Supporting Meaningful Daily Activities in Residential Long-Term Care in Viet Nam: Resident Choice, Accessible Participation and Everyday Wellbeing

Supporting Meaningful Daily Activities in Residential Long-Term Care in Viet Nam: Resident Choice, Accessible Participation and Everyday Wellbeing

Every morning, an older woman watches the activities coordinator prepare the communal room for games, music, and group exercise. The staff are friendly and invite everyone to participate, but she usually declines.

Before moving into residential care, she spent much of her day tending plants, preparing family meals, and looking after her grandchildren. She enjoyed being useful and having some control over how she spent her time. Now, although she receives appropriate personal care, eats regular meals, and has opportunities to socialize, most of her daily routine is organized by other people. She rarely feels that the day belongs to her.

When a care worker asks what she would actually like to do, her answer is simple. She wants to look after a few plants and have somewhere quiet to read in the afternoon.

The facility has been offering activities, but it has not yet understood what makes an activity meaningful to this particular resident.

This distinction matters in residential long-term care. A full calendar of entertainment does not necessarily mean that residents experience purpose, choice, or satisfaction in everyday life. Some people enjoy organized group activities, while others prefer familiar routines, individual interests, meaningful conversations, or opportunities to contribute in their own way.

For organizations caring for older people in Viet Nam, supporting meaningful daily activities involves more than offering recreational programs. It requires understanding individual preferences, removing unnecessary barriers, respecting the choice not to participate, and creating opportunities for residents to remain connected with activities and relationships that matter to them.

The aim is not simply to keep people occupied. It is to help them continue living lives that feel recognizable, worthwhile, and their own.

Meaningful Activity Is More Than Entertainment

Residential care facilities commonly organize music sessions, group exercise, games, celebrations, and other recreational activities. These programs can provide enjoyment, companionship, and opportunities for social participation, but their presence does not automatically mean that residents are spending their time in ways they value.

Meaningfulness is personal. One resident may enjoy singing with others, while another prefers listening to familiar music privately. Someone who previously worked as a teacher may appreciate discussing books or sharing knowledge with a younger person. A former gardener may find satisfaction in caring for plants, while another resident may simply enjoy sitting outdoors and observing the garden.

Ordinary activities can also carry considerable personal significance. Choosing clothing, arranging belongings, preparing a familiar beverage with appropriate support, or deciding how to spend a quiet afternoon may help preserve a sense of identity and control.

The National Institute for Health and Care Excellence (NICE), in Quality Standard QS50 on mental wellbeing in care homes, recognizes that meaningful activity includes everyday living as well as planned and spontaneous opportunities for physical, social, creative, intellectual, and leisure participation.

The standard emphasizes involving older people in choosing and defining what matters to them. Activities may be individual or shared, structured or informal, and may include family members, friends, or the wider community when the person wishes.

This offers an important lesson for care organizations. An activity does not become meaningful simply because it appears on the weekly calendar, is considered beneficial by staff, or has been popular with other residents. Its value depends on the person's interests, experiences, preferences, abilities, and circumstances.

A person-centered approach begins with the resident rather than the activity program.

Why Everyday Participation Matters

Moving into residential long-term care can change how an older person experiences ordinary life. Meals may be served at scheduled times, household responsibilities may be taken over by employees, and decisions about shared spaces may be made by management.

Some coordination is necessary to provide safe and consistent care. Other arrangements may reflect institutional convenience rather than individual needs.

Over time, residents may find that decisions about how they spend their days are increasingly made by others, even when they remain capable of making many of those choices themselves.

Opportunities to maintain familiar interests, make everyday decisions, and contribute to daily life can help preserve personal identity and a sense of autonomy.

International research supports the importance of these experiences, although the findings require careful interpretation.

A mixed-methods systematic review by Udkunta and colleagues, published online in February 2026 in the Journal of Advanced Nursing, examined 30 studies of person-centered care models and interventions in long-term care facilities.

The review identified recurring themes involving individual preferences, social participation, autonomy, dignity, wellbeing, homelike environments, family involvement, and organizational support. Some interventions demonstrated beneficial outcomes, while others did not show significant improvements. Implementation was influenced by factors such as workforce competence, leadership, organizational culture, and available resources.

