Community-Based Day Care for Older People in Viet Nam: From the 2026 Policy Framework to Safe, Person-Centered Services and Family Caregiver Support

LONG-TERM CARE QUALITY · MEASUREMENT, IMPLEMENTATION & LEARNING

Last reviewed: October 2026

An older woman in Viet Nam lives with her daughter, who works during the day. She can still make decisions about her everyday life, but walking, preparing meals and using the toilet have become more difficult. Her daughter worries about leaving her alone for several hours, although neither believes that moving into a residential care facility is necessary. In another household, an older man has gradually stopped attending community activities because he becomes tired easily and needs help getting around. He misses meeting his friends but does not want to depend on his family for every journey outside the home.

For both individuals, community-based day care could offer another form of support. They might spend part of the day in a familiar local setting, participate in activities suited to their abilities, receive assistance with everyday tasks and return home afterward. Their families could also have more time for work and other responsibilities.

The idea is appealing, particularly as Viet Nam responds to population aging. However, opening a place where older people can gather is different from operating a safe care service. A participant may need help transferring from a wheelchair to a chair. Another may experience difficulty swallowing during lunch. Someone who appeared well on arrival may become confused, short of breath or unusually weak later in the day. These situations require preparation, personnel with suitable skills and clear decisions about when professional medical attention is needed.

There are also questions about who should attend. Some older people need occasional assistance, while others require substantial personal care or ongoing clinical support. A day care point that accepts participants without considering its own capabilities may expose them to avoidable harm. At the same time, excluding someone simply because they use a wheelchair, have a chronic illness or experience cognitive difficulties may deny them an opportunity for community participation.

Viet Nam's policy developments in 2026 provide a clearer foundation for organizing daytime care for older people at the community level. Yet a legal framework alone cannot determine whether local services have the people, resources, procedures and supervision needed to provide dependable care.

The central question is therefore: How can Viet Nam translate its new community day care policy into safe, feasible and accountable services for older people?

Answering this question requires looking beyond the number of facilities established or activities organized. The challenge is to design a service that understands the needs of its participants, works within its legal and operational capacity, recognizes risks early and maintains effective communication with families and healthcare providers.

Understanding the Community-Based Day Care Model Under Viet Nam's 2026 Policy

Viet Nam's Law on Population No. 113/2025/QH15, adopted on 10 December 2025 and effective from 1 July 2026, provides an important legal foundation for responding to population aging. Government Decree No. 168/2026/NĐ-CP, issued on 15 May 2026 and effective from 1 July 2026, sets out more detailed provisions concerning care for older people at home and in the community.

Article 5 of the Decree distinguishes between community older-person care clubs and community-based day care points. The latter, formally referred to as điểm chăm sóc người cao tuổi ban ngày tại cộng đồng, is a specific model operating under the commune-level health station. It supports the Chairperson of the commune-level People's Committee in organizing care for older people within the locality.

Under this arrangement, older people attend during the day and return home afterward. The day care point has no separate legal personality and does not conduct medical examination or treatment activities. It may be located at a commune health station, a health station branch, a community cultural facility or another suitable existing location.

Article 7 identifies activities such as providing guidance on care and disease prevention, supporting physical and mental well-being, organizing suitable exercise and health-promoting activities, and assisting older people with activities of daily living. The decision to establish a day care point belongs to the Chairperson of the commune-level People's Committee, based on local conditions and a proposal from the commune health station. The number of older people, available personnel, location and safety considerations must be taken into account.

These provisions define both the purpose and the limitations of the model. A community-based day care point under Decree No. 168/2026/NĐ-CP should not be equated with a residential nursing home, a social assistance establishment, a privately operated care business or an independently licensed medical examination and treatment facility. Although these services may support older people, their legal structures, authorized activities and regulatory requirements can differ.

The distinction becomes particularly important when clinical needs arise. A participant may continue receiving healthcare through the commune health station, a hospital or another authorized provider. However, the day care point itself does not acquire authority to diagnose, prescribe or provide medical treatment simply because it operates within a health station building. Clinical activities must remain within the professional and legal scope of the healthcare provider delivering them.

