Rehabilitation and Reablement for Older People in Viet Nam: Restoring and Maintaining Function and Independence Across the Care Continuum

Rehabilitation and Reablement for Older People in Viet Nam: Restoring and Maintaining Function and Independence Across the Care Continuum

INTEGRATED CARE, REHABILITATION & FUNCTIONAL ABILITY

Last reviewed: October 2026

For an older person, recovery is not always measured by whether a disease has been treated successfully. Pneumonia may resolve, a fracture may be repaired and a stroke may become medically stable, yet the person may still return home unable to walk to the bathroom, prepare a meal, communicate as before or manage everyday activities without help.

That gap between medical stability and functional recovery matters. Function often determines whether an older person can return home safely, participate in family and community life, avoid unnecessary dependency and continue doing what matters to them. Sometimes the goal is to regain a lost ability. Sometimes complete recovery is not realistic, and success means maintaining remaining abilities, adapting the environment, using an assistive product or preventing avoidable further decline.

This is where rehabilitation and, increasingly in international care systems, reablement, become important. Rehabilitation can begin during treatment, continue through transitional or rehabilitation care, follow the person home and remain relevant in community and long-term care. Reablement brings additional attention to how everyday support is delivered: helping people retain or regain meaningful abilities instead of automatically replacing what they can still do themselves.

For Viet Nam, this is particularly timely. The Law on Medical Examination and Treatment 2023 defines rehabilitation broadly and requires rehabilitation needs to be considered during care. A national program is developing the rehabilitation system to 2030 with a vision to 2050. The National Strategy on Older Persons contains explicit rehabilitation targets, while 2026 professional guidance brings functional assessment and practical support further into homes and communities. The challenge is increasingly one of connection, quality and implementation.

Rehabilitation is about functioning, not simply physiotherapy

WHO defines rehabilitation as a set of interventions designed to optimize functioning and reduce disability in people with health conditions in interaction with their environment. Globally, an estimated 2.4 billion people live with a health condition that may benefit from rehabilitation, and need is expected to rise as populations live longer with chronic diseases and disability. In some low- and middle-income countries, more than half of people who need rehabilitation do not receive the services they require.

Rehabilitation can involve movement and strength, but it can also address cognition, communication, swallowing, self-care, psychological needs, environmental barriers and the use of assistive products. WHO emphasizes that rehabilitation is highly person-centered and can be delivered across hospitals, outpatient services, homes, workplaces and communities.

Viet Nam's legal framework takes a similarly broad view. The Law on Medical Examination and Treatment No. 15/2023/QH15 defines rehabilitation through interventions that may include medical approaches, rehabilitation techniques, assistive technology, educational, vocational and social measures and environmental improvement, with the aim of developing, achieving and maintaining the highest possible level of functioning and preventing or reducing disability in relation to the person's living environment.

Article 68 further requires rehabilitation needs to be considered during examination and treatment, early intervention where appropriate, and interventions to be continuous and comprehensive across stages of disease. It requires coordination between rehabilitation and other specialties and between healthcare facilities, individuals, families, communities and other relevant organizations, and explicitly recognizes community-based rehabilitation.

That matters because rehabilitation can easily become synonymous in everyday discussion with “physiotherapy” or “exercise.” Physiotherapy is important, but rehabilitation may also involve occupational therapy, communication or swallowing interventions, nursing, nutrition, psychological support, medical management, prosthetics and orthotics, assistive technology, caregiver education and environmental modification, depending on the person's needs and the workforce available.

The relevant question is therefore not simply “Does this person need physiotherapy?” It is “What is preventing this person from functioning as well as possible, and what combination of interventions could help?”

Restoring function is not always the same as returning to the previous level

The word “recovery” can create unrealistic expectations in older-person care. A previously independent person recovering from a hip fracture may regain most of their mobility. Someone with a mild stroke may relearn activities that became difficult. But an older person living with advanced frailty, progressive neurological disease or dementia may not return to an earlier functional baseline.