A systematic review by Habibian and colleagues, published in August 2026 in the Journal of Clinical Nursing, examined ten studies of social participation interventions and quality of life among older adults living in residential aged care.

Several interventions were associated with better quality-of-life outcomes, including selected exercise programs, virtual reality experiences, and multicomponent person-centered approaches. However, the evidence was heterogeneous, and the authors highlighted its limited and fragmented nature.

These findings do not establish that every activity improves wellbeing or that a particular intervention will produce similar benefits for all residents.

They support a more practical conclusion: meaningful participation deserves attention as part of care quality, but activities should be adapted to individual needs and evaluated in the settings where they are delivered.

Understanding What Matters to Each Resident

An effective approach to meaningful activity begins with listening.

When an older person enters residential care, staff commonly collect information about health conditions, functional abilities, personal care needs, and safety risks. These assessments are essential, but they may reveal relatively little about how the person would like to spend an ordinary day.

Previous occupations, hobbies, relationships, household routines, cultural experiences, and personal interests can provide useful starting points. They should not, however, become fixed assumptions.

Someone who worked as a teacher may no longer wish to participate in educational activities. A former musician may prefer listening to music rather than performing. A resident who previously attended religious gatherings may now value private reflection.

Preferences can also change. An activity that was enjoyable before hospitalization may feel exhausting during recovery. Someone who initially avoids group activities may become interested after developing friendships with other residents.

The most useful approach is therefore an ongoing conversation rather than a questionnaire completed only at admission.

Staff can ask what residents enjoy, what they miss about their previous routines, how they prefer to spend their time, and whether there are interests they would like to continue or explore. Observing how people respond to different opportunities can also provide useful information.

Families and others who know the resident well may help, particularly when communication is difficult. Their perspectives can provide context, but they should not automatically replace the person's own wishes.

Care workers should remain open to answers that do not fit the activities currently available. A resident should not feel obliged to choose between singing, exercise, and games when what they really want is a quiet place to read or an opportunity to talk with a friend.

Understanding what matters is a continuing process of listening, offering choices, observing responses, and adapting support.

Preserving Familiar Routines and a Sense of Contribution

For many older people, everyday routines carry meaning that may not be obvious to others.

A resident may prefer reading the newspaper after breakfast, listening to a particular radio program, practicing a spiritual tradition, or sitting outdoors at a familiar time of day. Another may value dressing carefully before receiving visitors or arranging personal belongings in a particular way.

These preferences can help preserve continuity when much of the person's environment has changed.

Residential care organizations should consider how familiar routines can be accommodated within safe and practical service arrangements. This does not mean that every preference can always be fulfilled exactly as requested. Shared living requires coordination, and some activities involve genuine safety, staffing, or environmental constraints.

However, facilities should distinguish necessary limitations from routines maintained mainly because they are convenient for employees.

Meaningful participation can also involve contributing to everyday life. Some residents may enjoy arranging flowers, organizing personal books, tending plants, helping prepare decorations, or sharing practical knowledge with others.

The value may lie less in the completed task than in having a role and feeling that one's contribution matters.

For someone who previously managed a household, continuing a familiar activity may offer satisfaction and reassurance. A person who spent many years teaching, mentoring, or practicing a craft may enjoy sharing that experience when opportunities arise naturally.

Participation must remain voluntary.

A resident's willingness to help should not become a reason to replace employees, reduce staffing, or assign unpaid responsibilities for the provider's benefit. Viet Nam's Law on Older Persons prohibits compelling older people to work or undertake activities contrary to law.

Care organizations should distinguish genuine, freely chosen participation from work imposed on residents. Individuals should not be pressured to continue tasks that cause fatigue, pain, distress, or unwanted responsibility.

Activities also need appropriate safety arrangements. Gardening may require accessible surfaces and suitable tools. Food-related activities may involve hygiene requirements and individual health considerations. Where specialized assessment or assistance is needed, appropriately qualified personnel should be involved.

The aim is to preserve opportunities for those who wish to contribute in ways they find enjoyable, appropriate, and meaningful, rather than assign residents duties.

Group Participation, Solitude, and the Right to Decline

Group activities can provide companionship, enjoyment, and social connection. Music, creative projects, discussions, cultural celebrations, and suitable movement sessions may help residents maintain interests and develop relationships.

However, participation in a group should not be treated as the default measure of a successful day.

