.

Residents should understand whether the group is advisory, which matters it can influence, and whether any responsibilities have formally been delegated to it.

An advisory group should not be described as having decision-making authority it does not possess. Nor should it be used to transfer management's legal responsibilities to residents.

For example, consultation cannot authorize a provider to disregard safety requirements, professional standards, employment obligations, or an individual's lawful rights.

The purpose of an advisory process is to improve organizational decisions through meaningful resident involvement. Management remains accountable for decisions within its responsibilities.

Making Participation Accessible to More Than the Most Confident Residents

One persistent challenge is that some residents find it much easier to participate than others.

People who are confident, articulate, familiar with meetings, or comfortable expressing disagreement may become regular contributors. Residents with hearing difficulties, limited mobility, communication impairments, cognitive changes, or lower confidence may be heard less frequently.

When consultation consistently involves only a small group, important experiences may be overlooked. This is particularly concerning when people with the greatest care needs are also those who face the greatest difficulties participating.

Facilities should therefore examine whose perspectives are represented and whose may be missing.

An advisory group does not necessarily need to reflect every characteristic of the resident population. However, management should consider whether its membership and consultation methods provide sufficient opportunities for people with different needs and experiences.

Some residents may prefer individual conversations because they cannot attend meetings. Others may need a quieter environment, accessible materials, communication assistance, or additional time to understand a proposal and express their views.

People with limited speech may use alternative forms of communication. Some may communicate more comfortably with a familiar caregiver than with an unfamiliar manager.

The organization should not assume that inviting everyone to the same meeting creates equal opportunities for participation.

Accessibility depends on whether people can actually contribute, not simply whether an invitation was offered. A credible process may require several methods and more than one opportunity to express a view.

Supporting Participation by Residents Living With Dementia

Residents living with dementia may experience particular barriers to formal organizational discussions.

Some may find long meetings tiring or difficult to follow. Others may struggle with complex information, unfamiliar terminology, or expressing preferences in a group setting.

These difficulties should not lead to the assumption that meaningful participation is impossible.

A resident may be able to discuss a proposed change through a brief individual conversation even if attending a formal meeting would be difficult. Another may respond more clearly when options are explained using photographs, familiar objects, or simple descriptions.

Some people communicate preferences through consistent responses, behavior, or emotional reactions rather than detailed verbal explanations.

These contributions deserve consideration, although staff should distinguish what the resident has communicated from their own interpretation.

Family members and familiar caregivers may provide useful context, but their views should not automatically replace those of the resident.

A person's ability to understand and contribute to a particular discussion should not be inferred solely from a diagnosis.

Someone may have difficulty understanding complex financial or organizational information while remaining able to express a clear preference about meal schedules, communal spaces, visiting arrangements, or daily routines.

The ability to communicate everyday preferences should also be distinguished from questions of civil legal capacity and formal representation under Vietnamese law.

Where legally authorized representation is required, the applicable provisions must be followed.

Meaningful inclusion involves adapting how people can participate, respecting their rights, and avoiding unsupported assumptions about incapacity.

Families Can Contribute Without Replacing Residents' Voices

Families often have valuable knowledge about an older person's preferences, history, communication needs, and experiences of care. They may notice changes, identify practical concerns, or help explain preferences that residents find difficult to communicate.

Family participation can therefore strengthen organizational understanding.

However, resident participation and family participation are not interchangeable.

An adult child may prefer a particular visiting schedule because it is convenient, while the resident may want something different. A family member may favor more organized activities, while the older person values quiet time and familiar routines.

Such differences should not automatically be resolved in favor of the family.

Residents' preferences and lawful rights remain central, subject to applicable decision-making and representation arrangements.

Facilities may create separate opportunities for residents and families to contribute or organize combined discussions where appropriate. It should be clear whose views are being expressed and how those views will be considered.

Families should not receive unrestricted access to another resident's personal or health information simply because they participate in an advisory process.

The purpose of family involvement is to add useful knowledge and support appropriate participation, not to replace the voice of the person receiving care.

Consultation Should Begin While Decisions Can Still Change

One of the most common weaknesses in organizational consultation is poor timing.

Management may develop a proposal, approve it internally, and then invite residents to comment shortly before implementation.

By that stage, there may be little realistic opportunity to influence the decision. Residents may recognize this, even when they are encouraged to speak openly.