The policy direction was strengthened by Prime Minister's Decision No. 1116/QĐ-TTg of 22 June 2026, which amended the Health Care Programme for Older People through 2030. The revised program sets a target for at least 20% of communes, wards and special administrative areas to pilot or develop a daytime older-person care facility model by 2030. This concerns the proportion of local administrative areas developing such models, not the proportion of all older people guaranteed a place in day care. The broader policy terminology should also not be assumed to have exactly the same legal meaning as the specific day care point defined in Decree No. 168/2026/NĐ-CP.

Ministry of Health Decision No. 1976/QĐ-BYT, issued on 1 July 2026, provides professional guidance on caring for older people at home and in the community. Circular No. 34/2026/TT-BYT, issued on 8 September 2026, addresses relevant implementation and training activities under the National Target Programme on Health Care, Population and Development.

Together, these measures create an opportunity to develop community-based care. The next task is to ensure that local services are organized in ways that are legally appropriate, operationally realistic and responsive to the older people they are intended to support.

International Experience Can Inform Service Design, but Local Needs Must Come First

Day care services for older people are available in many countries, although they do not all provide the same type of assistance. Some concentrate on social participation and recreation, while others include personal care, rehabilitation or clinical services. Staffing, financing, eligibility and regulatory requirements vary between settings.

A systematic review by Lunt, Dowrick and Lloyd-Williams, published in Health & Social Care in the Community in 2021, examined 45 articles from 16 countries. The review identified limited evidence suggesting improvements in psychological well-being, perceived health, quality of life and functioning among older people with long-term conditions attending day care. It also found potentially positive outcomes for family caregivers through temporary relief from caring responsibilities.

However, the authors noted important limitations in the quality and quantity of the evidence. Many studies did not adequately describe the services provided, the characteristics of participants or the interventions involved. The findings therefore do not establish that every form of day care improves functional ability, prevents hospitalization or delays admission to residential care.

The World Health Organization's 2024 Long-Term Care for Older People: Package for Universal Health Coverage provides a broader reference for developing integrated long-term care systems. WHO's 2024 publication on quality management in long-term care emphasizes continuous improvement and outcomes that matter to care recipients and caregivers.

WHO's second edition of the Integrated Care for Older People (ICOPE) handbook, published in September 2025, also provides guidance on identifying declines in intrinsic capacity, understanding social support needs and developing personalized care plans. Its approach is relevant to community services, although the handbook is not itself a mandatory Vietnamese operating standard for day care points.

These resources offer useful principles, but international day care models cannot be transferred directly into Viet Nam without considering their legal identity, staffing requirements and local context. A service designed to provide rehabilitation or medical treatment in another country may operate under licensing arrangements that differ from those applicable to community-based day care points under Decree No. 168/2026/NĐ-CP.

The more useful approach is to identify which elements of international experience can improve service design within the Vietnamese framework. These may include individualized support, defined responsibilities, workforce preparation, family communication and regular review of service quality.

For Viet Nam, the aim should not be to reproduce a foreign model. It should be to develop a service that local personnel can deliver safely and that older people and families find useful.

Designing a Service That Matches Local Needs and Available Capacity

Before opening a community-based day care point, local authorities and the commune health station need to understand who is likely to use it and what kind of assistance they require.

The needs of older people can differ considerably between localities. In an urban neighborhood, some may live with working relatives who cannot provide assistance throughout the day. In rural or mountainous communities, distance, transportation and limited access to trained personnel may present greater difficulties. Older people living alone may also face different challenges from those living in multigenerational households.

Planning should therefore consider the number and characteristics of older people in the community, their functional limitations, existing support services, accessibility and likely demand. Consultation with older people and families can reveal practical concerns that administrative data may not capture, such as preferred attendance hours, difficulties reaching the proposed location or worries about receiving personal care from unfamiliar people.

A suitable building is not necessarily a suitable care environment. A community meeting room may provide enough space for group activities but have inaccessible toilets, slippery floors or narrow entrances that make it difficult for participants using walking aids or wheelchairs. A location that is convenient for relatively independent older people may be difficult to reach for those who need assistance leaving home.