Some people prefer quiet activities or smaller social settings. A resident may enjoy speaking with one familiar person but feel overwhelmed by a large gathering. Another may value reading privately, practicing a personal hobby, or spending time outdoors without joining a scheduled program.

These preferences should not automatically be interpreted as withdrawal or lack of motivation.

The distinction between chosen solitude and unwanted isolation is particularly important. Someone who enjoys spending time alone is not necessarily lonely. Conversely, a person may attend several group activities and still feel disconnected or dissatisfied.

Care workers should remain attentive to whether residents have genuine choices and whether their preferences are respected.

The right to decline an activity is part of that choice. A resident may be tired, uninterested, uncomfortable, or simply prefer to do something else. Repeated pressure to participate can become intrusive even when staff believe the activity would be beneficial.

Family members may also encourage greater involvement, but their expectations should not automatically take precedence over the resident's wishes.

If someone consistently stops participating in activities they previously enjoyed, it may be appropriate to explore whether something has changed. Illness, pain, depression, sensory impairment, fatigue, communication difficulties, or an unsuitable environment may contribute to reduced engagement.

Such concerns deserve sensitive consideration, and clinical assessment may be appropriate when there are additional signs of ill health or psychological distress.

Nevertheless, choosing not to join an activity is not, by itself, evidence of a medical problem.

A good residential care program offers opportunities without treating attendance as an obligation. Participation becomes more meaningful when people are free to decide how, when, and whether to take part.

Making Participation Accessible to Different Residents

Offering an activity is not the same as making it accessible.

A resident may want to attend a music session but be unable to reach the activity room without assistance. Another may struggle to hear discussions, read printed materials, or use the equipment provided.

Someone with chronic pain may need more comfortable seating or a shorter session. A resident who becomes fatigued easily may prefer participating for only part of an activity.

These circumstances should influence planning rather than become reasons for excluding individuals.

Accessibility may involve adapting the environment, presenting information differently, adjusting the duration of activities, or arranging appropriate assistance.

A person with visual impairment may benefit from verbal descriptions or accessible materials. Someone with hearing difficulties may need suitable communication support and reduced background noise. Residents with limited mobility may require assistance reaching an activity safely.

Where physical exercise or movement is involved, the activity should be appropriate to the person's functional abilities, health conditions, and relevant clinical recommendations.

Care workers and activity coordinators should understand when professional advice is needed, particularly when an activity involves complex mobility needs, swallowing difficulties, significant cognitive impairment, or other health-related risks.

The objective is not to make every activity suitable for every resident. It is to ensure that people with different abilities have reasonable opportunities to participate in ways that are safe, accessible, and personally meaningful.

This also requires attention to scheduling. An activity may be accessible in principle but effectively unavailable if it takes place when the resident requires personal care, usually rests, or cannot obtain assistance to attend.

An invitation offered to everyone does not necessarily give everyone an equal opportunity to participate.

Supporting Meaningful Activities for People Living With Dementia

Residents living with dementia may experience particular challenges in organized activities. Some may have difficulty understanding complex instructions, remembering schedules, or communicating preferences. Others may become distressed by unfamiliar surroundings, excessive noise, or activities that do not reflect their interests.

These challenges do not mean that meaningful participation is no longer possible.

A person may retain emotional connections to familiar music, objects, sensory experiences, relationships, and activities associated with earlier life.

Someone who previously enjoyed gardening may continue to appreciate touching leaves, smelling familiar plants, or participating in a simple gardening task, even when independent gardening is no longer feasible. Another person may enjoy looking at photographs, listening to stories, folding familiar textiles, or engaging in a brief conversation.

Activities should be adapted to the person's present abilities, preferences, and responses.

Reminiscence and familiar activities should not automatically be assumed to be beneficial or enjoyable for everyone. Certain memories may be distressing, and activities that appear meaningful to family members may not interest the resident.

Staff should pay attention to whether the person appears comfortable, interested, or engaged. Signs of distress, fatigue, discomfort, or resistance deserve consideration.

Where verbal communication is limited, suitable communication support and careful observation may help staff understand the person's preferences. Such observations should be interpreted cautiously rather than treated as definitive evidence of what the person wants.

A diagnosis of dementia does not automatically remove the person's right to participate in everyday decisions or justify forcing participation.

