Climate-Resilient and Disaster-Ready Care for Older People in Viet Nam: From Heat and Flood Risks to Emergency Preparedness and Continuity of Care Across Settings
MEASUREMENT, IMPLEMENTATION & LEARNINGINTEGRATED CARE & CARE TRANSITIONSLONG-TERM CARE QUALITY
AGE-FRIENDLY CARE QUALITY · LONG-TERM CARE QUALITY
Last reviewed: October 2026
An older woman living alone becomes increasingly exhausted during several days of extreme heat. She has chronic kidney disease, takes several medications and relies on an electric fan to keep her room comfortable. When the electricity fails, the indoor temperature rises, but she is reluctant to leave home. Elsewhere in Viet Nam, an older man receiving regular dialysis faces a different problem. Heavy rain and flooding have made the road to his hospital impassable, and his family does not know where he can safely receive his next treatment. Meanwhile, a residential care facility preparing for an approaching storm must decide whether to remain in place or evacuate residents, including people living with dementia, those requiring assistance with transfers and others who depend on continuous medical support.
These situations illustrate why extreme weather and natural disasters are not simply environmental events or temporary disruptions to daily life. For older people, a heatwave, flood or storm may directly threaten health while simultaneously interrupting the medications, equipment, electricity, water, transport and personal assistance on which they depend.
The consequences are not determined by age alone. An older person who remains independently mobile, lives in suitable housing and has reliable family support may be relatively well prepared. Someone of the same age who lives with frailty, cognitive impairment, limited mobility or multiple chronic conditions may face substantial difficulties responding to an emergency without assistance.
In Viet Nam, these concerns are increasingly relevant as population aging intersects with exposure to extreme heat, typhoons, flooding, landslides, drought and saltwater intrusion. The challenge extends beyond hospitals because older people receive care across homes, communities, rehabilitation services and residential long-term care settings, often involving different professionals and family caregivers.
Disaster preparedness should therefore be considered part of healthcare quality, patient safety and continuity of care. A warning is useful only when the person receives, understands and can act on it. An evacuation plan is incomplete if it does not account for mobility limitations, essential treatment and medical equipment. A hospital may survive a storm without major structural damage but still struggle to provide safe care if electricity, water, transport or staffing arrangements are disrupted.
The real measure of preparedness is not whether an organization has an emergency plan on paper. It is whether that plan can protect the people who depend on its services, maintain essential care during disruption and support a safe recovery afterward.
Climate Hazards Affect Older People Through More Than Direct Exposure
Extreme weather can affect health through several pathways. High temperatures may cause heat exhaustion, heatstroke, dehydration and physiological stress that can worsen cardiovascular, respiratory, kidney and metabolic conditions. Heavy rainfall and flooding can cause injuries, drowning, displacement and exposure to contaminated water. Storms and landslides may damage homes, interrupt communication and prevent access to essential services. Drought and saltwater intrusion can threaten reliable supplies of safe water.
These hazards can also produce indirect health consequences. A flooded road may prevent someone from reaching dialysis. A power outage may interrupt an oxygen concentrator or compromise the storage of temperature-sensitive medicines. A damaged pharmacy may be unable to dispense prescriptions, while a care worker may be unable to reach a homebound patient. A family caregiver may face the same emergency as the person they support.
The World Health Organization's 2023 Operational Framework for Building Climate Resilient and Low Carbon Health Systems recognizes that climate change threatens both human health and the ability of health systems to maintain essential services. The framework addresses leadership, workforce capability, climate risk assessment, early warning, infrastructure, supply chains, health programs, emergency management and financing.
These elements are closely connected. Clinical services cannot remain reliable when essential supporting systems become unavailable. A facility may have qualified professionals and functioning medical equipment but still be unable to operate safely if water supplies are contaminated, electricity is interrupted or staff cannot reach the building.
An important distinction is that climate change should not be used to explain every individual storm or flood. Viet Nam has long experienced natural hazards because of its geography and climate. Climate change can influence the frequency, intensity, duration or consequences of certain hazards, while local exposure and vulnerability are also shaped by housing, land use, drainage, infrastructure and socioeconomic conditions.
For healthcare organizations, preparedness must therefore be based on the hazards that actually affect their locations and populations. A facility exposed to prolonged urban heat may face different operational risks from a hospital in a flood-prone river basin or a community service operating in a mountainous area vulnerable to landslides.
The question is not simply which natural disasters might occur. It is how those events could affect the people receiving care and the services they need to remain safe.