The physical environment should be assessed according to the needs of its intended participants. Suitable seating, safe walking routes, accessible toilets, adequate lighting, ventilation, drinking water, sanitation and opportunities for rest all matter. Local weather conditions, including extreme heat, heavy rainfall or flooding, may also affect access and safe operation. The point should have practical arrangements for fire safety, evacuation and other foreseeable emergencies, particularly when some participants cannot move independently.

Decision No. 1976/QĐ-BYT refers to applicable requirements concerning the location, basic space and minimum equipment of community-based day care points. These requirements, together with relevant local guidance and other applicable laws, should be checked before opening. International design recommendations may help inform planning, but they should not be presented as mandatory Vietnamese specifications unless incorporated into applicable regulations.

The service also needs a realistic description of what it can provide. This should cover operating hours, intended participants, activities, daily living assistance, meals where available, transportation arrangements if offered and procedures for obtaining medical help. Equally important is explaining which needs exceed the point's capacity.

For example, a service may be able to assist people who need occasional help walking or eating but may not have sufficient trained personnel or equipment to support someone requiring frequent complex transfers or continuous clinical monitoring. A participant who needs substantial assistance throughout the day may require more personnel than the service can consistently provide.

These limitations should be discussed before attendance begins. A family should not discover only after an incident that the service cannot provide the assistance it had expected.

Capacity should not be determined simply by the size of the building or the number of available seats. A point may have sufficient room for many participants but lack the personnel needed to support several people requiring help with toileting or mobility at the same time. Conversely, a smaller service may be able to provide more individualized assistance when staffing and participant needs are well matched.

The question is not how many people the facility can physically accommodate, but how many it can safely support with the personnel, equipment and resources available during actual operating hours.

Selecting Participants and Understanding Their Support Needs

One of the most important decisions is whether an older person's needs can be met by the day care point.

Decision No. 1976/QĐ-BYT provides a specific basis for participation. Its guidance identifies older people who wish to attend and whose reduced ability to care for themselves has been determined by the commune health station through the screening process described in Chapter V.

This distinguishes the day care point from a general recreational club. Participation is linked to an identified need for support rather than age or interest in community activities alone.

The Ministry of Health guidance incorporates the WHO ICOPE approach to screening declines in intrinsic capacity, including cognition, mobility, nutrition-related concerns, vision, hearing and depressive symptoms. Screening findings help the commune health station identify relevant care needs and consider further assessment or referral when appropriate.

However, screening should not be confused with a complete medical diagnosis or a detailed plan for everyday assistance. A practical participation assessment also needs to establish what the person can do independently, which tasks require support and whether the day care point has the resources to provide that support.

Someone who needs occasional help standing from a chair may participate safely if suitable seating, accessible facilities and trained assistance are available. Another person who requires substantial physical support for every transfer may need equipment or a staffing arrangement that the point does not possess.

A diagnosis alone should not determine whether someone can attend. An older person with dementia, diabetes or a history of stroke may still benefit from community participation when the necessary support can be provided safely. The relevant considerations are current functioning, specific risks, personal preferences and the service's actual capabilities.

For someone with cognitive impairment, these considerations may include whether they can participate comfortably in familiar activities, understand simple instructions or remain safe with the supervision available. Cognitive difficulties should not automatically lead to exclusion, but significant disorientation, wandering or other complex support needs may require additional arrangements.

When a person's needs exceed the service's capabilities, the response should involve an appropriate discussion with the older person and relevant family members, consideration of additional support and referral when necessary. An unsafe admission does not become person-centered simply because it avoids exclusion.

Participation also needs to be reviewed when circumstances change. A recent fall, hospital admission, new swallowing problem or significant decline in mobility may require reassessment before the person resumes normal activities.

Once someone is accepted, the assessment findings should be translated into a practical daily support plan. This does not need to become an extensive clinical record, but it should identify the person's usual abilities, assistance needs, communication preferences, important safety concerns and relevant emergency contacts.

The plan should explain what help is needed with mobility, meals, toileting or other activities, as well as the participant's preferences and any circumstances requiring professional attention. Someone with hearing impairment may benefit from face-to-face communication, while another person may need familiar routines and additional time to understand instructions.