Nor should an activity be described as treatment for dementia or as a way to prevent cognitive decline unless there is appropriate evidence supporting that specific claim.

The aim is to preserve opportunities for enjoyment, personal agency, and connection while respecting the individual's present condition and wishes.

Respecting Cultural, Personal, and Spiritual Preferences

Cultural relevance is important in Viet Nam, where older people have diverse personal histories, family circumstances, languages, beliefs, and experiences.

Some residents may enjoy traditional music, Vietnamese literature, folk stories, calligraphy, gardening, or activities associated with familiar celebrations. Others may prefer contemporary music, technology, foreign languages, films, or interests developed through education and professional life.

Religious and spiritual practices may be meaningful to some residents but not to others.

A respectful care organization should not assume that all older Vietnamese people share the same interests or that a traditional activity is automatically meaningful simply because it reflects a familiar cultural practice.

A person's gender, place of origin, religion, or previous occupation should not be used to assign interests without considering their wishes.

Cultural celebrations can provide valuable opportunities for community participation, but residents should be free to decide whether and how they wish to take part.

Activities should also respect applicable Vietnamese law, the rights of other residents, and legitimate safety arrangements.

Cultural responsiveness is best demonstrated through individual choice rather than a standardized calendar that assumes everyone values the same traditions.

Maintaining Relationships Beyond the Residential Facility

Meaningful daily life does not end at the boundaries of a residential care facility.

Residents may wish to maintain relationships with relatives, friends, former colleagues, neighbors, and community organizations. Some may also want to continue participating in familiar cultural, educational, spiritual, or social activities outside the facility.

These connections can help preserve continuity with life before admission.

Organizations should consider how residents can maintain contact and participate in community life according to their preferences and circumstances.

Family visits, telephone calls, video conversations, community visitors, and suitable outings may all provide opportunities for connection. Technology can be useful, but it should not be assumed to replace personal contact or suit everyone.

Some older people enjoy video calls. Others find them confusing, tiring, or less satisfying than a familiar conversation in person.

Family involvement should be guided by the resident's wishes. A person may welcome frequent visits, prefer private time with selected individuals, or want to maintain relationships independently of relatives.

Where volunteers, students, community groups, or external organizations are involved, the facility should establish appropriate arrangements for supervision, conduct, safeguarding, privacy, and resident consent where relevant.

Outings require consideration of mobility, transportation, environmental conditions, necessary assistance, and other individual care needs.

Community participation can enrich residential life, but opportunities should remain safe, voluntary, and consistent with the person's preferences.

Balancing Safety With the Opportunity to Participate

Some meaningful activities involve foreseeable risks.

Gardening may involve tools or uneven surfaces. Food-related activities may involve heat and hygiene considerations. Group exercise may require physical assistance. Outings may involve transportation, unfamiliar environments, or changes in routine.

These risks deserve appropriate assessment.

However, automatically eliminating every activity involving some risk can also reduce opportunities for independence, enjoyment, and personal choice.

A person-centered approach considers what the resident wants to do, their abilities, the potential consequences, and the safeguards that could make participation reasonably safe.

Where an activity requires specialized equipment, clinical supervision, or physical assistance, suitable arrangements should be identified. Staff should not undertake tasks beyond their training, competence, or lawful authority.

Residents should not be encouraged to perform activities inconsistent with relevant clinical restrictions simply because the activities are described as beneficial for wellbeing.

Whenever possible, residents should be involved in decisions about their participation and acceptable arrangements.

If an activity cannot be undertaken safely in its original form, an adapted version may be appropriate. Someone who can no longer garden independently outdoors may still enjoy caring for plants at a comfortable height.

Adaptation should preserve the aspects of an activity that make it meaningful to the person. Replacing a valued activity with an unrelated task simply because it is easier to supervise may not achieve the intended purpose.

Safety and participation should be considered together rather than treated as opposing goals.

Protecting Privacy and Dignity During Activities

Participation should not require residents to surrender their privacy.

Residential care organizations may wish to photograph activities for websites, social media, family newsletters, or promotional materials. However, attending an event does not automatically mean that a resident has agreed to be photographed, identified, or featured publicly.

Viet Nam's Civil Code No. 91/2015/QH13, particularly Article 32 concerning the right to one's image, provides an important legal foundation for the use of identifiable photographs. The Article establishes individual rights over images and conditions governing their use, including consent requirements and specified legal exceptions.