Why Climate-Resilient Older-Person Care Matters in Viet Nam
Viet Nam's exposure to natural hazards is well established. Coastal communities, river deltas, mountainous areas and densely populated cities face different combinations of extreme heat, storms, flooding, landslides, drought and water-related risks.
Recent disasters demonstrate that interruptions to healthcare can extend well beyond the immediate emergency. Typhoon Yagi struck northern Viet Nam in September 2024, causing widespread damage to homes, roads, healthcare facilities and essential infrastructure. An initial WHO assessment published that month reported damage to more than 550 healthcare facilities. A subsequent United Nations-led recovery update in June 2025 reported that more than 800 healthcare facilities had been damaged, reflecting information available at a later stage of the response.
The June 2025 update also reported that the disaster had affected approximately 3.6 million people across 26 provinces. The consequences included injuries, displacement and major disruptions to infrastructure, communication, healthcare access and everyday living conditions. Restoring essential health services became an important part of recovery.
Viet Nam experienced further severe storms and flooding in 2025. Following Typhoon Bualoi in September, WHO supported emergency water safety measures, including water purification supplies and containers. This response highlighted an important reality: protecting health after flooding depends not only on emergency medical treatment but also on restoring access to safe drinking water, sanitation and routine healthcare services.
Climate resilience is also relevant to slower-developing environmental pressures. In the Mekong Delta, drought and saltwater intrusion can threaten freshwater supplies. WHO-supported improvements at Cu Lao Minh Area General Hospital have demonstrated how strengthened water treatment infrastructure can support safer clinical services. At Yen Thanh District General Hospital in Nghe An, improvements in water supply reliability have similarly addressed a critical operational dependency.
These examples connect climate adaptation with everyday healthcare quality. Safe water is necessary for infection prevention, cleaning, sterilization and patient care. Reliable electricity supports medical equipment, communication, environmental control and the safe storage of certain medicines. Without these services, healthcare delivery can deteriorate even when clinical professionals remain available.
However, evidence about climate-related health risks in Viet Nam should not be confused with evidence specifically measuring disaster preparedness among older Vietnamese people. Available national and international information does not establish how consistently hospitals, community health services, home-care providers or residential long-term care organizations can protect older people during different emergencies.
That evidence gap matters. It suggests the need for practical risk assessment, preparedness evaluation and implementation research rather than assuming that existing emergency arrangements adequately address older people's care needs.
Vulnerability Depends on Health, Function and Available Support
Older people should not be treated as a uniform group during emergency planning. Some remain physically active, independently mobile and capable of preparing for emergencies without substantial assistance. Others live with frailty, multiple chronic conditions, sensory limitations, cognitive impairment or dependence on medical equipment and caregivers.
Several conditions can increase risk during extreme weather. Cardiovascular and kidney disease, diabetes, respiratory illness, reduced mobility and medications affecting hydration or temperature regulation may influence physiological vulnerability. Impaired vision or hearing can make warnings difficult to receive, while cognitive impairment may affect understanding, judgment and the ability to follow unfamiliar instructions.
Living circumstances are equally important. Someone who lives alone may have no one to recognize early signs of illness. An older person in a poorly ventilated home may have limited protection during a heatwave. Another person may understand an evacuation warning but be unable to leave safely because of stairs, inaccessible transport or the absence of a caregiver.
Dependence on essential healthcare creates additional risks. People requiring dialysis, oxygen therapy, ventilatory support, complex wound care or temperature-sensitive medicines may need specific arrangements when normal services become unavailable.
A useful preparedness assessment should therefore consider the person's exposure to hazards, underlying health conditions, functional abilities, essential care dependencies and available support. It should identify what the person can do independently, what assistance may be needed and what would happen if the usual arrangements failed.
This is different from assuming that everyone above a particular age requires evacuation or institutional care. Such an approach may unnecessarily restrict autonomy and overlook the capabilities of older people who are well prepared.
Older people should participate in decisions about their preparedness wherever possible. Their experience, preferences and priorities can help determine which arrangements are realistic and acceptable.
The purpose of assessment is not to classify older people simply as vulnerable or independent. It is to understand what support each person may need under different emergency conditions.
Extreme Heat Requires More Than Advice to Drink Water
Extreme heat is an increasingly important health concern for older populations. The WHO's updated Heat and Health fact sheet, published on 31 July 2026, identifies heat as a significant environmental health hazard that can worsen underlying cardiovascular, respiratory, kidney, metabolic and other conditions. Older people may be particularly susceptible because of physiological changes, chronic illness, medication use and environmental or social circumstances.