Responsibilities should be clear. If a participant needs help walking to the toilet, personnel should know who will provide that assistance and what happens when the usual person is unavailable. Where special equipment or additional trained personnel are necessary, the service should not rely on an untrained volunteer working alone.

Families can contribute information about everyday routines and recent changes, but the older person's own wishes should remain central whenever they can participate in decisions. The plan should also be reviewed when needs change.

Its purpose is to help staff and volunteers provide consistent assistance, rather than leave important information dependent on the memory of one individual.

Organizing Arrival, Daily Activities and Safe Return Home

The quality of a day care service becomes visible during ordinary daily routines.

On arrival, personnel need to know who is expected, who has attended and whether anyone requires assistance entering the facility. A simple attendance process can help account for participants and identify unexpected absences.

Arrival is also an opportunity to recognize changes from a person's usual condition. A family member may report that the participant slept poorly, fell the previous evening or recently returned from hospital. The older person may appear more tired, confused or breathless than usual.

Such information should influence the day's arrangements. If a significant new concern is identified, the point should seek appropriate professional advice rather than automatically continue with normal activities.

Decision No. 1976/QĐ-BYT includes guidance on measuring basic health indicators at day care points, including blood pressure, temperature, pulse, respiratory rate, height and weight. These observations can support appropriate monitoring when performed by personnel with suitable training and assigned responsibilities. They do not authorize unqualified staff or volunteers to diagnose conditions or change treatment.

During attendance, activities should reflect participants' interests and abilities. Some may enjoy conversation, music, cultural activities or gentle exercise. Others may prefer quieter activities, shorter sessions or additional rest.

A fixed schedule should not take priority over comfort, safety or individual choice. Participation should remain voluntary, and assistance should support the abilities older people retain rather than unnecessarily taking over tasks they can still perform.

The daily routine should also allow personnel to notice changes in functioning. Someone who normally walks independently may begin requiring assistance, or a participant who usually enjoys group activities may become withdrawn or unusually tired. These observations may be important even when they do not represent an immediate emergency.

The return-home process deserves similar attention. Personnel should know whether a participant can leave independently, who is authorized to collect them and whether important information needs to be shared.

If someone is not collected as expected or becomes unable to return home safely, the point should have an agreed response rather than rely on an improvised arrangement. Where transportation is provided or organized, the service should consider assistance with boarding, safe travel and arrival at the intended destination.

Transportation should not be assumed to be a universal entitlement under the 2026 Decree. Where it is offered, the arrangements must reflect participants' needs and comply with applicable transport and safety requirements.

A dependable daily routine connects arrival, activities, personal support and departure through clear communication and assigned responsibilities.

Managing Everyday Safety in Mobility, Meals and Personal Care

Many important risks in community-based day care arise during ordinary activities rather than organized exercise or health education.

An older person may need help standing, walking across an unfamiliar room or transferring to a toilet. Another may require assistance during meals because of weakness or difficulty using utensils. Someone experiencing urinary incontinence may feel embarrassed asking for support.

Safe mobility assistance begins with understanding the individual's abilities and the environment. Stable seating, accessible pathways, adequate lighting and appropriate walking aids can reduce hazards. Personnel also need training in the transfer and assistance techniques relevant to their duties.

A walking aid or wheelchair does not automatically make movement safe. Equipment must suit the individual, and personnel need to recognize when assistance cannot be provided safely with the available resources.

Fall prevention should not mean preventing older people from moving unnecessarily. Maintaining suitable physical activity and participation can help preserve independence. The aim is to reduce avoidable hazards while providing assistance when needed.

Meals and hydration require attention when included in the service. Food safety, allergies, personal preferences and the person's ability to eat and drink should be considered. Some participants may have chewing or swallowing difficulties requiring professional assessment and individualized advice.

The service should not assume that softer food is always safer or independently prescribe complex dietary modifications. Personnel should recognize possible choking or aspiration and know when eating or drinking must stop while appropriate help is obtained.

Access to drinking water and opportunities for hydration are also important, particularly during hot weather. However, advice about fluid intake may need to be individualized for older people with medical conditions requiring restrictions or specific monitoring.