That does not mean rehabilitation has failed. WHO places independence and participation in meaningful life roles at the center of rehabilitation. Improving function is important, but maintaining function, slowing avoidable decline, compensating for impairment and enabling participation can also be meaningful outcomes.

A person with Parkinson disease may continue to experience disease progression while benefiting from strategies that make transfers safer. Someone living with dementia may not regain lost cognition but may retain the ability to dress with simplified routines and environmental cues. A person with severe arthritis may continue to experience pain yet become more independent in toileting after changes in equipment and technique.

The goal should therefore be understood as restoring function where possible and maintaining, adapting or compensating for function where complete recovery is not realistic.

Reablement brings everyday ability into sharper focus

Reablement overlaps with rehabilitation and should not be treated as its opposite. Both are concerned with functioning, independence and participation.

An internationally developed consensus definition describes reablement as a person-centered, holistic approach aimed at enhancing functioning and increasing or maintaining independence in meaningful activities of daily living, particularly in the person's place of residence. Common components include comprehensive assessment, goal-oriented support, regular reassessment, participation in everyday activities, environmental modification, assistive products and involvement of the person's social network.

What reablement brings into particularly sharp focus is how everyday assistance is provided. Instead of asking only, “What does this person need someone else to do?”, it asks “What does this person want and remain able to do, and what support would help them participate more?”

The terminology should nevertheless be used carefully. A 2025 scoping review of 41 systematic reviews on rehabilitation, reablement and restorative care in aged-care settings found considerable variation in definitions, models and evidence; only 14 of the reviews clearly defined the approach being examined.

For Viet Nam, reablement is therefore used here as an international care approach, not as a distinct licensed or legally defined Vietnamese service category in the instruments discussed in this article. Viet Nam already has concepts that overlap with it, including rehabilitation, community-based rehabilitation, support with activities of daily living, environmental adaptation, assistive products and caregiver training, but these should not simply be relabeled “reablement” as though a formal Vietnamese reablement service already exists.

The practical principle remains useful: support the person to participate and do what they can rather than automatically doing everything for them.

Viet Nam already has a national program for developing rehabilitation

Rehabilitation in Viet Nam is not developing without a national framework. Decision No. 569/QĐ-TTg of 24 May 2023 approved the Program for Development of the Rehabilitation System for 2023–2030, with a vision to 2050. Its overall objective is to improve access to quality, comprehensive, continuous and equitable rehabilitation for people with disabilities and others who need rehabilitation.

Decision 569 is population-wide rather than specific to older people, but its relevance to population aging is clear because many conditions associated with later life create substantial rehabilitation needs.

By 2030, the Program targets implementation of community-based rehabilitation models in 90% of provinces and centrally governed cities. It also aims for more than 90% of rehabilitation facilities to be maintained, strengthened and developed; more than 90% of rehabilitation hospitals to reach at least the “khá” category under Ministry of Health hospital-quality criteria; and at least 0.5 health personnel working in rehabilitation per 10,000 population.

Its longer-term direction is particularly relevant to integrated care. By 2050, rehabilitation is envisaged across levels both inside and outside the health sector, providing comprehensive, continuous and quality services. Community-based rehabilitation is intended to become a strategic approach to disability and eventually operate across local levels while being integrated with social services outside healthcare.

This national direction aligns closely with the WHO South-East Asia Regional Rehabilitation Framework, published in October 2025. WHO describes rehabilitation access across the Region as still limited, fragmented and under-prioritized and calls for rehabilitation to be integrated at all levels of healthcare, including primary and community care. The Framework organizes action around six areas: leadership and governance; rehabilitation services at all levels of care; information and digital technology; the interdisciplinary workforce; assistive technology; and sustainable financing.

For Viet Nam, the direction is increasingly clear. The harder challenge is making continuous rehabilitation visible in the actual journey of an older person through the care system.

Older-person policy makes rehabilitation even more relevant

The National Strategy on Older Persons to 2035, with a vision to 2045, approved through Decision No. 383/QĐ-TTg in February 2025, brings rehabilitation explicitly into Viet Nam's aging agenda.

