Long-Term Care Quality in Viet Nam: Building Safe, Person-Centered Care Across Home, Community and Residential Settings
LONG-TERM CARE, HOME & COMMUNITY CARE
Long-Term Care Quality in Viet Nam: Building Safe, Person-Centered Care Across Home, Community and Residential Settings
LONG-TERM CARE, HOME & COMMUNITY CARE
Last reviewed: October 2026
Long-term care is sometimes understood simply as care provided in a nursing home. That is too narrow.
For an older person whose physical or mental capacity has declined, long-term care may include support with everyday activities at home, help from family caregivers, rehabilitation, management of chronic conditions, community-based services, day care, assistive products, palliative care or, when needed, residential care. The combination can change over time as the person’s health, function, preferences and family circumstances change.
WHO describes long-term care as a continuum that includes health services such as management of chronic geriatric conditions, rehabilitation, palliation, prevention and health promotion, together with caregiving and social support. These services should be integrated and organized around person-centered care, with the wider aim of enabling people with significant declines in capacity to live in accordance with their rights, freedoms and dignity.
That distinction matters for Viet Nam. The country had 14.2 million people aged 60 and older in 2024, 2.8 million more than in 2019, and this number is projected to approach 18 million by 2030. As the population ages, the question is not only how Viet Nam can develop more care services. It is also how care provided at home, in communities and in residential settings can remain safe, person-centered, coordinated and consistently good.
Long-term care is a continuum, not a place
The need for long-term care does not begin when someone enters a residential facility. It often begins much earlier. An older person may initially need occasional help with shopping, meals or medication. Later, support may be needed with mobility, bathing, rehabilitation after illness or other activities of daily living. Family members may become increasingly involved, while community services can provide social connection, daytime activities or practical support. If needs become more complex, additional home-based services, rehabilitation, palliative care or residential care may become appropriate.
These are not separate systems from the perspective of the person receiving care. They may be different parts of the same care journey.
WHO’s framework for an integrated continuum of long-term care emphasizes integration with existing health and social-care systems rather than treating LTC as a stand-alone institutional sector. It calls for care that is person-centered, aligned with people’s values and preferences, supportive of functional ability, community-oriented and connected across settings.
This framing is particularly relevant to Viet Nam, where families continue to play a major role in older-person care while formal home, community and residential services are still developing. An April 2026 analysis published by the Ministry of Health’s Population Department similarly argues that future care arrangements cannot rely on families alone and will require a broader, more integrated care system. Vietnam Tourism
The aim should therefore not be to replace families with institutions. It should be to build a system that supports older people and families with services that can adapt as needs change.
Quality starts with the person, not the service
A service can meet basic operational requirements and still provide care that does not work well for the individual.
A residential facility may be clean and well equipped, but residents may have little influence over daily routines. A home-care worker may complete every assigned task without recognizing that an older person’s mobility or cognition is deteriorating. A community program may offer useful activities but lack a clear pathway when a participant develops a health problem that requires clinical assessment.
Good long-term care therefore cannot be defined only by buildings, staffing numbers or a list of services. Quality needs to begin with the person: What matters to them? What can they still do independently? Where do they need support? What risks need to be managed? What level of autonomy can be maintained? Who is involved in their care, and how should that care change when their needs change?
Person-centeredness is more than being kind or respectful. It means that assessment, care planning, daily routines and decisions take account of the person’s needs, abilities, preferences, goals and rights rather than fitting everyone into the same care model. WHO similarly places person-centeredness, dignity, autonomy and rights at the heart of long-term care.
Safety looks different when care continues for months or years
Patient safety is often associated with hospitals, procedures and acute clinical events. Long-term care presents a different safety challenge because risks may accumulate gradually and involve both health and everyday living.
An older person receiving ongoing support may experience medication-related harm, falls, pressure injuries, malnutrition, dehydration, infections, worsening cognition, functional decline, neglect or inappropriate restriction. Changes can be subtle, and the first person to notice them may be a family member or care worker rather than a physician.
Medication safety illustrates the complexity. Many people using long-term-care services have multimorbidity and take multiple medicines. A 2025 systematic review identified 442 individual quality indicators relating to safe and effective medication use across long-term-care facilities and in-home aged-care services. Eighty percent were process indicators, while only 7% addressed person-centered measures such as involvement in medication-related decisions.