Medication support requires equally clear boundaries. Chapter IV of the guidance accompanying Decision No. 1976/QĐ-BYT addresses assistance with using medicines according to prescriptions. This does not authorize volunteers or other unqualified personnel to prescribe, independently change treatment or perform medical procedures.

Where assistance with prescribed medicines forms part of the day care arrangement, responsibilities should be assigned to personnel with suitable competence and lawful authority. The service should have clear arrangements for handling relevant medicines, following prescribed instructions, recognizing concerns and obtaining professional advice.

If a participant refuses medication, misses a dose or develops a possible adverse reaction, personnel should follow the agreed procedure and seek advice from an appropriately qualified healthcare professional rather than independently modify treatment.

Personal hygiene and toileting assistance should protect privacy and dignity. Personnel should explain the assistance offered, obtain appropriate consent and support independence wherever possible. Someone may need help reaching the toilet but be able to manage personal hygiene afterward. Such differences should be respected.

Care should not be rushed simply because several participants need assistance. Privacy, respectful communication and appropriate support are particularly important during activities that may cause embarrassment or discomfort.

Hand hygiene, environmental cleaning, sanitation and safe handling of soiled materials also need to be incorporated into daily procedures. When a participant appears acutely unwell or may have an infectious illness, staff should follow appropriate precautions and seek professional advice before continuing ordinary group activities.

These practices do not require an unnecessarily complicated service model. They require personnel who understand their responsibilities, know their limits and have been prepared to perform their assigned tasks consistently.

Knowing When Community Support Must Connect With Medical Care

One of the most important safeguards is a clear process for responding when an older person's health changes.

Because community-based day care points under Decree No. 168/2026/NĐ-CP do not conduct medical examination or treatment, staff and volunteers need to understand the difference between recognizing a problem, providing immediate assistance within their competence and obtaining professional healthcare.

Some situations require an urgent emergency response. Suspected stroke, sudden severe breathing difficulty, chest pain suggesting a serious cardiac event, loss of consciousness, severe bleeding or other potentially life-threatening conditions should trigger emergency medical assistance without unnecessary delay.

Other changes may require prompt clinical assessment. New confusion, a significant decline in mobility, persistent inability to eat or drink or unusual weakness may indicate that the person needs professional attention even when there is no obvious immediate emergency.

The day care point should establish practical arrangements for contacting emergency services, communicating with the commune health station, informing the appropriate family contact and transferring relevant information to healthcare professionals.

Personnel should be encouraged to report observations rather than make unsupported diagnoses. Explaining when a change began, what was observed and how the person differs from their usual condition can help healthcare professionals determine the next steps.

Staff and volunteers also need to understand what they can safely do while waiting for professional help. Basic first aid and other immediate assistance must remain within their actual training and competence.

The procedure should cover what happens after a participant has received medical attention. Relevant findings may require changes to the support plan or reassessment before attendance resumes. Information about the event should be recorded appropriately so that the service can review its response and identify any necessary improvements.

An effective escalation process does not transfer clinical responsibilities to volunteers. It helps ensure that warning signs are recognized and that older people reach the appropriate healthcare service without avoidable delay.

Preparing Staff and Volunteers for Their Actual Responsibilities

Community-based day care may involve commune health station professionals, population collaborators, village health workers, social workers and volunteers. This combination can help mobilize local resources, but the people involved have different qualifications, experience and responsibilities.

Article 8 of Decree No. 168/2026/NĐ-CP recognizes volunteers who assist older people with activities of daily living according to assignments from the commune health station. Under the arrangement described in the Decree, these volunteers participate without remuneration. The Decree also provides for the participation of relevant healthcare and community personnel under assigned and concurrent-duty arrangements.

Decision No. 1976/QĐ-BYT provides professional guidance on care activities and personnel responsibilities. Circular No. 34/2026/TT-BYT also addresses relevant training activities and the adaptation of educational materials to local circumstances.

The practical challenge is to ensure that assigned tasks match actual competence. A volunteer trained to help someone walk or participate in daily activities should not automatically be expected to interpret abnormal clinical findings or independently administer treatment.