Heat risk is influenced by more than the temperature reported in a weather forecast. Humidity, airflow, solar radiation, indoor conditions, duration of exposure and the ability to recover during cooler periods all affect the body's capacity to manage heat. Consecutive hot nights may be particularly difficult when buildings retain heat and indoor conditions remain uncomfortable.
Some older people may experience dehydration, dizziness, weakness, fatigue or worsening symptoms of an existing illness. Severe heat-related illness can involve confusion, collapse, cardiovascular instability or heatstroke. Heatstroke is a medical emergency requiring immediate cooling and urgent medical treatment. The presence of sweating does not exclude heatstroke, and new confusion or altered consciousness during significant heat exposure should never be treated as a minor symptom.
Medication review is an important part of prevention. Diuretics and certain other medicines may influence fluid or electrolyte balance, while some treatments can affect sweating, blood pressure or temperature regulation. However, older people should not be advised to stop or adjust prescribed medicines independently when hot weather is expected. Those at increased risk may benefit from an individualized plan developed with their treating clinician.
Advice about fluids must also reflect the person's clinical condition. Adequate hydration is important, but someone with heart failure, advanced kidney disease or another condition requiring fluid restriction may need specific instructions. Encouraging excessive water consumption is not universally appropriate.
Protective measures should focus on reducing heat exposure, maintaining safer indoor conditions and recognizing deterioration early. Suitable cooling, shade, ventilation, light clothing and avoiding unnecessary activity during the hottest periods may help, but their effectiveness depends on the environment and the person's health.
Electric fans can improve comfort under some conditions, but they should not be assumed to provide sufficient protection during every extreme heat event, particularly when indoor temperatures are very high. Access to a reliably cooler location may be necessary. Cooling arrangements also need to consider what happens during an electricity outage.
For people receiving home care or living in residential facilities, monitoring should extend beyond asking whether they feel thirsty or uncomfortable. Changes in alertness, behavior, mobility, breathing or usual activity may indicate the need for clinical assessment.
A practical heat preparedness plan should identify who is at increased risk, how indoor conditions and official warnings will be monitored, what protective actions will follow a warning and who is responsible for checking that those actions have worked.
Turning Heat Warnings Into Protective Action: What WHO's 2026 Guidance Adds
In June 2026, the WHO Regional Office for Europe published the second edition of Heat–Health Action Plans: Guidance. The document provides an updated framework for developing coordinated public health responses to extreme heat.
It identifies eight core elements: governance, heat-health warning systems, populations at increased risk, communication, health system resilience, reduction of heat exposure, heat-health surveillance, and monitoring, evaluation and learning.
Although developed for the WHO European Region, the framework can inform planning elsewhere when adapted to local climate conditions, health systems and available resources.
One of its most useful principles is that warnings should lead to predefined protective actions. A heat alert should not simply trigger a general message advising people to avoid the sun. It should lead relevant health and community services to identify people at increased risk, review environmental conditions, activate agreed support arrangements and determine whether additional clinical assessment or practical assistance is necessary.
A residential care facility might adjust activities, increase observation of residents at higher risk and confirm that cooling and backup power systems are operational. A community service might contact selected homebound patients whose access to safe cooling or essential treatment is uncertain.
Such arrangements need to reflect local circumstances. Temperature thresholds, warning categories and response measures should be linked to relevant official information, local risk assessment and the capabilities of the service. A single temperature trigger should not be imposed universally without considering humidity, indoor exposure, local climate and population vulnerability.
The WHO guidance also recognizes the importance of surveillance and learning. When heat-related symptoms increase or protective arrangements prove insufficient, response measures may need adjustment. After a period of extreme heat, organizations should review what happened and whether their interventions reached the people who needed them.
The 2026 WHO guidance does not establish mandatory operating standards for Vietnamese healthcare organizations. Its value is in offering an evidence-informed approach to connecting early warning, organizational responsibilities and practical protection.
For older-person care, that connection is essential. Knowing that a heatwave is approaching is useful only if people who require assistance can receive it in time.
Flooding, Storms and Evacuation Create Distinct Care Risks
Flooding, storms and landslides can threaten life through injuries, drowning and structural damage. They can also interrupt ordinary care even when an older person experiences no direct injury.
A flooded road may prevent someone from attending dialysis or collecting medication. A damaged pharmacy may be unable to provide prescriptions. An older person with limited mobility may become isolated when transport routes are inaccessible. A caregiver may be unable to reach the home, while disrupted electricity and communication make it difficult to request help.