Organizations must also consider Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Government Decree No. 356/2025/ND-CP, both effective from January 1, 2026.

Appropriate legal grounds and safeguards must be established before collecting, using, or disclosing identifiable images and other personal information. Where consent is the applicable legal basis, it should be obtained appropriately and should not be presumed simply because the resident participated in an activity.

Residents should be able to decline publicity without losing access to the activity itself.

Information about activity participation, personal preferences, health conditions, and identifiable photographs or recordings may constitute personal data. The relevant purposes, legal grounds, access arrangements, security measures, retention, and disclosure requirements should therefore be considered.

Activity records should not automatically become marketing materials.

Privacy also matters within the facility. Some people may prefer not to discuss family matters, personal memories, health experiences, or spiritual beliefs in a group. Others may enjoy sharing stories but wish to control which details remain private.

A meaningful activity should not pressure residents to disclose information or experiences they would rather keep to themselves.

Respect for dignity should shape both the activity itself and the way participation is documented and communicated.

Creating an Environment That Supports Everyday Choice

The physical environment can influence what residents are able or willing to do.

A facility may have a large communal room but few quiet spaces. Another may have attractive outdoor areas that residents cannot easily access without assistance. Some people may require suitable lighting, comfortable seating, quieter surroundings, or accessible routes to participate.

These factors deserve attention when organizing everyday life.

A homelike environment is not created through decoration alone. It also depends on whether residents can use spaces in ways that reflect their preferences and retain a reasonable degree of control over their surroundings.

This may include opportunities to sit with friends, receive visitors privately, pursue personal interests, or spend time away from organized group activities.

Residents should be involved in decisions about shared spaces where practical.

Environmental arrangements must also comply with applicable building, fire safety, accessibility, infection prevention, and other relevant requirements. Activities, furniture, or equipment should not obstruct emergency exits or compromise essential safety arrangements.

The aim is to provide spaces that people can access comfortably and use for activities they value.

A well-designed activity environment is not necessarily the largest or most elaborately equipped. Its value lies in whether residents can use it safely, comfortably, and in ways that support everyday choice.

Workforce Support and Organizational Responsibility

Meaningful daily activities are sometimes treated as the responsibility of a designated activities coordinator.

Such a role can be valuable, but residents' everyday experiences are shaped by the wider care team.

Care workers may learn about personal interests through ordinary conversations, help someone reach an activity, or support small opportunities for choice during routine assistance.

They may also recognize when an activity becomes unsuitable because of fatigue, distress, illness, or changing care needs.

These contributions do not require every employee to become a recreational specialist. They do require an understanding that residents' preferences and opportunities for engagement are relevant to care quality.

Organizations should provide appropriate preparation, supervision, staffing, and resources.

An activity calendar has limited value when residents cannot attend because no one is available to assist them. A program may appear inclusive on paper but remain inaccessible when workers lack the time, equipment, or practical support needed.

Workforce planning should therefore consider the assistance required for meaningful participation, particularly among residents with greater functional dependency.

At the same time, activities should not become additional responsibilities imposed on already overstretched staff without realistic support.

A sustainable approach incorporates opportunities for choice and participation into everyday care where appropriate and provides dedicated resources for activities requiring additional organization or expertise.

Management should consider not only whether activities have been scheduled but whether residents can actually access and enjoy them.

Learning From Residents Rather Than Counting Attendance

Activity programs are often evaluated by counting how many sessions were organized and how many residents attended.

These figures can provide useful operational information, but they do not establish whether the activities were meaningful.

A resident may attend a group session simply because staff brought them there. Another may participate enthusiastically while wishing that different activities were available. Someone who declines every scheduled group event may nevertheless enjoy a satisfying routine of reading, gardening, receiving visitors, or pursuing personal interests.

Attendance alone cannot distinguish these experiences.

Quality assessment should consider whether residents have opportunities reflecting their preferences, whether barriers to participation are addressed, and whether individuals value the experiences available to them.

Appropriate conversations, observations, and resident feedback can provide useful information. Methods should be accessible to people with different communication abilities.

Where residents have substantial cognitive impairment, observations of engagement, comfort, or distress may help inform care planning, but staff interpretations should remain cautious and individualized.

Families may offer additional insight without automatically replacing the resident's perspective.