A more meaningful approach begins while relevant options remain available.

If a facility is considering changing dining arrangements, residents can be asked what currently works, what difficulties they experience, and what alternatives they would prefer.

Management can then consider those suggestions alongside staffing arrangements, nutritional needs, food safety, costs, and other operational requirements.

This does not mean that every resident proposal must be accepted.

Some suggestions may be impractical or inconsistent with legal, professional, financial, or safety requirements. Those limitations should be explained clearly.

Residents should understand which parts of a proposed decision are genuinely open to influence and which are constrained by requirements that management cannot disregard.

Consultation becomes misleading when people are invited to choose between options that are not actually available.

Being transparent about the purpose and limits of participation helps establish realistic expectations and makes the process more credible.

Shared Priorities Must Account for Different Needs

Residents may express preferences that differ or conflict.

Some may prefer earlier meals, while others want a later schedule. One group may support more communal activities, while another may be concerned about noise or reduced access to quiet spaces.

A facility may also need to balance requests involving accessibility, staffing, service costs, and the needs of residents who require substantial assistance.

Participation does not mean that every decision should be determined through a majority vote.

A majority preference may provide useful information, but it does not automatically override the rights or essential needs of individuals who disagree.

For example, a popular proposal to reduce assistance in a particular area would be inappropriate if it left residents with substantial care needs without necessary support.

Likewise, residents cannot collectively decide whether another individual should receive healthcare, retain personal privacy, or exercise legally protected rights.

Management should assess proposals using relevant considerations such as resident experience, safety, fairness, feasibility, legal obligations, and the consequences for different groups.

Where priorities compete, the organization should explain how it reached a decision.

Residents may disagree with the outcome while still recognizing that their views received fair consideration.

Shared priority-setting does not require unanimous agreement. It requires an understandable process in which affected people have meaningful opportunities to contribute and decisions can be justified.

Residents Should Be Able to Raise Their Own Priorities

Consultation can become too narrow when residents are invited to discuss only topics selected by management.

The facility may seek feedback on activities while overlooking concerns about privacy, communication, visiting arrangements, or the use of shared spaces.

Residents should therefore have opportunities to propose issues themselves.

They may identify recurring difficulties that do not appear in routine quality reports.

For example, residents may feel that maintenance work is poorly communicated, that communal areas offer insufficient privacy, or that changes to familiar routines are introduced without adequate explanation.

Some suggestions may be straightforward to address. Others may require detailed assessment, additional resources, or management approval.

The facility should not promise to implement every proposal, but it should establish a fair way to determine which concerns require further consideration.

Resident-generated priorities can help reveal the difference between what management considers important and what people experience as important in everyday life.

The process should also allow residents to question whether previously agreed changes are working.

Participation becomes more useful when it develops into an ongoing relationship rather than a series of isolated meetings.

Connecting Resident Recommendations to Organizational Decisions

Even a thoughtful consultation process can fail if nobody is responsible for considering the information collected.

Residents may contribute practical ideas, but their recommendations may never reach the manager or governing body authorized to act.

An effective arrangement needs a clear pathway from consultation to decision-making.

The facility should identify who receives recommendations, who evaluates them, and which person or body has authority to approve relevant changes.

Different matters may require different levels of consideration.

A minor adjustment to an activity schedule may be resolved by operational management. A substantial change to facility policy, staffing arrangements, or service structure may require higher-level review.

Where proposals affect clinical safety, professional responsibilities, legal compliance, or other technical matters, appropriately qualified advisers may need to contribute.

Residents should understand how the process works without being expected to master the organization's internal management structure.

The system should remain practical. A small facility may assign responsibility to a designated manager who reviews proposals regularly and reports back to residents.

A larger organization may establish a residents' advisory group with a formal relationship to a quality committee, senior management, or governing body.

The structure matters less than whether responsibilities are clear, proposals receive appropriate consideration, and residents are informed about the outcome.

Accountable Follow-Through Makes Participation Credible

Residents may become discouraged when they repeatedly offer suggestions but never hear what happened afterward.

Management may have discussed a proposal internally, yet without communication, the process can appear to have achieved nothing.

This is where accountable follow-through becomes important.

When a recommendation is received, the organization should determine whether it will be accepted, modified, deferred, or not pursued.

The decision should be communicated in a way residents can understand.