Floodwater may contain sewage, chemicals and other contaminants. Exposure can increase the risk of gastrointestinal illness, skin and wound infections and other health problems. Damage to water and sanitation systems may compromise safe food preparation, personal hygiene and infection prevention.
However, disease outbreaks should not be assumed to occur automatically after every flood. Actual risks depend on environmental conditions, population exposure, existing patterns of disease transmission and the effectiveness of water, sanitation and public health measures.
Evacuation introduces another set of challenges. Moving away from an unsafe location may be essential, but the process itself can create risks when transport is inaccessible, medical equipment is unavailable or the receiving location cannot provide necessary support.
A person living with dementia may experience confusion and distress when moved abruptly. Someone using a wheelchair may be unable to enter an ordinary evacuation vehicle. An older person with swallowing difficulties may require modified food and fluids, while another may need oxygen, regular medication or electricity-dependent equipment.
The decision to evacuate or remain in place must therefore reflect the immediate hazard, official instructions, building safety and the person's health and support needs.
Remaining in place is not appropriate when authorities require evacuation or the location is unsafe. Equally, an evacuation should not be considered adequately planned merely because transportation has been arranged.
A safer approach identifies the destination in advance, confirms that essential care can be provided there, and considers accessible transport, necessary equipment, medication continuity and communication with families.
Preparedness also involves knowing when evacuation should begin. Waiting until floodwater has entered a building may make transfer significantly more dangerous for residents who require wheelchairs, stretchers or several people to assist with movement.
For older people with substantial care dependencies, evacuation is both an emergency safety operation and a clinical care transition. Both dimensions need to be managed.
Individual Emergency Plans Should Protect Essential Care Dependencies
Emergency planning is more useful when the older person, family and care providers have already discussed what should happen if normal conditions are disrupted.
An individualized preparedness plan should identify relevant local hazards, how official warnings will be received, what assistance the person may need and whom to contact if the usual caregiver is unavailable. It should also include an alternative contact and practical arrangements for communication when mobile networks or electricity fail.
Essential medical information needs to remain accessible. This may include important diagnoses, allergies, current medications, treatment schedules, equipment requirements and contact information for relevant healthcare providers. A current paper medication list can be useful if electronic systems become unavailable, provided that sensitive information is kept secure.
People who depend on dialysis, oxygen concentrators, ventilatory support or other electricity-dependent equipment require more specific arrangements. These should be developed with treating clinicians, equipment suppliers and relevant service providers. Planning may need to address backup power, equipment operating time, alternative treatment locations, safe transport and what to do if the usual service cannot be accessed.
Backup electricity also requires attention to safety. Generators and other alternative power systems must be operated according to applicable technical and safety requirements. Fuel-powered generators should never be used indoors or in enclosed areas because of the risk of carbon monoxide poisoning, and they must be kept safely away from doors, windows and ventilation openings. Backup equipment should be tested and maintained rather than assumed to function when needed.
Medication preparedness involves more than keeping additional supplies at home. Prescription requirements, storage conditions, expiry dates, refrigeration needs and the availability of refills should be considered. A suitable emergency supply may be agreed with the treating clinician or pharmacist, but patients should not independently change doses, ration essential medicines or improvise substitutions.
Temperature-sensitive medicines require particular care during prolonged outages. Insulin and other products should be stored according to product-specific instructions and professional guidance. They should not be placed directly against ice or frozen indiscriminately, and products exposed to unsuitable conditions may need professional assessment before continued use.
Assistive devices are also essential. Glasses, hearing aids, batteries, walking aids, wheelchairs, continence products and other personal items may determine whether someone can communicate, move safely and maintain independence during an emergency.
The plan should be practical enough to use under stress. Excessively complex documentation may be difficult for families or frontline staff to follow when communication and transport are disrupted.
Whenever possible, older people should help decide whom to contact, which assistance they prefer and where they would wish to go if evacuation becomes necessary. A plan developed without their involvement may be less acceptable and harder to implement.
Home and Community Services Must Plan for Support That May Become Unavailable
In Viet Nam, many older people receive most of their daily support from family members rather than residential long-term care services. This makes home preparedness particularly important.
A person may live with relatives who provide regular assistance, but those relatives may be working elsewhere when an emergency occurs. Another older person may live alone and depend on periodic visits from healthcare workers or family members. During severe weather, the usual caregiver may be affected by the same disaster or unable to reach the home.
A realistic plan should therefore consider what happens when ordinary support is temporarily unavailable.
For someone with mobility limitations, this may involve identifying who can assist with transfers or evacuation. A person living with dementia may need a familiar caregiver who can explain instructions and reduce distress. Someone receiving regular nursing, wound care or rehabilitation may require an alternative arrangement if scheduled visits cannot take place.