For the 2025–2030 period, the Strategy includes a target that 70% of older people with disabilities are screened, have disabilities identified and receive intervention or rehabilitation. It also sets a target for at least 10,000 disadvantaged older people without caregivers to receive appropriate care, rehabilitation and assistance in rehabilitation and social-assistance establishments. At least 50% of families caring for older people with memory impairment, severe disability or other major difficulties are to receive training and guidance in care, assistance and rehabilitation.

The Strategy also calls for stronger networks for early identification, healthcare, rehabilitation, orthopedic services and assistive products, together with home- and community-based support and social-assistance establishments capable of providing care and rehabilitation.

Decision No. 1976/QĐ-BYT of 1 July 2026 adds a practical layer at home and community level. The Ministry of Health guidance incorporates assessment of intrinsic capacity and daily functioning and provides detailed support for mobility, avoiding falls, wheelchair use, positioning, eating and drinking and other activities of daily living.

Decision 1976 should not be interpreted as a complete national rehabilitation protocol. Much of it concerns practical care and support rather than specialist rehabilitation. Its importance lies in helping connect healthcare, functional assessment, caregivers and the person's actual living environment.

Function should be noticed before dependency becomes obvious

One common problem in older-person care is that function receives attention only when an activity can no longer be performed. A person may still walk but be substantially slower. They may still dress independently but require much longer than before. They may stop shopping because carrying groceries has become too difficult or stop climbing stairs even though they still appear “independent” during a brief clinic visit.

These changes matter because functional decline may develop gradually before it becomes obvious dependency.

Assessment therefore needs to look beyond diagnoses. Relevant areas can include mobility, balance, strength, transfers, basic activities such as bathing and dressing, instrumental activities such as shopping and managing medicines, cognition, communication, swallowing, pain, endurance, continence, sensory impairment and environmental barriers.

WHO's ICOPE 2nd Edition, published in 2025, uses a four-step pathway moving from basic assessment, to in-depth assessment, to development of a personalized care plan, followed by implementation and monitoring. It identifies declines in intrinsic capacity, including mobility, and connects these findings with wider health, social-care and caregiver needs.

The purpose is not to assess every possible domain because a form exists. It is to identify meaningful change early enough that something useful can still be done.

Rehabilitation should begin when the need appears, not only after acute treatment ends

WHO explicitly challenges the idea that rehabilitation should begin only after other treatment has failed or finished. In many cases rehabilitation can start as soon as a health condition and associated limitation in functioning are identified and continue alongside other interventions.

This is particularly important in hospital care. An older person may enter hospital walking independently and leave needing assistance after several days of acute illness, low activity, pain, delirium or restricted mobility. Preventing and addressing that decline requires more than a rehabilitation referral made on the day of discharge.

Functional goals should influence care during admission: getting out of bed when clinically appropriate, maintaining mobility, avoiding unnecessary immobilization, supporting nutrition, managing pain, preventing or recognizing delirium, reviewing medicines and practicing activities the person will need after discharge.

Rehabilitation also needs to fit the underlying clinical pathway. After stroke it may involve mobility, upper-limb function, communication, cognition and swallowing. After hip fracture it may focus on transfers, gait, balance and returning to daily activities. After prolonged acute illness it may involve strength, endurance, nutrition and rebuilding confidence.

The diagnosis explains what happened. Rehabilitation asks what the person can do now, what has changed and what might still be regained or maintained.

Discharge should transfer a functional plan, not only a medical plan

An older person may be medically ready to leave hospital while still being functionally unready to resume their previous life.

A discharge summary may correctly describe diagnoses, procedures and medicines while saying very little about whether the person can climb the stairs to their bedroom, get on and off the toilet, prepare food, use a newly prescribed walker correctly or remain alone safely.

A rehabilitation-informed handover therefore needs to communicate function. What could the person do before admission? What can they do now? Do they require supervision or hands-on assistance? What mobility device is needed? Are there weight-bearing restrictions? Are swallowing, communication or cognitive difficulties present? Which activities should continue? Which goals remain unfinished? Who is expected to review progress, and when?