Where a change is approved, responsibility for implementation should be assigned. Residents should receive appropriate information about what will change and, where relevant, the expected implementation arrangements.

If a proposal cannot be implemented, management should explain why rather than dismissing the concern.

A suggestion may be reasonable but require resources that are not immediately available. Another may conflict with an essential safety requirement. In some cases, an alternative approach may address part of the issue.

The important point is that residents receive a meaningful response.

Written records can support this process, but extensive paperwork should not become the main objective.

For many issues, a simple record of the concern raised, management's decision, the person responsible for action, and the outcome may be sufficient.

Accountability is demonstrated when residents can see that their contributions have been considered and that the organization follows through on its commitments.

Checking Whether Agreed Changes Actually Work

Implementing a proposal does not necessarily mean that the underlying problem has been resolved.

A facility may change dining arrangements in response to resident feedback, only to discover that the new schedule creates difficulties for another group.

A redesigned communal space may improve accessibility for some residents while making the environment less comfortable for others.

The organization should therefore return to residents after significant changes and ask whether the intended improvement has occurred.

This connects participation with continuous quality improvement.

Consultation helps identify experiences and possible priorities. Implementation introduces a change. Evaluation examines whether the change has produced the intended result and whether further adjustments are needed.

A useful review may combine resident feedback with relevant operational information.

For example, revised visiting arrangements may be evaluated through residents' experiences, staff observations, accessibility concerns, and relevant safety or service issues.

The organization should not assume that a change has succeeded simply because it was completed on schedule.

If the new arrangement does not work as expected, residents should be able to raise concerns without being regarded as difficult or ungrateful.

A credible participation process allows the organization to learn from unsuccessful changes as well as successful ones.

Participation Must Be Safe and Free From Retaliation

Some residents may hesitate to criticize an organization on which they depend for essential care.

They may worry that employees will treat them differently, their concerns will be dismissed, or participation could damage relationships with caregivers.

Others may fear disapproval from management or family members.

These concerns can limit meaningful engagement even when formal consultation opportunities exist.

Organizations should create an environment in which residents can express views without intimidation or inappropriate consequences.

Staff should understand that disagreement with a policy is not necessarily a criticism of an individual employee.

A resident who questions an organizational decision may be contributing useful information to quality improvement.

Consultation should not become a way for management to identify troublesome residents, discourage criticism, or create pressure to agree with existing plans.

Where residents prefer private discussions, appropriate confidential channels should be available.

Independent facilitation may be useful in some circumstances, particularly where there is a significant imbalance of power or a history of mistrust. It is not necessary for every consultation, and the level of support should reflect the situation.

Participation arrangements must also remain distinct from complaints, safeguarding, and urgent incident response procedures.

Reports of abuse, immediate danger, or serious harm may require prompt protective action and notification through appropriate legal or professional pathways.

Such concerns should not wait for the next residents' meeting or be resolved through collective voting.

Meaningful governance participation should strengthen, not obstruct, the organization's responsibilities to protect residents.

Protecting Privacy During Consultation

Residents may share sensitive personal information when discussing the quality of care.

Someone may describe a health problem, difficulties with personal assistance, a relationship with a staff member, or concerns involving another resident.

Organizations should distinguish issues suitable for collective discussion from matters requiring confidential individual handling.

For example, a general concern about bathroom accessibility may be appropriate for an advisory meeting. A specific allegation involving another person's medical information or private conduct may need a separate process.

Meeting records should not unnecessarily identify individuals or disclose confidential details.

Residents should understand how their contributions may be recorded, shared, or used. When minutes or summaries are distributed, personal information should be appropriately limited.

Digital surveys, meeting recordings, photographs, and online consultation platforms may create additional data protection responsibilities.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Government Decree No. 356/2025/ND-CP both took effect on January 1, 2026.

Organizations must consider applicable legal grounds, purposes, access controls, security measures, retention, and disclosure requirements when processing personal information.

Residents should not have to accept unnecessary exposure of their private lives in order to participate in organizational discussions.

Privacy and meaningful engagement should reinforce one another.

Staff and Leadership Responsibilities

Resident participation is sometimes assigned entirely to an activities coordinator or quality manager.

These individuals may be well placed to organize discussions, but meaningful engagement requires support from the wider organization.

Care workers frequently hear residents' concerns during ordinary conversations. They may recognize preferences or difficulties that are not raised in formal meetings.