The point is not that every provider needs hundreds of medication indicators. It is that medication safety in long-term care extends beyond whether a prescription is technically correct. It involves review, administration, monitoring, communication, recognition of adverse effects and the person’s involvement in decisions. The same principle applies to falls, nutrition, skin integrity, cognition and infection prevention: quality depends on recognizing risk, responding appropriately and learning when problems occur. That requires reliable systems, not just individual goodwill.
Quality at home includes the caregiver
Home-based care can allow older people to remain within familiar relationships, routines and surroundings, but “care at home” should not become shorthand for “the family will manage.”
When needs become substantial, family members may help with medicines, mobility, personal care, appointments, nutrition, behavioral changes or medical equipment while also working, raising children or managing their own health. WHO therefore identifies support for unpaid caregivers and development of a sustainable, appropriately trained workforce as core foundations of effective long-term-care systems.
A care plan that appears reasonable on paper may fail if the caregiver does not understand it, lacks the necessary skills, cannot physically perform the required tasks or cannot sustain the amount of care being assumed. Caregiver education, access to advice, respite where available and clear escalation pathways therefore matter. When a care model depends heavily on an unpaid caregiver, caregiver capability and sustainability become part of care quality.
This does not mean families should become substitutes for professional services. It means that the realities of family caregiving need to be considered explicitly when care is planned.
Community care can help people remain supported in familiar settings
Community-based care can provide an important layer of support as older people’s needs change. Depending on the model, this may include daytime activities, physical activity, social interaction, support with daily living, health education and connections to other services.
This area changed significantly in Viet Nam in 2026. The Law on Population No. 113/2025/QH15 took effect on 1 July 2026, and Decree No. 168/2026/NĐ-CP provides detailed arrangements for older-person care at home and in the community.
Decree 168 recognizes older-person care clubs and community day-care points. It also defines care activities including guidance on care and prevention, health promotion, early recognition of common health problems, physical activity and assistance with daily living.
An important legal and operational boundary needs to remain clear. Under the decree, a community day-care point is a special model under the commune-level health station, has no separate legal-person status and does not perform medical examination or treatment activities. It may operate at a commune health station, health-station point, cultural house or another appropriate local site.
Community-based support should therefore not be assumed to replace medical examination or treatment, or clinical rehabilitation when these are required. Those activities need to be provided within the applicable professional and organizational scope under Vietnamese law. If a community worker notices repeated falls, worsening confusion, weight loss or declining mobility, quality depends partly on what happens next: whether there is a clear route to assessment, whether the family understands what to do, whether the older person reaches an appropriate service and whether information flows back afterward.
Community care becomes integrated care when the interfaces work.
Residential care should be more than accommodation
For some older people, remaining at home may eventually become unsafe, impractical or inconsistent with their needs or preferences. Residential care can then be an important part of the continuum, but residential long-term care is more than housing with staff available.
Residents may live with frailty, dementia, multimorbidity, mobility limitations, complex medication regimens or palliative needs. Quality therefore depends on both the living environment and the systems supporting health and care. Relevant areas can include assessment and individualized care planning, medication management, nutrition, mobility and falls, skin integrity, infection prevention, cognition and behavioral symptoms, rehabilitation, goals-of-care discussions where appropriate, emergency escalation and communication with hospitals and clinicians.
At the same time, a residential facility is also the person’s home. Privacy, autonomy, relationships, personal routines, meaningful activities and protection from abuse, neglect or unnecessary restriction are not secondary amenities. They are part of quality.
The balance matters. Excessive risk aversion can unintentionally reduce mobility, independence and personal choice, while an approach focused mainly on hospitality can under-recognize genuine clinical risk. High-quality residential care needs to manage risk without reducing the person to a set of risks.
Workforce quality is care quality
Buildings and technology cannot compensate for a workforce that lacks the skills, time, supervision or support needed to provide good care.
Depending on their role, long-term-care workers may need competency in personal care, mobility assistance, recognition of deterioration, dementia care, communication, nutrition, medication support, infection prevention, documentation and escalation. Professionalization does not mean that everyone who supports an older person needs to become a clinician. It means roles should be clear, competencies should match those roles, training and supervision should be available, and workers should know when a situation is beyond their scope and requires escalation.