Equipment also needs to reach the person at the right time. A walker prescribed at discharge but unavailable for a week does not support a safe transition. Nor is telling a family to “continue rehabilitation” useful if they do not understand what to do or whom to contact.

The transition from hospital to transitional care, rehabilitation, home or another setting should therefore be understood as part of the rehabilitation pathway, not as the point where rehabilitation responsibility ends.

Home can be a place of rehabilitation

Many of the abilities that matter most to an older person cannot be fully understood in a hospital therapy room. Can the person get into their own shower? Can they move safely between the bedroom and toilet at night? Can they prepare a simple meal, reach their clothes or walk to a nearby shop?

These are functional questions tied to the person's real environment.

A 2024 systematic review of eight randomized studies of structured home-based rehabilitation programs for adults aged 60 years and older found that monitored, progressive and individualized programs may improve physical and psychological outcomes, functional capacity and self-care. The interventions and outcome measures were heterogeneous, however, and stronger research is still needed.

Evidence from particular conditions is also encouraging but should not be overstated. A 2024 systematic review and meta-analysis of 21 randomized trials involving 2,470 older adults after hip-fracture surgery found benefits of home-based exercise for measures including balance, Timed Up and Go performance, knee-extensor strength and the physical component of quality of life. Significant improvements were not demonstrated for every outcome, including gait speed, six-minute walking distance, SPPB, activities of daily living or fear of falling, and certainty varied between outcomes.

The conclusion should therefore not be that home rehabilitation is superior to facility-based rehabilitation for everyone. It is that home is a legitimate rehabilitation setting when it matches the person's needs, risks, goals and available support.

Reablement asks whether everyday care is building ability or unintentionally replacing it

Consider an older person who can still dress slowly but needs help fastening buttons. A caregiver under time pressure begins dressing the person completely every morning. The immediate problem is solved, but repeated full assistance may eventually remove opportunities to practice an ability the person still has.

The same tension can arise with walking, bathing, eating, toileting and preparing meals.

This is where reablement principles are useful. Instead of measuring success only by whether a task was completed quickly, the care team asks what level of assistance is actually needed and whether the person could safely participate more.

International consensus emphasizes person-centered goals, meaningful daily activities, reassessment, environmental adaptation, assistive products and coordinated support. An important underlying ethos is often described as “doing with” rather than automatically “doing for.”

This should never be interpreted as withholding help. Someone who requires full assistance should receive it. Independence is not an ethical requirement and should not be pursued at the expense of safety, comfort or dignity.

The quality issue is whether assistance is matched to actual ability and to the person's own goals.

Reablement is promising, but it should not be oversold

Reablement attracts interest because it may improve independence and, in some circumstances, reduce ongoing need for formal home-care services. The evidence is encouraging in some areas, but it is not uniform.

A 2022 systematic review of randomized trials found that ongoing service requirements decreased in several studies, while statistically significant improvements were reported for functional ability in some studies and quality of life in some outcomes. Interventions were heterogeneous, several studies had design or risk-of-bias limitations, and effects tended to be more evident at earlier than later follow-up.

The 2025 scoping review of 41 systematic reviews reached a broader conclusion. Rehabilitation, reablement and restorative care all aim to enhance independence and quality of life in aged care, but differences in definitions, service models, funding and outcomes make the evidence landscape fragmented. The review does not justify claiming that one approach is universally superior across all older populations and settings.

For Viet Nam, the useful response is therefore not to import reablement as a fashionable label. It is to consider which principles are valuable locally: meaningful goals, functional assessment, graded assistance, practice of everyday activities, environmental adaptation, appropriate assistive products, caregiver capability and regular reassessment.

Rehabilitation goals should begin with what matters to the person

A clinical team may want an older person to improve lower-limb strength. The person may simply want to be able to walk downstairs and have coffee with friends.

Both matter, but the second explains why the first matters.