However, employees should not be expected to turn every conversation into a survey or promise changes they have no authority to approve.

They need to understand how relevant suggestions can be communicated to the appropriate manager and how residents will receive a response.

Staff preparation may help distinguish between listening respectfully, documenting a concern, escalating a safety issue, and making an organizational decision.

Management should also provide realistic time and resources for the participation arrangements it establishes.

A consultation process may become inconsistent if employees are expected to organize meetings, assist residents with communication, prepare records, and coordinate follow-up without adequate support.

Leadership has another responsibility: being willing to hear views that challenge existing assumptions.

A policy designed for efficiency may create inconvenience or distress. A procedure that seems reasonable to management may work poorly in daily life.

Residents can provide knowledge that is not captured in routine administrative reports.

However, sharing influence does not mean abandoning leadership responsibilities.

Management remains accountable for lawful operation, workforce arrangements, financial stewardship, resident safety, and service quality within its applicable responsibilities.

Some decisions cannot be delegated to advisory groups.

The role of leadership is to establish which matters are open to resident influence, listen to different perspectives, make defensible decisions, and explain the outcome.

This balance is especially important in residential long-term care, where organizations must respect individual rights while managing shared resources and collective living arrangements.

Measuring Whether Participation Is Meaningful

A facility may report that it held six residents' meetings or received dozens of suggestions during the year.

These figures demonstrate that participation activities took place, but they do not necessarily show that residents were meaningfully involved.

A more useful evaluation considers whether people had accessible opportunities to contribute, understood the issues being discussed, and could express their views without inappropriate pressure.

It should also examine whether recommendations reached the appropriate decision-makers, whether responses were communicated, and whether agreed improvements were implemented.

Residents' experiences are particularly important.

Do they believe their views are taken seriously? Do they understand what happened to their recommendations? Can they identify changes that resulted from their participation?

These questions may be explored through accessible conversations, appropriate feedback methods, or other approaches suited to the resident population.

Participation should also be examined across different groups.

If nearly all contributions come from relatively independent residents who are comfortable attending meetings, the facility may need additional methods to hear people with greater care dependency or communication difficulties.

The percentage of accepted recommendations should be interpreted cautiously.

A high acceptance rate does not automatically indicate good governance. Management should not approve unsafe or inappropriate proposals simply to improve a performance indicator.

Likewise, declining a recommendation for a legitimate legal, professional, or safety reason does not necessarily mean consultation has failed.

The quality of the process depends on whether residents had a genuine opportunity to contribute, whether their perspectives were considered fairly, and whether decisions were explained.

The purpose of evaluation is not simply to increase participation numbers. It is to understand whether organizational decisions are better informed by the people who live in the facility.

What International Governance Frameworks Can Contribute

International frameworks provide examples of how resident participation can be connected to formal organizational accountability.

Australia's strengthened Aged Care Quality Standards, implemented under the new aged care framework from November 1, 2025, include Outcome 2.1, Partnering with Individuals.

The outcome requires providers within its scope to engage in meaningful and active partnerships with older people to inform organizational priorities and continuous improvement.

It addresses participation in setting priorities and strategic directions, as well as the design, delivery, evaluation, and improvement of services.

Australia's Aged Care Act 2024 also establishes advisory body requirements for specified categories of registered providers.

Section 158 distinguishes between quality care advisory bodies and consumer advisory bodies, which have different purposes and requirements.

Under the consumer advisory body provisions, qualifying registered providers must offer individuals receiving funded aged care services and their supporters the opportunity to establish one or more consumer advisory bodies.

For providers within the applicable scope, this offer must be made in writing at least once every 12 months.

If a consumer advisory body is established, the governing body must consider its feedback and provide a written response explaining how that feedback was considered.

The legislation also establishes protections concerning participation in these advisory arrangements.

These provisions provide an example of connecting service-user perspectives with formal governance responsibilities.

However, the Australian requirements apply within that country's regulatory framework and to the providers specified by its legislation.

They do not establish a general legal obligation for every residential care facility in Viet Nam to create an equivalent body or follow the same procedures.

England's Care Quality Commission also addresses participation through Regulation 17 on good governance.

The regulation requires providers within its scope to seek and act on feedback from people using services and other relevant stakeholders as part of evaluating and improving service quality.