Training should focus on situations personnel are likely to encounter. These include mobility assistance, meals, toileting, infection prevention, respectful communication, recognition of warning signs, appropriate emergency responses, privacy and reporting concerns.

Practical demonstrations and supervised exercises may be more useful than relying entirely on lectures. A training certificate alone cannot establish that someone can safely perform a difficult transfer or respond appropriately when a participant becomes unwell.

Supervision and continuity are also important. A service that depends on one experienced volunteer may face difficulties when that person is absent. Staffing arrangements should account for participant needs throughout operating hours, including periods when several people require assistance simultaneously.

There is no single staffing ratio that can be assumed suitable for every day care point from the provisions discussed here. The necessary staffing level depends on participant needs, the assistance being provided and the environment in which activities take place.

The more useful operational question is whether the available personnel can provide the necessary assistance safely, given the number and needs of participants.

Keeping Families Informed and Supporting Family Caregivers

Family caregivers play an important role in enabling older people to continue living at home. For some households, regular caregiving affects employment, personal responsibilities and the caregiver's own well-being.

Day care may offer temporary relief by providing suitable supervision and assistance during agreed attendance periods. However, the extent of that benefit depends on the actual service.

A point that operates for only a few hours may support families differently from one offering regular full-day attendance. Transportation, meals, personal care assistance and the reliability of operating hours can also influence whether participation genuinely reduces caregiving pressure.

A family may benefit when the point is close to home and the older person enjoys attending. Another may find that arranging transportation creates additional difficulties. These differences should be understood rather than assuming that every day care arrangement provides effective respite.

The service should discuss expectations with families before attendance begins. Relatives need to understand what assistance is available, what responsibilities remain with them and how important changes will be communicated.

Communication should continue during ordinary operations, not only when an incident occurs. Personnel may need to report increased tiredness, new mobility difficulties or changes in eating. Families may provide information about recent medical appointments, changes in medication or difficulties observed at home.

The communication process should be manageable and proportionate. Not every activity requires a detailed report, but significant changes should reach the appropriate person in time to support safe decisions.

Older people should remain involved in decisions whenever possible. Family participation is valuable, but it should not automatically replace the older person's preferences or rights.

The Ministry of Health's 2026 professional guidance also contains a specific provision concerning counseling for people aged 60 or older who are no longer able to care for themselves, requiring the consent and participation of relatives. This provision should be applied within its stated scope rather than treated as a universal condition requiring every day care participant to be accompanied by a family member.

Where someone has significant cognitive or communication difficulties, decisions about consent, representation and information sharing should follow applicable legal and professional requirements. Families and personnel should avoid assuming that a diagnosis alone determines the person's ability to participate in decisions.

A further legal distinction is necessary. Decree No. 168/2026/NĐ-CP provides the organizational framework for community-based day care points, but it does not automatically establish a universal entitlement to specialized respite care, paid caregiver leave or publicly funded replacement care for every family.

Nor does the Decree, by itself, guarantee an identical package of free services for every older person regardless of local organizational and funding arrangements.

Support for family caregivers is therefore a potential benefit that should be evaluated through actual implementation. Families can help determine whether the service is useful, accessible and compatible with their everyday responsibilities.

Accountability, Privacy and Sustainable Operation

A community-based day care point requires resources for premises, equipment, trained personnel, supervision, cleaning, materials and other operational needs.

Article 12 of Decree No. 168/2026/NĐ-CP provides that funding for the operation of community-based day care points comes from local government budgets and other lawful sources. The Decree also encourages organizations, businesses, families and individuals to support older-person care at home and in the community, including the development of day care points.

These arrangements can help mobilize resources, but they do not guarantee identical funding or service capacity across localities.

Financial planning should reflect what the point is expected to deliver. A model that depends entirely on short-term donations may be difficult to maintain once the initial support ends. Volunteer participation can be valuable, but it does not remove the need for training, supervision and reliable organization.

Operational accountability is equally important. Personnel should know who coordinates activities, receives incident reports, communicates with families and oversees equipment, records and safety arrangements.

Because the day care point has no separate legal personality, external sponsorship or technical collaboration should not be interpreted as giving it independent authority to conduct activities beyond its lawful scope. The roles of supporting organizations should be clearly defined and consistent with applicable law.