Good rehabilitation connects technical objectives with meaningful life goals. “Improve balance” becomes “walk safely to the community club.” “Improve shoulder movement” becomes “dress without assistance.” “Improve endurance” becomes “walk to the local market again.”

Not every goal will be achievable, and clinical judgment and safety remain important. But negotiated goals reduce the risk of rehabilitation becoming something done to a person rather than with them.

This is particularly important for older people living with multimorbidity, where fatigue, pain, cognition, treatment burden and caregiver capacity may all influence which rehabilitation goals are worth pursuing.

Rehabilitation requires an interdisciplinary workforce

Function does not belong to one profession. Depending on the person's needs and the workforce available locally, rehabilitation physicians, physiotherapists, occupational therapists, nurses, professionals addressing communication and swallowing, nutrition professionals, psychologists, social workers, pharmacists, prosthetists, orthotists and others may all contribute.

A physiotherapist may work on strength, mobility and balance. Occupational therapy may focus on activities of daily living, environmental adaptation and task strategies. Communication or swallowing intervention can be central after stroke. Nurses frequently reinforce mobility and self-care throughout the day rather than only during scheduled therapy. Nutrition can affect whether someone has enough energy and muscle to recover, while medication review can identify drugs contributing to dizziness, sedation or poor participation.

The WHO South-East Asia Rehabilitation Framework identifies rebuilding an interdisciplinary rehabilitation workforce as one of its six strategic areas. Viet Nam's Decision 569 similarly includes an explicit workforce-development target.

But interdisciplinary care is not achieved simply because several professionals see the same person. They need shared goals, clear responsibilities and communication about progress.

Everyday care can reinforce, or undermine, rehabilitation

Rehabilitation does not occur only during a session labeled “therapy.” If a person practices walking with a rehabilitation professional in the morning but is routinely kept in bed for the rest of the day without a clinical reason, the wider care environment may undermine the rehabilitation goal. If someone learns to dress independently but caregivers subsequently complete the entire activity because it is faster, opportunities for practice disappear.

This makes rehabilitation partly a care-model issue.

Physicians, nurses, rehabilitation professionals, caregivers and family members need to know what the person should do independently, what should be practiced with supervision and what genuinely requires assistance. For a function-oriented service, the rehabilitation plan should influence ordinary daily routines rather than exist as a separate document.

Family caregivers can support recovery, but they should not become unpaid rehabilitation professionals

Families play a central role in older-person care in Viet Nam, particularly after hospital discharge and where formal home-based services are limited. They can encourage mobility, reinforce safe practice, help with meaningful daily activities, observe deterioration and build confidence. Decision 383 explicitly recognizes training families in care, assistance and rehabilitation as a national priority for older people with significant needs.

But family involvement requires appropriate boundaries.

A complex transfer, swallowing problem, new orthosis or exercise program after major surgery may require professional assessment and instruction. Families should not be expected to improvise clinical rehabilitation simply because formal services are unavailable.

Caregivers also need to understand the appropriate level of assistance. Helping too little can create risk. Helping too much may unintentionally remove opportunities for the older person to use or maintain abilities they still have.

The relevant question is therefore not “Can the family take over?” It is “What can the family safely support, what training do they need, and what still requires professional input?”

Assistive technology should enable function, not become equipment without follow-up

A cane, walker, wheelchair, grab rail, communication device or adapted utensil can substantially increase independence, but equipment alone is not rehabilitation.

The assistive product needs to match the person's functional ability and environment. It has to be appropriately selected and fitted, understood by the person and caregiver, maintained and reviewed as needs change.

A wheelchair that cannot pass through the bathroom door may increase dependency rather than reduce it. A walker adjusted incorrectly can make mobility less safe. Equipment prescribed in hospital may become difficult or impossible to use if the person's home environment was never considered.

The WHO South-East Asia framework therefore treats access to assistive technology as a core element of rehabilitation-system strengthening rather than as an isolated equipment issue. Viet Nam's legal definition of rehabilitation also expressly includes assistive technology and environmental improvement.