The home environment also influences preparedness. A ground-floor dwelling in a flood-prone area presents different risks from an upper-floor apartment that becomes excessively hot during an outage. Staircases, narrow exits, inaccessible bathrooms and the location of essential equipment may affect how quickly someone can leave safely.
Families should understand official warnings and local evacuation arrangements before an emergency becomes imminent. An evacuation route that works for a physically independent adult may not be suitable for someone who requires a wheelchair or assistance from several people.
Community health services can contribute by identifying patients with critical treatment or functional dependencies and helping connect them with relevant emergency arrangements. Commune-level healthcare providers and local organizations may already have relationships with older people receiving chronic disease management or community support.
However, this should not be interpreted as a requirement to create a public register of everyone above a certain age. Identification of people who may need additional assistance should be based on relevant risk factors, actual service responsibilities and lawful handling of personal information.
Warnings may need to reach people through more than one communication channel. Telephone contact, accessible written messages and direct communication may be useful for those with hearing, vision or cognitive difficulties. In some circumstances, language and literacy also need consideration.
Sending a warning does not establish that it has been understood or acted upon. For selected individuals at increased risk, an agreed welfare check or another form of follow-up may be appropriate. When a problem is identified, the response should connect the person with suitable healthcare, transport, emergency services or practical assistance.
Neighbors, community volunteers and local organizations may provide useful support, but their roles must remain clear. They should not be assumed to provide clinical monitoring, emergency rescue or medical transportation unless those capabilities and responsibilities have actually been established.
A dependable community approach connects risk information with realistic action and recognizes when the resources available locally are insufficient.
Hospitals Need More Than Resilient Buildings
Hospitals can be affected by the same hazards that increase demand for their services.
Flooding may damage buildings, electrical systems and medical equipment. Extreme heat may strain cooling systems and increase demand for emergency treatment. Water shortages can affect sanitation, sterilization and infection prevention. Interrupted roads may prevent patients, staff, supplies and emergency vehicles from reaching the facility.
For older patients, these disruptions may be particularly serious when they depend on continuous treatment, clinical monitoring or assistance with basic activities.
Hospital preparedness should begin with a location-specific assessment of hazards and critical service dependencies. The organization needs to understand which systems are essential for patient safety, how long they can remain operational during disruption and what alternatives are available if they fail.
Electricity is a major dependency. Backup power arrangements should account for critical clinical equipment, communication systems and relevant cooling or refrigeration requirements. They also require maintenance, safe fuel arrangements, realistic testing and an understanding of the limits of available backup capacity.
Water is equally fundamental. Reliable supplies of suitable water are needed for hand hygiene, cleaning, sanitation, sterilization and many clinical procedures. Preparedness should consider both interruption and contamination, including the circumstances in which services may need to be restricted, transferred or temporarily suspended.
The WHO's 2020 guidance on climate-resilient and environmentally sustainable healthcare facilities identifies four important areas: health workforce; water, sanitation, hygiene and healthcare waste management; energy; and infrastructure, technologies and products.
The WHO's 2021 vulnerability assessment checklists provide practical tools for assessing risks associated with floods, storms, heatwaves, drought and other climate-related hazards. Its 2024 overview of safe, climate-resilient and environmentally sustainable healthcare facilities and the 2025 WHO–UNICEF global progress report further reinforce the importance of reliable basic services for safe healthcare delivery.
These documents offer useful professional references, but they do not replace applicable Vietnamese regulatory requirements or facility-specific engineering and operational assessments.
Clinical operations require similar attention. Hospitals should identify time-critical services, define arrangements for patients who cannot safely experience treatment interruption, and establish communication and referral processes with appropriate receiving facilities. Electronic record downtime, medication access and the safe transfer of essential clinical information should also be anticipated.
Staff availability can become a limiting factor during disasters. Employees may be unable to travel or may need to care for family members affected by the emergency. Plans should consider essential competencies, safe staffing, communication, workforce fatigue and the possibility that ordinary shifts cannot be maintained.
A written emergency plan is useful, but its reliability depends on how well these systems function together. The most demanding scenarios often involve several failures at once, such as interrupted electricity, contaminated water and reduced staff availability during prolonged flooding.
The objective is to maintain essential clinical functions safely and recognize when services must be transferred or modified because continued operation would create unacceptable risks.
Residential Long-Term Care Requires Individualized Protection
Residential long-term care facilities face a distinctive challenge because the setting is both a place of care and the residents' home.