WHO Europe's 2024 technical document, Promoting Quality Management in Long-Term Care: Principles, Key Components and Directions for Policy Action, emphasizes continuous improvement and service systems responsive to people's needs and preferences.

Its State of Long-Term Care conceptual framework, also published in 2024, incorporates participatory governance into system-level assessment and continuous learning.

These frameworks reinforce the principle that people receiving care should contribute to quality decisions rather than remain separate from organizational management.

Nevertheless, foreign regulatory models must be interpreted within their own legal systems. Their requirements should inform comparative learning, not be represented as Vietnamese statutory obligations.

ISO 25557:2026 and Person-Centered Governance

ISO 25557:2026, Ageing Societies — Care Quality for Older Persons at Home and in Care Facilities, was published in March 2026.

The standard specifies requirements and recommendations for the quality of health and social care services provided to older people at home and in care facilities.

Its scope emphasizes individual needs and preferences, self-determination, participation, safety, and inclusion, together with broader responsibilities relating to service quality.

These principles are relevant to organizations seeking to strengthen resident participation.

A care provider may use ISO 25557 as a reference when examining whether its systems reflect the views, preferences, and experiences of older people.

However, ISO 25557 should not be presented as requiring every residential care facility to adopt a particular residents' council or advisory committee structure.

Publication of the international standard also does not automatically make it a mandatory Vietnamese legal requirement.

The World Health Organization released a consultation draft of its proposed Global Standards for Long-Term Care on May 18, 2026.

The public consultation period ended on October 30, 2026.

As of November 3, 2026, the draft should not be presented as a finalized WHO normative standard.

For Viet Nam, these international developments offer useful reference points for strengthening quality governance, but implementation must remain appropriate to local needs, organizational capabilities, and applicable law.

Viet Nam's Legal and Regulatory Context

Resident participation in residential long-term care should be understood within Viet Nam's legal framework concerning older people's rights, social assistance services, civil decision-making, and personal information.

The Law on Older Persons No. 39/2009/QH12, as amended, establishes important rights and protections.

The consolidated text issued as Document No. 23/VBHN-VPQH on February 26, 2026, provides an updated official reference.

Article 3 recognizes rights relating to basic living needs, healthcare, personal living arrangements, participation in cultural and social activities, and other lawful interests.

Article 9 prohibits specified conduct that infringes older people's dignity, rights, or property.

These provisions provide a relevant foundation for treating older people as individuals with continuing rights, preferences, and interests.

However, they should not be interpreted as creating a universal statutory requirement for every residential care provider to establish a residents' council or grant residents formal governing-body authority.

The Civil Code No. 91/2015/QH13 contains relevant provisions concerning civil legal capacity, representation, and guardianship.

An older person's age, disability, or diagnosis does not automatically determine their legal capacity or justify excluding them from discussions affecting their lives.

Where legally authorized representation is relevant, the applicable provisions must be followed.

For organizations legally classified as social assistance establishments, Government Decree No. 103/2017/ND-CP, as amended, remains part of the applicable regulatory framework as of November 3, 2026.

A new regulatory framework has been issued.

Government Decree No. 395/2026/ND-CP on the operation and management of social assistance establishments was issued on October 23, 2026, and is scheduled to take effect on December 7, 2026.

The Decree establishes provisions concerning the organization, operation, management, and services of facilities within its defined scope.

Organizations should review the requirements relevant to their legal classification and prepare for implementation.

However, the Decree must not be treated as already effective before December 7, 2026.

It should also not be interpreted as universally requiring resident participation structures identical to Australian consumer advisory bodies.

The specific responsibilities of residential care providers depend on their legal status, authorized activities, contractual arrangements, and other applicable laws.

Resident involvement can therefore be developed as a lawful, person-centered quality management practice while maintaining a clear distinction between voluntary improvement approaches and statutory obligations.

Building a Practical Resident Participation System in Viet Nam

Residential long-term care organizations in Viet Nam vary considerably in size, governance structure, workforce capability, and available resources.

A larger organization may be able to establish a formal residents' advisory committee supported by administrative and quality management personnel.

A smaller facility may prefer periodic resident discussions, structured consultation on proposed changes, and a reliable process for management responses.

The method should reflect the people living in the facility and the organization's ability to support meaningful participation.

A practical starting point is to identify decisions where resident input could make a useful difference.

These might include communal routines, communication arrangements, the use of shared spaces, activity opportunities, accessibility, and selected quality improvement priorities.