Transparency also matters to older people and their families. Information about eligibility, operating hours, available assistance, any applicable costs and procedures for raising concerns should be communicated clearly.

The protection of personal information must be considered from the beginning. Community-based day care may involve records concerning health conditions, functional limitations, assistance needs, emergency contacts and family circumstances.

The Law on Personal Data Protection No. 91/2025/QH15, effective from 1 January 2026, together with Government Decree No. 356/2025/NĐ-CP detailing its implementation, provides an important legal framework for processing personal data in Viet Nam.

The obligations of the organizations involved depend on how information is collected, stored, used and shared, as well as their respective legal responsibilities.

Information necessary for care and operation should be collected and accessed only by appropriately authorized personnel. Digital records or messaging applications may help communication, but they should not lead to unnecessary disclosure of sensitive information.

Older people should also have a clear way to express concerns about the service, including experiences of disrespect, neglect or inappropriate assistance. These concerns need to be addressed sensitively through suitable organizational and professional processes.

A dependable service requires transparency about what it provides, how it is funded, who is responsible for decisions and how problems are handled.

Measuring Service Quality Through Everyday Experience and Outcomes

As community-based day care expands, progress may be reported through the number of points established and the number of older people attending. These measures are useful, but they cannot demonstrate whether the assistance provided is safe or effective.

A point may have high attendance while struggling to respond when participants need help with mobility or personal care. Another may support fewer people but provide more consistent assistance to individuals with greater needs.

Quality measurement should therefore examine what happens during actual service delivery.

One area is whether participants have been assessed appropriately and have support plans reflecting their needs. Another is whether personnel have received relevant training, whether responsibilities match their competence and whether assistance is available when required.

Safety information may include falls, injuries, choking incidents, significant changes in health and problems involving delayed communication or referral. Such information should be reviewed to understand what happened, whether the response was appropriate and what can be improved.

Raw incident counts need careful interpretation. A point supporting people with greater dependence may encounter more reported concerns, while better reporting practices may increase recorded incidents without necessarily indicating poorer care.

The experiences of older people and families are equally important. Participants may be asked whether they feel comfortable, respected and able to take part in meaningful activities. Family caregivers may report whether attendance is reliable, communication is adequate and the service makes everyday care more manageable.

Access should also be examined. A service may be functioning well for people who can reach it easily while remaining inaccessible to older people with substantial mobility limitations, limited family support or financial difficulties. Understanding who cannot use the service, and why, can help local authorities identify practical barriers.

Operational sustainability deserves attention as well. A point that performs well during an initial pilot but cannot maintain essential personnel, supplies or activities may not provide dependable support over time.

Where evaluation includes changes in well-being, functioning or caregiver burden, the findings should be interpreted cautiously. An improvement observed during participation cannot automatically be attributed to day care without considering other influences and the evaluation design.

These measures are potential tools for local evaluation and quality improvement. They should not be represented as a nationally mandated accreditation indicator set under the 2026 Decree.

The purpose of measurement is not simply to produce reports. It is to understand whether the service is meeting participants' needs and to identify practical changes that improve everyday care.

Moving From a Policy Framework to a Workable Local Service

For many localities, a carefully planned pilot may provide a practical starting point.

The commune health station and relevant local authorities can begin by assessing local needs, identifying a suitable location and defining a manageable scope of assistance. The proposed arrangements should then be checked against the requirements of Decree No. 168/2026/NĐ-CP and the applicable Ministry of Health guidance.

Before opening, the point should establish a participant assessment process, assign staff and volunteer responsibilities, prepare daily support procedures and agree on arrangements for emergencies and communication with families.

The physical environment should be reviewed against the needs of the intended participants. Personnel should receive relevant preparation before being asked to provide assistance for which they are not competent. The service should also understand how participants will reach the point and return home safely.

Starting with a manageable number of participants allows the team to observe how the service functions in practice.

The first weeks may reveal problems that were not obvious during planning. More assistance may be required during arrival and departure than during scheduled activities. Toileting needs may place unexpected demands on personnel. A room may prove difficult for wheelchair users, or families may find that the operating hours are unsuitable.