Organizations should also consider people who rarely participate. Are they choosing not to join, or are activities difficult to access because of mobility limitations, communication barriers, unsuitable scheduling, or insufficient assistance?

These questions are more informative than treating every low participation rate as a problem belonging to the resident.

The purpose of evaluation is to determine whether meaningful opportunities are available and whether the organization responds when existing arrangements do not meet people's needs.

Measuring Wellbeing Without Turning Participation Into a Target

A practical quality improvement approach may examine how consistently residents are asked about their preferences and whether those preferences influence activity planning.

It may also consider the accessibility of activities, availability of individual options, adequacy of support, and opportunities to maintain personal interests and relationships.

Resident-reported enjoyment, sense of choice, satisfaction with daily life, and perceived opportunities to contribute can provide valuable information.

These experiences should not, however, be treated as interchangeable or reduced to a single participation score.

A person may value independence without wanting extensive social engagement. Another may enjoy frequent group activities but still feel that important personal interests are missing.

Changes in wellbeing may also be influenced by illness, functional decline, family circumstances, bereavement, or other factors unrelated to the activity program.

An increase in attendance does not automatically prove that an intervention improved quality of life. Likewise, a resident's decision to participate less does not necessarily indicate deterioration.

Where standardized quality-of-life or wellbeing instruments are used, organizations should consider whether they are appropriate for the population, language, cultural context, setting, and intended purpose.

Staff should not make clinical diagnoses based on informal activity satisfaction surveys.

A useful measurement system combines resident feedback with information about accessibility, individualized planning, and the reliability of support.

The objective is not to create participation targets that pressure people into activities. It is to learn what residents value and improve the opportunities available to them.

Viet Nam's Legal and Regulatory Context

Viet Nam's Law on Older Persons No. 39/2009/QH12, as amended, provides an important foundation for supporting participation and everyday wellbeing.

The official consolidated text, Document No. 23/VBHN-VPQH, was issued on February 26, 2026.

Article 3 recognizes older people's right to be given opportunities to participate in cultural, educational, physical, sporting, recreational, travel, and leisure activities.

Article 14 addresses the responsibilities of the State and society to create favorable conditions for older people to participate in learning, research, cultural activities, physical exercise, recreation, and travel.

The law also recognizes the importance of older people's continued contribution to society and the protection of their dignity and lawful rights.

These provisions are relevant to residential long-term care, but they do not establish a universal recreational timetable, mandatory participation rate, or prescribed number of activity sessions for every facility.

Article 9 also prohibits compelling older people to work or undertake activities contrary to law. This is particularly relevant when facilities encourage residents to participate in household or community tasks.

Voluntary participation in meaningful activities should not be confused with compulsory labor or the use of residents to replace employees.

The specific obligations of a provider depend on its legal classification, services, contractual arrangements, and other applicable laws.

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

An important regulatory change is approaching.

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

Article 6 identifies the functions and tasks that social assistance establishments may perform according to their type, services, and applicable requirements.

Clause 7 includes organizing rehabilitation activities and assisting service users with self-management, cultural, sporting, and other activities appropriate to their age and health.

Separately, Article 9 establishes general operating requirements for social assistance establishments within its applicable scope.

Clause 7 of Article 9 addresses access to cultural, sporting, physical, and recreational activities consistent with applicable Vietnamese law and appropriate to people's traditions, beliefs, religions, ages, and individual characteristics.

This distinction is relevant to residential long-term care. Article 6 addresses organizational tasks, while Article 9 establishes operating requirements for the facilities to which those provisions apply.

The Decree also distinguishes different types of social assistance establishments and provides category-specific requirements and certain exceptions. The scope of Article 9 must therefore be read together with the applicable provisions of Article 10 and the relevant appendices, rather than assumed to apply identically to every care provider.

As of November 3, 2026, Decree No. 395/2026/ND-CP has not yet taken effect. Organizations within its scope should review the requirements and prepare for implementation, but the new provisions should not be presented as already enforceable.

The Decree's provisions should also not be interpreted as requiring residents to participate in activities against their wishes or as establishing a fixed number of recreational sessions for every facility.

Organizations should consider other applicable requirements relating to healthcare, accessibility, occupational safety, food hygiene, fire safety, personal data protection, and the lawful activities they provide.