The meaningful quality measure is not simply whether equipment was supplied. It is whether that equipment improved functioning in the person's daily life.

Cognitive impairment does not automatically end rehabilitation

Dementia or cognitive impairment should not automatically mean that function-focused intervention stops.

Someone who has difficulty learning a complex new sequence may still benefit from simplified instructions, repetition, environmental cues, familiar routines and practice of meaningful everyday activities. The level of supervision and caregiver involvement may need to increase, and goals should reflect the person's cognitive and functional capacity.

The intervention may shift from learning entirely new skills toward maintaining familiar activities for as long as possible. Evidence in this population remains heterogeneous, so rehabilitation should be individualized rather than based on an assumption that everyone with cognitive impairment will respond in the same way.

The principle remains important: maintenance can also be a meaningful rehabilitation outcome.

Long-term care should not become the place where rehabilitation ends

Moving into long-term care is sometimes treated as evidence that rehabilitation is no longer relevant. That assumption deserves challenge.

A person entering residential care may still be able to improve transfers, walking, feeding, dressing, communication or participation. Others may benefit from maintaining abilities that would otherwise decline more quickly. Someone who already lives in a long-term care facility may require new rehabilitation after a fracture, stroke or acute hospitalization.

The 2025 scoping review found rehabilitation, reablement and restorative approaches across home, community and residential aged-care settings, with recurring themes including multidisciplinary care, functional independence, physical activity, falls, goal setting and transitions. The authors also emphasized that terminology and evidence remain fragmented.

Long-term care quality should therefore ask not only whether assistance is provided, but whether the style and amount of assistance preserve the person's abilities whenever reasonably possible.

The difference can be subtle. A caregiver may routinely wheel someone to the dining room because it is faster. In another situation, the same person may safely walk part of that distance with support because maintaining walking remains one of their goals. Both involve care, but only the second may also be preserving an ability that still matters to the person.

Rehabilitation, long-term care and palliative care can overlap

Older-person care rarely fits neatly into separate boxes labeled curative care, rehabilitation, long-term care and palliative care.

A person with advanced cancer may benefit from rehabilitation to conserve energy and remain able to use the bathroom independently. Someone receiving long-term care may need rehabilitation after a fracture. A person with progressive neurological disease may simultaneously need symptom relief, assistance with daily life and function-focused interventions that preserve mobility or communication.

Rehabilitation does not always mean trying to reverse the underlying disease. What changes across the continuum is often the goal: recovery where possible, maintenance where appropriate, adaptation where necessary and comfort when that becomes the overriding priority.

These approaches should therefore be coordinated rather than treated as mutually exclusive services competing for the same person.

Quality measurement should focus on what the person can actually do

Counting therapy sessions is easy. It does not necessarily tell us whether rehabilitation worked.

A meaningful measurement system should include functional outcomes relevant to the person's goals and setting. Depending on the individual, these might include mobility, transfers, basic and instrumental activities of daily living, communication, swallowing, participation, confidence, pain, the amount of caregiver assistance required and the ability to remain safely in the preferred living environment.

Service performance also matters. Was the need for rehabilitation identified? Did intervention start when appropriate? Was there an avoidable gap after discharge? Did required equipment arrive? Was the functional plan communicated across settings? Was progress reassessed? Were goals achieved, revised or appropriately discontinued?

Hospital readmission or entry into long-term care may be useful system outcomes in some programs, but they should not become the sole definition of success. Someone may require long-term care despite excellent rehabilitation because the underlying condition or social circumstances make independent living unrealistic.

A fairer question is: Did this person achieve the best functional outcome reasonably possible given their health, goals and circumstances?

A quality rehabilitation pathway needs accountability

Fragmentation can undermine even technically excellent rehabilitation.

Imagine an older person after stroke. The hospital rehabilitation team recommends daily mobility practice. The functional plan does not reach the next service. The family receives exercises but does not understand how to help safely. A walking aid arrives late. Nobody reassesses progress for several weeks.