Residents may have different levels of mobility, cognition, medical dependency and ability to communicate. Some can respond independently to warnings and move safely with minimal assistance. Others require help with transfers, medication, nutrition, toileting or continuous clinical support.
A facility therefore needs to understand how an emergency would affect each resident, not simply how many people must be accommodated or transported.
During extreme heat, residents with frailty, cognitive impairment or certain chronic conditions may be unable to recognize symptoms or communicate discomfort clearly. Others may depend on staff to access a cooler environment, obtain appropriate fluids or adjust activities safely.
Facilities should know which rooms are most exposed to excessive heat, how indoor conditions will be monitored and whether cooling systems can continue operating during outages. Staff should recognize possible heat-related deterioration and know when urgent clinical assessment is necessary.
Storms and floods present different challenges. Critical equipment and supplies may need protection, while staffing and transport arrangements may become unreliable. If evacuation is necessary, the plan must account for residents who cannot walk, those requiring wheelchairs or stretchers, and people who may become distressed in unfamiliar environments.
A receiving location should be identified according to actual care needs rather than assumed to be suitable simply because it can provide shelter. Medication continuity, necessary equipment, communication with families and transfer of relevant clinical information all require attention.
Sheltering in place may be appropriate when the building is safe, official instructions permit it and essential services can be maintained. The decision should be based on current conditions and professional assessment rather than a fixed preference for either evacuation or remaining on site.
Emergency exercises should test realistic situations. A nighttime power outage during extreme heat, for example, may expose problems that a routine daytime evacuation drill would miss. Flooding that prevents essential staff from reaching the facility may reveal weaknesses in workforce arrangements, resident monitoring or medication administration.
For residents, successful emergency management should mean more than reaching a safe physical location. It should also seek to prevent avoidable clinical deterioration, unnecessary distress and prolonged disruption of essential support.
Continuity of Essential Treatment Is a Critical Patient Safety Issue
During disasters, interruption of ongoing care can cause serious harm even when the person has not experienced a direct injury.
An older person taking medicines for cardiovascular disease, diabetes or another chronic condition may run out of treatment because a pharmacy is closed or transport is unavailable. Someone receiving dialysis may miss a scheduled session. Another person may be unable to obtain supplies for oxygen therapy, wound care or other essential treatment.
These situations require planning before the usual service pathway becomes inaccessible.
Healthcare organizations should identify treatments that are time-critical and determine what alternative arrangements are feasible. This may involve coordination with other providers, appropriate medication supplies, revised treatment arrangements or transfer to another clinical facility when necessary.
The response must remain individualized. Not every missed appointment creates the same level of urgency, and not every medicine can be stored, substituted or adjusted in the same way. Patients and caregivers should not be encouraged to ration medications or change treatment without suitable professional advice.
Communication becomes especially important when people must be relocated. The receiving care team needs clinically relevant information about current treatments, allergies, equipment requirements and recent changes affecting safety.
Temporary interruption of electronic records should also be anticipated. Appropriate downtime procedures, secure access to essential information and safe documentation of care delivered during an outage can reduce the risk of errors.
The goal is not to promise that every routine service can continue unchanged during a major disaster. It is to identify which care cannot safely be delayed, protect access where possible and establish clinically appropriate alternatives when normal arrangements fail.
Recovery Should Address Health and Function, Not Only Reopening Services
The end of a storm or flood does not necessarily mean that its health consequences have ended.
An older person may return to a damaged home with unsafe electrical systems, persistent moisture or contaminated water. Someone who has spent several days in temporary accommodation may become weaker because of reduced mobility, poor sleep or inadequate nutrition. Others may experience anxiety, emotional distress or difficulty returning to familiar routines.
Chronic disease management may have been interrupted. Medications may need replacement, missed treatments may require review and changes in blood pressure, glucose control or other clinical indicators may need reassessment.
After flooding, attention may also be required for wounds, gastrointestinal symptoms, skin conditions and other concerns associated with exposure to contaminated environments. Indoor dampness and mold can contribute to respiratory problems, particularly in susceptible individuals. Safe water, sanitation and environmental cleaning remain important during recovery.
Functional recovery deserves particular attention. Someone who was independently mobile before the disaster may now struggle with walking, transfers or daily activities. A person living with dementia may experience increased confusion after displacement, while a family caregiver may be exhausted by prolonged disruption.
These changes should not automatically be considered permanent deterioration. Appropriate assessment may identify treatable problems and opportunities for rehabilitation, reablement or additional support.