The appropriate approach is to recognize the legal importance of participation while keeping individual choice, safety, and service-specific obligations at the center of implementation.

What International Standards Can Contribute

International guidance provides useful principles for incorporating meaningful daily activities into residential care quality.

NICE Quality Standard QS50, Mental Wellbeing of Older People in Care Homes, includes a quality statement specifically addressing participation in meaningful activity.

It emphasizes offering opportunities throughout the day and involving residents in choosing and defining activities they value. The guidance recognizes spontaneous and planned activities, including everyday tasks and individual interests, rather than limiting participation to scheduled recreational sessions.

Australia's strengthened Aged Care Quality Standards, effective from November 1, 2025 for providers within their scope, provide a more recent regulatory example.

Standard 7, The Residential Community, includes Outcome 7.1 on Daily Living. It requires relevant providers to support older people in using their skills and strengths, doing the things they want to do, and maintaining quality of life within the residential community.

The Australian guidance also recognizes privacy, personal choice, cultural diversity, social connection, and the importance of balancing safety with opportunities for independence and participation.

These principles can inform care quality in Viet Nam, but the specific statutory obligations of Australia do not automatically apply to Vietnamese providers.

ISO 25557:2026, Ageing societies — Care quality for older persons at home and in care facilities, offers another international reference.

Published in March 2026, the standard provides requirements and recommendations relating to health and social care services for older people. Its scope emphasizes individual needs and preferences, self-determination, participation, safety, and inclusion.

It supports an understanding of care quality that extends beyond meeting basic physical needs.

However, ISO 25557 is not a dedicated recreational therapy guideline and does not establish a mandatory activity schedule for Vietnamese residential care facilities.

The World Health Organization's proposed Global Standards for Long-Term Care underwent public consultation between May 18 and October 30, 2026.

At the review date of this article, the consultation draft should not be presented as a finalized WHO normative standard.

International references can inform the design and evaluation of meaningful activity programs, but implementation must remain appropriate to Vietnamese law, local resources, residents' needs, and organizational capabilities.

Building Practical Opportunities in Viet Nam

Residential long-term care providers in Viet Nam vary in size, resources, staffing, physical environments, and service models.

Some facilities may have dedicated activity coordinators, accessible gardens, and extensive communal spaces. Others may operate on a smaller scale with limited facilities and a workforce primarily focused on essential daily care.

Meaningful participation does not have to depend on expensive equipment or elaborate programs.

A smaller organization can begin by asking residents about their preferences, identifying opportunities already available in daily life, and adapting activities to the people receiving care.

A resident may enjoy arranging flowers. Another may value having a quiet reading corner. Someone else may want regular opportunities to speak with friends, participate in cultural events, or spend time outdoors.

These preferences can inform practical changes that do not necessarily require extensive new infrastructure.

Organizations should also identify activities that need additional equipment, physical assistance, specialized skills, clinical advice, or external partnerships.

Where resources are limited, management should be realistic about what can be offered consistently. Promising an extensive activity program without sufficient staff or accessible facilities may create expectations that the organization cannot meet.

Meaningful activities should not replace essential personal care, create unsafe workloads, or become a means of reducing the provider's staffing responsibilities.

Partnerships with suitable community organizations, volunteers, cultural groups, or educational institutions may create additional opportunities. Such arrangements require appropriate supervision, safeguarding, privacy protection, and organizational oversight.

The aim is to develop locally appropriate opportunities that residents can genuinely choose, rather than import standardized programs disconnected from their preferences and circumstances.

From Filling Time to Supporting Everyday Wellbeing

Residential long-term care is often evaluated through services that protect residents from harm, including personal care, medication safety, nutrition, infection prevention, supervision, and access to healthcare.

These responsibilities are fundamental. However, a person's experience of residential care cannot be understood solely through the absence of adverse events or the completion of necessary care tasks.

Older people continue to have interests, memories, preferences, relationships, and the desire to make choices about their lives.

Some may seek companionship and shared activities. Others may value privacy, familiar routines, creativity, or opportunities to contribute.

High-quality care recognizes these differences.

The most meaningful activity is not necessarily the most entertaining, expensive, or popular. It may be something ordinary that allows a person to feel connected with who they have always been.

For residential long-term care organizations in Viet Nam, supporting everyday wellbeing means moving beyond the question of how many activities are offered.