Such findings should lead to changes in organization, staffing or activities before the service expands.

A pilot should have a defined evaluation period and clear responsibilities for reviewing results. Decisions about expansion should reflect demonstrated readiness and the ability to maintain essential safety practices, rather than simply the desire to increase participant numbers.

Different localities may need different arrangements because their populations, environments and resources differ. This variation is not necessarily a weakness, provided the legal framework is respected and fundamental quality and safety responsibilities are maintained.

Experience from early implementation should also be documented and shared where appropriate. Information about participant needs, staffing difficulties, operating costs, family experiences and safety concerns may help other localities avoid similar problems.

The objective should be to build a service that local personnel can actually deliver well, rather than an ambitious model that looks comprehensive on paper but cannot be sustained.

From Community Day Care Policy to Services Older People Can Trust

Viet Nam's 2026 policy framework creates an opportunity to expand community-based support for older people who wish to continue living at home while receiving assistance during the day.

For an older woman whose daughter works, day care may provide a setting where she receives suitable support without moving away from her familiar community. For someone with declining mobility, it may create opportunities to remain active and socially connected. For family caregivers, it may offer some relief when the service fits their practical needs.

These benefits are meaningful, but they cannot be assumed merely because a day care point has opened.

The essential decisions concern who the point can support, what assistance is needed, whether personnel are prepared, how ordinary activities are managed safely and when professional healthcare must become involved. Families need clear information, while older people need to be treated as individuals with different abilities, preferences and expectations.

Quality must be built into the service from the beginning and reviewed as experience develops. A point that consistently provides appropriate assistance, responds to problems and learns from participants and families is more valuable than one judged mainly by attendance figures.

The central question remains: How can Viet Nam translate its new community day care policy into safe, feasible and accountable services for older people?

The answer lies in treating community-based day care as a service requiring careful planning, appropriate competence, clear responsibilities and continuous improvement, rather than simply as a facility for daytime activities.

A successful community-based day care point is one where older people receive the support they need, retain as much independence and dignity as possible, and remain connected to everyday community life.

As Viet Nam works toward its 2030 policy targets, the real measure of progress should be whether new services become places that older people can use with confidence and that families and local healthcare professionals can depend on.

References

1. National Assembly of Viet Nam. Law on Population No. 113/2025/QH15. Adopted 10 December 2025; effective 1 July 2026.

2. Government of Viet Nam. Decree No. 168/2026/NĐ-CP detailing certain provisions and measures for implementing the Law on Population. Issued 15 May 2026; effective 1 July 2026.

3. Prime Minister of Viet Nam. Decision No. 1579/QĐ-TTg approving the Health Care Programme for Older People through 2030. 13 October 2020.

4. Prime Minister of Viet Nam. Decision No. 1116/QĐ-TTg amending and supplementing Decision No. 1579/QĐ-TTg on the Health Care Programme for Older People through 2030. 22 June 2026.

5. Ministry of Health of Viet Nam. Decision No. 1976/QĐ-BYT issuing professional guidance on care for older people at home and in the community. 1 July 2026.

6. Ministry of Health of Viet Nam. Circular No. 34/2026/TT-BYT guiding certain activities under the National Target Programme on Health Care, Population and Development for 2026–2035, Phase I: 2026–2030. 8 September 2026.

7. National Assembly of Viet Nam. Law on Personal Data Protection No. 91/2025/QH15. Adopted 26 June 2025; effective 1 January 2026.

8. Government of Viet Nam. Decree No. 356/2025/NĐ-CP detailing certain provisions and measures for implementing the Law on Personal Data Protection. 31 December 2025; effective 1 January 2026.

9. World Health Organization. Integrated Care for Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care. 2nd edition. Geneva: WHO; 2025.

10. World Health Organization. Long-Term Care for Older People: Package for Universal Health Coverage. Geneva: WHO; 2024.

11. World Health Organization Regional Office for Europe. Promoting Quality Management in Long-Term Care: Principles, Key Components and Directions for Policy Action. Copenhagen: WHO Regional Office for Europe; 2024.

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