Healthcare and care organizations should also review what happened during the emergency. Delayed warnings, inaccessible transport, medication interruptions, equipment failures and uncertainty about responsibilities may all reveal opportunities for improvement.
Recovery should therefore include both the restoration of essential services and an assessment of whether older people have returned to their previous level of functioning or need additional care.
A resilient system learns from disruption and reduces the likelihood that preventable problems will recur.
Viet Nam's Legal and Policy Framework Recognizes Older-Person Vulnerability During Disasters
Viet Nam has an established legal and policy foundation for disaster prevention, emergency response and recovery.
The Law on Natural Disaster Prevention and Control No. 33/2013/QH13, as amended, provides a central legislative framework. Its provisions are consolidated in Document No. 85/VBHN-VPQH, issued by the Office of the National Assembly on 27 March 2026.
Article 3 identifies older people among groups considered vulnerable to disasters. The definition also includes people whose characteristics or circumstances may expose them to greater adverse impacts, such as children, people with disabilities and people with serious illnesses. The law addresses a range of natural hazards and establishes principles and responsibilities for disaster prevention, response and recovery.
The framework requires attention to vulnerable populations in relevant disaster planning and response arrangements, including early warning, evacuation from dangerous areas and emergency assistance. These provisions provide an important legal foundation for considering older people's needs, although they do not prescribe an identical response for every older person.
Document No. 85/VBHN-VPQH is a consolidated version of the law incorporating amendments. It should not be described as a separate new law establishing an entirely new disaster management system in March 2026.
The Law on the Elderly No. 39/2009/QH12, as amended and reflected in Consolidated Document No. 23/VBHN-VPQH of 26 February 2026, provides another relevant foundation. Article 2 defines older people for the purposes of the law as Vietnamese citizens aged 60 years and above. Article 3 recognizes their right to receive priority in relief assistance, healthcare and accommodation to address initial difficulties resulting from natural disasters or other force majeure events, in accordance with the law.
The Law on Civil Defense No. 18/2023/QH15, as amended, forms part of the wider national emergency preparedness and response framework. Its provisions are relevant to the organization, coordination and implementation of civil defense and emergency response activities.
Climate adaptation is also addressed through national policy. Prime Minister's Decision No. 1422/QĐ-TTg of 19 November 2024 issued the updated National Climate Change Adaptation Plan for 2021–2030, with a vision to 2050. The plan focuses on reducing vulnerability, strengthening adaptive capacity and addressing climate-related risks.
Within the health sector, Ministry of Health Decision No. 7562/QĐ-BYT of 24 December 2018 approved the Health Sector Action Plan to Respond to Climate Change for 2019–2030, with a vision to 2050. It provides policy context for strengthening the health sector's capacity to respond to climate-related impacts.
These instruments establish important responsibilities and national directions, but they should not be interpreted as creating one comprehensive Vietnamese clinical standard specifically governing climate-resilient long-term care for older people.
Similarly, WHO guidance on heat-health action planning, climate-resilient health systems and healthcare facility vulnerability assessment provides professional and policy references. These documents do not automatically become binding Vietnamese legal requirements or facility accreditation standards.
The obligations applicable to an individual healthcare or care organization depend on its activities, licensing status, relevant laws and implementing regulations. Planning must also consider applicable requirements for fire prevention, rescue, technical safety, clinical operations and protection of personal information.
Where organizations collect or share identifiable information about patients or residents who may require emergency assistance, the Law on Personal Data Protection No. 91/2025/QH15, effective from 1 January 2026, and other applicable privacy and confidentiality requirements must be considered. Preparedness arrangements should enable necessary communication without unnecessary disclosure of sensitive health information.
For Viet Nam, the practical opportunity is to translate existing legal principles and relevant international evidence into locally appropriate arrangements that protect older people and maintain essential care during emergencies.
Turning Preparedness Plans Into Reliable Practice
Climate resilience does not necessarily require every healthcare or long-term care organization to establish a separate, large-scale program. Many improvements can be incorporated into existing emergency preparedness, clinical risk management and quality improvement activities.
A sensible starting point is to understand the hazards that could affect the service. A facility in a flood-prone area may need to prioritize safe evacuation routes, protection of equipment and transport arrangements. An organization exposed to prolonged urban heat may need to focus on indoor temperatures, cooling capacity and electricity reliability. A healthcare facility facing water shortages or saltwater intrusion may need to strengthen water treatment and storage arrangements.
The next step is to identify critical care dependencies. Organizations should understand which patients or residents require time-sensitive treatment, electricity-powered medical equipment, specific medication storage conditions, accessible transport or direct caregiver support. These needs should be reviewed when health or functional circumstances change.