Management can then determine which decisions are open to consultation, how people will be invited to contribute, and what assistance may be needed to make participation accessible.

Facilities should also identify who receives recommendations, who has authority to act, and how outcomes will be communicated.

Residents need to understand the purpose of consultation and the limits of their influence.

This does not necessarily require complex software or extensive reporting.

For many issues, a clear record of the concern raised, management's response, the responsible person, and the outcome may provide a useful basis for follow-up.

Consistency matters more than administrative complexity.

Residents should not need to repeat the same concern indefinitely because nobody has responsibility for addressing it.

When a participation arrangement proves ineffective, management should be willing to revise the process.

The participation system itself should be subject to learning and improvement.

From Resident Consultation to Shared Organizational Learning

Resident participation is most meaningful when it changes how an organization learns and makes decisions.

Management may believe that a service is functioning well because performance indicators are satisfactory and complaints are infrequent.

Residents may experience the same service differently.

They may recognize barriers that are difficult to measure through administrative records or identify priorities that managers have not considered.

These perspectives can help organizations understand whether services are meeting their intended purpose.

Resident input is not a substitute for professional assessment, safety monitoring, or other evidence. Quality decisions should consider relevant clinical, operational, legal, financial, and resident-experience information together.

The value of participation is that it adds knowledge that might otherwise be missing.

A facility should be able to explain how residents' views informed its priorities, what changes were considered, which actions followed, and what was learned from the results.

For older people, this creates opportunities to influence the environment in which they live.

For employees, it provides a better understanding of what matters to residents beyond routine care tasks.

For organizational leaders, it connects governance decisions with everyday experience.

Meaningful participation is not demonstrated simply by the existence of an advisory committee, the number of meetings held, or the volume of feedback collected.

It becomes visible when residents can contribute in accessible ways, their views receive fair consideration, decisions are explained, and the organization follows through.

Residential long-term care should not be managed as though the people living there are merely recipients of services designed entirely by others. They are individuals whose daily lives are directly affected by organizational decisions.

For Viet Nam's developing long-term care sector, strengthening resident participation offers an opportunity to make quality governance more inclusive, responsive, and accountable.

A facility becomes more genuinely person-centered when residents are not only asked what they think about the care they receive, but also given meaningful opportunities to help shape how that care is organized and improved.

Key References and Regulatory Context

National Assembly of Viet Nam. (2009). Law on Older Persons No. 39/2009/QH12, as amended. Particularly Articles 3 and 9 concerning older persons' rights and prohibited conduct.

Office of the National Assembly of Viet Nam. (2026). Consolidated Document No. 23/VBHN-VPQH — Law on Older Persons. Issued February 26, 2026.

National Assembly of Viet Nam. (2015). Civil Code No. 91/2015/QH13, as applicable. Particularly provisions concerning civil legal capacity, representation, and guardianship.

Government of Viet Nam. (2017). Decree No. 103/2017/ND-CP on the Establishment, Organization, Operation, Dissolution and Management of Social Assistance Establishments, as amended and applicable on the review date.

Government of Viet Nam. (2026). Decree No. 395/2026/ND-CP on the Operation and Management of Social Assistance Establishments. Issued October 23, 2026; scheduled to take effect December 7, 2026.

National Assembly of Viet Nam. (2025). Law on Personal Data Protection No. 91/2025/QH15. Effective January 1, 2026.

Government of Viet Nam. (2025). Decree No. 356/2025/ND-CP Detailing Certain Articles and Measures for Implementation of the Law on Personal Data Protection. Effective January 1, 2026.

World Health Organization Regional Office for Europe. (2024). Promoting Quality Management in Long-Term Care: Principles, Key Components and Directions for Policy Action. Published December 10, 2024.

World Health Organization Regional Office for Europe. (2024). State of Long-Term Care: Conceptual Framework for Assessment and Continuous Learning in Long-Term Care Systems. Published November 12, 2024.

World Health Organization. (2026). Call for Public Consultation on Global Standards for Long-Term Care. Published May 18, 2026; consultation closed October 30, 2026.

Australian Government. (2024). Aged Care Act 2024, as applicable and subsequently amended. Particularly Section 158 concerning advisory body requirements.

Australian Government. (2025). Aged Care Rules 2025, as amended. Particularly Standard 2, Outcome 2.1: Partnering with Individuals, and relevant advisory body provisions.