It means asking whether residents have genuine choices, whether they can access opportunities that matter to them, and whether the organization is willing to adapt when existing arrangements do not work.

A facility can maintain a full activity calendar while leaving residents feeling that their time is controlled by others. It can also create meaningful experiences through relatively simple changes when those changes reflect what residents genuinely value.

Ultimately, the quality of daily life should not be judged by how busy a residential care facility appears.

It should be judged by whether older people have opportunities to spend their days in ways that preserve dignity, choice, relationships, and a continuing sense of purpose.

That is an important part of making residential long-term care not only safe, but genuinely person-centered.

Key References and Regulatory Context

National Assembly of Viet Nam. (2009). Law on Older Persons No. 39/2009/QH12, as amended. Particularly Articles 3, 9, and 14 concerning older persons' rights, prohibited conduct, and participation in cultural, educational, recreational, and physical activities.

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

National Assembly of Viet Nam. (2015). Civil Code No. 91/2015/QH13. Particularly Article 32 concerning individuals' rights to their images.

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

Government of Viet Nam. (2026). Decree No. 395/2026/ND-CP on the Operation and Management of Social Assistance Establishments. Issued October 23, 2026; scheduled to take effect December 7, 2026. Particularly Articles 6(7), 9(7), and 10 concerning organizational tasks, general requirements, and category-specific application.

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

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

National Institute for Health and Care Excellence. (2013). Mental Wellbeing of Older People in Care Homes. NICE Quality Standard QS50. Particularly Quality Statement 1: Participation in Meaningful Activity.

Australian Government Department of Health, Disability and Ageing. (2025). Strengthened Aged Care Quality Standards. Effective November 1, 2025. Particularly Standard 7, Outcome 7.1: Daily Living.

Australian Aged Care Quality and Safety Commission. Strengthened Quality Standards Guidance — Outcome 7.1: Daily Living.

Udkunta, K., Efstathiou, N., & Guo, P. (2026). Models of Care and Interventions to Improve Person-Centred Care for Older People in Long-Term Care Facilities: A Mixed Methods Systematic Review. Journal of Advanced Nursing, 82(10), 8857–8890. Published online February 15, 2026. DOI: 10.1111/jan.70527.

Habibian, S., Huang, G., Wabe, N., Westbrook, J. I., & Nguyen, A. D. (2026). The Impact of Social Participation Interventions on Quality of Life of Older Adults in Residential Aged Care Facilities: A Systematic Review. Journal of Clinical Nursing. Published online August 4, 2026. DOI: 10.1111/jocn.70483.

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

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

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

About Healthy Longevity Vietnam

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

Disclaimer

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

Meaningful daily activities should be offered according to residents' preferences, abilities, health conditions, communication needs, and applicable legal and organizational requirements. Participation should be voluntary, and a resident's decision not to take part in a particular activity should be respected.

Older people must not be compelled to work or undertake unlawful activities. Activities involving physical exertion, equipment, food preparation, community outings, or other potential hazards may require individualized risk assessment, appropriate supervision, and qualified professional advice.

Dementia, physical disability, frailty, or communication difficulties do not automatically remove a person's right to participate in decisions about daily life or justify unnecessary restrictions.

The research discussed in this article concerns person-centered care and selected participation interventions. It does not establish that every activity improves wellbeing, prevents cognitive decline, treats depression, or produces equivalent outcomes for all residents.

Personal information associated with activities, including identifiable photographs, recordings, preferences, participation records, and health-related information, must be processed in accordance with applicable Vietnamese law and appropriate privacy safeguards.

Providers' obligations depend on their legal status, authorized services, resident population, contractual arrangements, and the relevant Vietnamese laws and regulations.

Government Decree No. 395/2026/ND-CP was issued on October 23, 2026, and is scheduled to take effect on December 7, 2026. Its provisions must not be treated as already effective on the review date or as imposing identical activity requirements on every residential care provider in Viet Nam.

International research, standards, and foreign regulatory examples are presented for educational and comparative purposes. They do not automatically establish mandatory activity schedules, staffing levels, clinical interventions, participation targets, or legal obligations for Vietnamese organizations.

Residential long-term care providers should develop locally appropriate activity and participation arrangements with input from residents, qualified care professionals, families where appropriate, and relevant advisers when specialized safety or clinical considerations arise.

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