This challenge is already visible in Viet Nam. The Ministry of Health’s Population Department has highlighted shortages in geriatric and care-related human resources and the limited training available to many people involved in community-level older-person care. Decision No. 1116/QĐ-TTg also expands professional training for people involved in older-person care across health facilities, commune health stations, care facilities, population staff and community volunteers.
In long-term care, the workforce is therefore not simply an input. It is one of the main ways through which quality is created.
Quality also depends on safeguarding and accountability
Long-term care often involves people who depend on others for essential parts of daily life. That dependency creates a particular responsibility to protect dignity, autonomy and safety.
Safeguarding — including protection from abuse, neglect and inappropriate restriction — should therefore be built into governance rather than considered only after an incident occurs. Organizations need clear expectations around respectful care, consent, privacy, complaints, reporting concerns and responses to suspected abuse or neglect. Older people and families also need practical ways to raise concerns without fearing that doing so will jeopardize care.
The same learning principle applies to incidents. A fall, medication error, unexplained injury or hospital transfer should not automatically trigger blame, but repeated events should prompt questions about patterns, care planning, staffing, communication and system design. Quality improvement becomes possible when organizations can identify problems clearly enough to understand and respond to them.
Measuring quality means looking beyond activity
A long-term-care organization can report how many people it serves, how many visits were completed or how many activities were organized. These numbers describe activity, but they do not necessarily describe quality.
Depending on the setting, useful measures may include falls and injuries, medication-related problems, pressure injuries, nutrition, infections, functional change, emergency transfers, hospital use, completion of care-plan reviews, continuity, patient or resident experience, caregiver experience, complaints and safeguarding events.
International experience illustrates both the opportunity and the complexity of measurement. A 2025 scoping review identified 327 quality indicators across 18 long-term-care quality programs in 13 countries. About 79% related to safety and effectiveness, and commonly measured areas included falls, medication-related issues and pressure injuries.
Outcome measures also need context. A facility supporting people with very complex needs may naturally experience more hospital transfers than a service caring for relatively independent residents. Measures therefore require clear definitions, careful interpretation and, where appropriate, adjustment for differences in the populations served.
Person-centered outcomes matter too. Are older people involved in their care plans? Do they feel respected? Can they make meaningful choices about daily life? Are their goals understood? Is care helping maintain function and participation where possible?
The goal should not be the longest possible dashboard. It should be a manageable set of measures that helps an organization understand whether care is safe, responsive and protecting or improving the things that matter to the people it serves.
WHO is developing the first global standards framework for long-term care
The international policy environment is also changing.
On 18 May 2026, WHO released the Global Standards for Long-Term Care for public consultation. WHO describes the consultation draft as the first global framework of standards intended to guide the planning, delivery, monitoring and improvement of long-term care for older people. The draft contains 34 standards and 106 quality statements organized across eight chapters covering definitions and principles; home- and community-based care; facility-based care; support for unpaid caregivers; workforce; financing; governance; and quality monitoring.
This breadth is important because it makes clear that long-term-care quality cannot be addressed by regulating residential facilities alone. Services, caregivers, workforce, financing, governance and measurement all form part of the quality architecture.
As of 2 October 2026, these remain draft standards under public consultation, which is open until 30 October 2026. WHO states that consultation feedback will inform revision before finalization and official publication. The consultation draft should therefore not be described as a finalized WHO requirement or as an established WHO certification standard.
For Viet Nam, the value of this process is not that a global model can simply be copied. A more useful approach is to examine the emerging principles against Viet Nam’s own care environment and ask what they imply for local service models, workforce, financing, governance, measurement and regulation.
Viet Nam has made important policy moves, but the system is still developing
Viet Nam’s policy environment for older-person care is changing quickly.
The National Strategy for Older Persons to 2035, with a vision to 2045 was approved in February 2025. In June 2026, Decision No. 1116/QĐ-TTg amended the Program for Health Care of Older Persons to 2030. Among its updated targets, by 2030, 90% of communes, wards and special zones are expected to have at least one older-person care club and one volunteer care team, while at least 20% are expected to pilot or develop day-care models. The decision also sets targets for expansion of older-person care facilities and geriatric capacity and strengthens training for people involved in older-person care.
The Population Law and Decree 168 have also added a more explicit legal basis for home and community care from July 2026. Taken together, these measures are meaningful building blocks for a broader care environment that extends beyond hospital-based health care alone.