Warning systems should then be connected with predefined actions. Relevant official meteorological and disaster information should trigger decisions appropriate to the local risk, including communication with staff and families, protection of essential services, monitoring of people at increased risk and activation of evacuation or referral arrangements when required.
The organization should also understand its operational limits. How long can essential equipment function without normal electricity? What happens if water becomes unavailable or contaminated? Can patients be transferred if roads are flooded? Who is responsible for contacting receiving services? What happens when staff cannot reach the facility?
Answers to these questions should be tested rather than assumed.
Emergency exercises are most useful when they reflect realistic failures and involve the people responsible for responding. A facility may discover that a generator functions but cannot support all critical equipment, or that an evacuation vehicle is unsuitable for residents requiring stretchers. Identifying these problems during an exercise provides an opportunity to correct them before a real emergency.
Coordination beyond the organization is equally important. Hospitals, community providers, emergency responders, local authorities, residential care services and relevant community organizations may each contribute to a safe response. Their roles need to be understood before the emergency occurs.
Not every organization has the resources to maintain extensive backup infrastructure or provide specialized medical transport. A practical preparedness approach should acknowledge these limitations and establish realistic arrangements for referral, escalation and assistance.
Preparedness is strongest when it reflects actual capabilities rather than an idealized plan that cannot be implemented.
Measuring Preparedness Means Testing Whether Essential Care Can Continue
Organizations may report that they have emergency plans, provide training or maintain supplies. These activities are useful, but they do not necessarily demonstrate that older people will remain safe during a real disaster.
A written plan may not identify people who depend on electricity-powered medical equipment. An evacuation drill may be completed without testing whether medications and essential care information accompany residents. A facility may have a backup generator but lack a reliable process for checking its operational capacity during an extended outage.
Meaningful evaluation should therefore consider readiness, implementation and outcomes.
Potential process measures include whether local hazards have been assessed, whether people with critical care dependencies have appropriate preparedness arrangements, whether backup systems are maintained and whether communication and referral arrangements have been tested.
Emergency exercises may assess whether staff can identify people requiring assistance, access essential information, communicate reliably and carry out assigned actions. The results should inform improvements rather than simply document that an exercise took place.
During actual events, organizations may examine interruptions to time-sensitive treatment, medication or equipment failures, unsuccessful attempts to contact patients at increased risk, unplanned transfers and delays in restoring essential services.
Patient-centered outcomes also matter. An older person may survive an evacuation but experience avoidable functional decline, prolonged distress or interruption of necessary treatment. These consequences should be considered when reviewing the quality of the response.
Feedback from older people, family caregivers and frontline staff can reveal difficulties that formal incident records may not capture.
These measures are potential areas for local quality improvement, not a nationally mandated Vietnamese climate-resilient older-person care indicator set. Their selection should reflect organizational responsibilities, available information and the risks being addressed.
The purpose of evaluation is to determine whether preparedness arrangements actually protect people and maintain essential care, not merely whether planning documents have been completed.
From Emergency Plans to Reliable Care During Disruption
For an older person living alone, climate-resilient care may mean receiving a warning in time, having someone check on their safety during extreme heat and knowing where to obtain assistance when electricity fails.
For someone receiving dialysis, it may mean having an alternative treatment arrangement when flooding interrupts transport. For a person living with dementia, it may mean evacuation assistance that accounts for communication, familiar support and necessary medication. For a resident in long-term care, it may mean remaining safe during a prolonged outage without losing access to essential clinical and personal care.
These outcomes depend on decisions made before an emergency occurs.
As Viet Nam strengthens disaster preparedness while adapting to population aging, older-person care should be included in climate and emergency planning from the beginning. Hospitals, community services, residential care providers and families need arrangements that recognize both environmental hazards and individual care dependencies.
A healthcare facility is not necessarily resilient because its building remains standing after a storm. A community has not necessarily protected older people simply because warnings were issued. An evacuation is not fully successful if essential treatment is interrupted or people are transferred without appropriate support.
The more meaningful question is whether older people can remain safe, receive necessary care and recover without avoidable deterioration when their usual environment and services are disrupted.
Climate-resilient care for older people is ultimately about maintaining the reliability of care under difficult and changing conditions. It means anticipating risks, protecting essential support, responding safely when disruption occurs and helping people recover their health and everyday functioning afterward.
That is why climate resilience and disaster preparedness belong within high-quality, age-friendly, integrated and long-term care in Viet Nam.
References
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