Every organization may have completed an individual task, yet the person still experiences a broken pathway.

Quality governance therefore needs clear responsibility for functional assessment, referral, transition planning, equipment, caregiver preparation, follow-up and reassessment. Someone needs to know what should happen next and whether it actually happened.

The WHO South-East Asia Rehabilitation Framework makes leadership and governance its first strategic area for a reason. Rehabilitation quality depends not only on professional technique, but also on how the system organizes access, continuity, coordination and accountability.

A practical rehabilitation and reablement framework for older-person care in Viet Nam is possible

Viet Nam does not need to build this approach from zero. The Law on Medical Examination and Treatment already defines rehabilitation broadly and requires continuity and coordination. Decision 569 provides a national rehabilitation-system development program. Decision 383 places rehabilitation clearly within the national aging agenda. Decision 1976 brings functional assessment and practical support closer to older people at home and in the community. Internationally, WHO ICOPE and the South-East Asia Rehabilitation Framework provide complementary approaches for implementation.

These components could be connected through a practical pathway for older people. Functional assessment should identify what the person can do, what has changed and what matters to them. Goal-oriented rehabilitation planning should translate impairments into meaningful functional objectives. Early intervention should begin during acute care when appropriate rather than waiting until discharge.

Transition planning should communicate current function, goals, required assistance, equipment and follow-up across settings. Home and community rehabilitation should continue recovery where clinically appropriate and address the person's real-life environment. Reablement principles can help caregivers and services support the person to retain or regain meaningful daily abilities rather than automatically replacing them.

Assistive technology and environmental modification should be integrated into the same pathway rather than treated as separate purchases. Caregiver capability should be assessed and supported. Reassessment and measurement should determine whether goals remain appropriate and whether function is improving, stable or declining. Finally, quality governance should make it visible when continuity breaks down.

The strength of such a model would not come from creating another isolated program. It would come from connecting rehabilitation to the care that already surrounds the older person.

From treating disease to supporting ability

For an older person, the difference between needing help and remaining independent can come down to something that looks very small: standing from a chair, walking twenty meters safely, buttoning a shirt, swallowing without fear, using the toilet independently, preparing breakfast or getting outside again.

These outcomes may never appear on a list of diagnoses, yet they can determine where someone lives, how much assistance they need and whether they can continue participating in the life that matters to them.

For hospitals, good rehabilitation means thinking about function before discharge rather than after dependency has developed. For transitional care, it means continuing recovery rather than merely filling the gap between hospital and home. For families and community services, it means supporting ability without creating avoidable dependency. For long-term care, it means recognizing that needing care does not mean a person has lost every opportunity to improve or maintain function.

As Viet Nam develops its rehabilitation system and its wider architecture for older-person and long-term care, the question should therefore not simply be: “Did this person receive rehabilitation?”

A more meaningful question is: “Did we identify what mattered to this person, help them regain or maintain as much function as reasonably possible, and make sure that support continued as they moved across the care continuum?”

That is the difference between providing rehabilitation as a service and building a care system around functional ability.

References

1. World Health Organization. Rehabilitation. Fact sheet. Geneva: World Health Organization; updated 22 April 2024.

2. World Health Organization Regional Office for South-East Asia. Framework on provision of rehabilitation services in the WHO South-East Asia Region. New Delhi: WHO Regional Office for South-East Asia; 2025.

3. World Health Organization. Integrated care for older people (ICOPE): guidance for person-centred assessment and pathways in primary care. 2nd ed. Geneva: World Health Organization; 2025.

4. National Assembly of Viet Nam. Law No. 15/2023/QH15 on Medical Examination and Treatment. 9 January 2023.

5. Prime Minister of Viet Nam. Decision No. 569/QĐ-TTg approving the Program for Development of the Rehabilitation System for 2023–2030, with a vision to 2050. 24 May 2023.

6. Prime Minister of Viet Nam. Decision No. 383/QĐ-TTg approving the National Strategy on Older Persons to 2035, with a vision to 2045. 21 February 2025.

7. 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.

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