Australian Aged Care Quality and Safety Commission. Strengthened Aged Care Quality Standards Guidance — Outcome 2.1: Partnering with Individuals.

Australian Aged Care Quality and Safety Commission. Provider Governance Obligations. Guidance concerning advisory bodies, governing-body responsibilities, and feedback.

Care Quality Commission, England. Regulation 17: Good Governance. Guidance updated May 16, 2025.

Hutchinson, M., Gilhuly, J., Ramsden, G., Lee, C., Tripp, D., Collingwood, B., et al. (2025). Listened to but Rarely Heard: A Scoping Review of Resident Engagement in the Organizational Design and Governance of Their Long-Term Care Homes. Canadian Journal on Aging, 44(4), 552–564. DOI: 10.1017/S0714980825100263.

Staempfli, S., Havaei, F., Dawson, L., Novek, S., Slater, K., Kaulius, M., & Ahmed, A. (2025). Raise Your Voice: How to Increase the Effectiveness of Resident and Family Councils in Long-Term Care Homes. Canadian Journal on Aging, 44(2), 225–234. DOI: 10.1017/S0714980825000029.

Westworth, S. E., Lu, A., Long, K. M., & Andrew, N. E. (2025). Evaluating Co-Design Processes Used in the Development of Healthcare Interventions in Residential Aged Care: A Scoping Review. Journal of Public Health, 47(4), 814–827. DOI: 10.1093/pubmed/fdaf111.

International Organization for Standardization. (2026). ISO 25557:2026 — Ageing Societies — Care Quality for Older Persons at Home and in Care Facilities.

United Nations General Assembly. (1991). United Nations Principles for Older Persons. Resolution 46/91.

About Healthy Longevity Vietnam

Healthy Longevity Vietnam (HLVN) is an independent initiative focused on advancing quality, safety, and implementation in age-friendly, integrated, and long-term care for older people in Viet Nam. Through evidence-informed approaches, quality improvement, measurement, and collaboration, HLVN supports healthcare and care organizations in developing safer, more coordinated, and person-centered care across settings.

Disclaimer

This article is intended for general education, quality improvement, and organizational development. It does not constitute individualized clinical advice, legal advice, an official regulatory interpretation, or a mandatory national governance standard for residential long-term care in Viet Nam.

Resident participation arrangements should respect older people's rights, preferences, communication needs, decision-making abilities, privacy, and applicable legal requirements. Participation should be voluntary and should not be used to pressure residents into attending meetings, disclosing personal information, or accepting decisions they have not lawfully authorized.

Residents' councils, advisory groups, consultation meetings, and related mechanisms are examples of possible quality improvement approaches. This article does not establish a universal legal requirement for Vietnamese residential care providers to create such bodies or delegate governing authority to them.

The legal responsibilities of organizations, governing bodies, managers, residents, families, and legally authorized representatives depend on the provider's legal status, authorized activities, contractual arrangements, and applicable Vietnamese law.

Age, disability, care dependency, or a diagnosis of dementia does not automatically establish that a person lacks legal capacity or should be excluded from participation.

Resident consultation does not replace professional judgment, safeguarding arrangements, emergency action, statutory reporting, or management responsibilities. Collective preferences cannot be used to override individual rights or applicable safety and legal requirements.

Personal information collected through surveys, meetings, recordings, or advisory processes must be processed and protected in accordance with applicable Vietnamese confidentiality and personal data protection laws.

Government Decree No. 395/2026/ND-CP was issued on October 23, 2026, and is scheduled to take effect on December 7, 2026. Its provisions must not be treated as already effective on the review date or as establishing identical resident participation requirements for every residential care organization.

International standards, research findings, and foreign regulatory requirements are provided for educational and comparative purposes. They do not automatically establish mandatory advisory structures, decision-making powers, reporting intervals, or governance obligations in Viet Nam.

The available research does not establish that creating an advisory body, holding more consultation meetings, or collecting additional feedback necessarily improves care outcomes. Organizations should evaluate whether participation is accessible, influential, and followed by appropriate action.

Residential long-term care providers should develop locally appropriate participation arrangements in consultation with residents, relevant care and quality professionals, families where appropriate, and qualified legal or governance advisers when necessary.

Information and regulatory context reviewed as of November 3, 2026.