At the same time, Viet Nam should not yet be described as having a fully developed long-term-care system. An April 2026 analysis published on the Ministry of Health Population Department’s website notes that Viet Nam does not yet have a complete legal framework specifically for long-term care and identifies gaps involving definition and scope, financing, service packages and standards, workforce and intersectoral responsibilities. These are analytical recommendations rather than a separate binding legal instrument, but they provide a useful picture of issues still requiring development.
This distinction matters. Viet Nam now has more policy building blocks, but a coherent LTC system requires those components to work together. Care pathways, professional roles, financing, safeguarding, quality standards, data, regulation and accountability cannot be developed indefinitely as separate pieces.
Financing is part of the quality conversation
A long-term-care system cannot deliver equitable and sustainable quality if services are financially inaccessible to people who need them or financially unsustainable for providers.
LTC is particularly challenging because support may be needed for years rather than days. Costs may fall on households, public budgets, health and social systems, insurance mechanisms or combinations of these. WHO therefore includes financing as one of the eight chapters in its draft Global Standards for Long-Term Care, while its earlier LTC framework places sustainable financing among the core system elements needed for an integrated continuum.
Financing remains an important question for Viet Nam. The April 2026 Population Department analysis recommends studying a dedicated long-term-care insurance mechanism as part of future system development.
This is not separate from quality. Inadequate financing can contribute to staffing shortages, limited training and supervision, restricted service availability and greater pressure on families. Sustainable quality therefore requires attention to both how care is delivered and how it is financed.
What can organizations begin doing now?
Viet Nam does not need to wait for a complete national LTC architecture or final WHO standards before organizations begin strengthening quality within their existing responsibilities.
A home-care provider can define clearly what its workers are trained and authorized to do, how changes in condition are recognized and escalated, how caregivers are supported and how medication or safety concerns are communicated. A community program can clarify the boundary between social support and clinical services and establish referral routes when health needs emerge.
A residential provider can develop standardized assessment and individualized care planning, staff competency systems, medication-safety processes, incident reporting, infection prevention, safeguarding and a practical set of quality measures. It can also examine whether residents retain meaningful choices in daily life rather than treating absence of adverse events as the only definition of success.
Hospitals and other health-care organizations also have a role. Long-term care does not begin where hospital responsibility simply ends. Hospitals need to understand where older patients are going after discharge, what the receiving service can realistically provide and how information and responsibility move across that transition.
Across all settings, one principle should remain consistent: quality should follow the older person even when the organization providing care changes.
Building quality while the system is still developing
In rapidly growing sectors, it is understandable to focus first on capacity: more services, more facilities, more care workers and more places where support can be provided. The risk is that quality systems are treated as something to add later.
Viet Nam has an opportunity to build capacity and quality together. Because important parts of the long-term-care system are still developing, workforce competencies can be defined as roles emerge, person-centered assessment can be embedded before routines become fixed, useful measures can be designed alongside new services, and safeguarding and accountability can become part of governance from the beginning.
WHO’s emerging standards may eventually provide a useful international reference, but Viet Nam will still need to determine how quality should be organized within its own families, communities, health services, care organizations, financing arrangements and regulatory environment.
The aim should not be to import a foreign model of long-term care. It should be to build a continuum suited to Viet Nam in which older people can receive the right care, in the right setting, with the right level of support while remaining safe, respected and involved in decisions about their own lives.
As Viet Nam ages, the question will increasingly be not only how many long-term-care services the country needs, but how to ensure that care remains safe, person-centered, coordinated and worthy of trust wherever an older person receives it - at home, in the community or in residential care. Building that quality into the system as it develops may be one of the most important opportunities ahead.
References
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World Health Organization. Webinar: Public consultation on the WHO Global Standards for Long-Term Care. 30 July 2026. World Health Organization
General Statistics Office of Viet Nam. Press Release: Results of the 2024 Mid-Term Population and Housing Census. 2025. Government of Vietnam
National Assembly of Viet Nam. Law on Population No. 113/2025/QH15. 10 December 2025; effective 1 July 2026. Chinh Phu
Government of Viet Nam. Decree No. 168/2026/NĐ-CP detailing provisions and implementation measures of the Law on Population. 15 May 2026; effective 1 July 2026. THƯ VIỆN PHÁP LUẬT
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