Abstract: This article analyzes the legal framework governing investment and healthcare for the elderly in Vietnam amid a rapidly aging population. The nation has established a foundational legal corridor to promote socialization, thereby fostering a market for care services and steering development towards a “silver economy”. However, a significant gap persists between policy and implementation, manifested in three primary bottlenecks: (1) Investment incentives are difficult to access due to land-related administrative hurdles and high capital requirements; (2) The absence of national standards has led to unregulated market development and quality control risks; and (3) The geriatrics sector faces a human resources crisis, stemming from a lack of formal training programs and inadequate remuneration policies.
To address these challenges, this paper proposes five integrated solutions. The focus is on refining the institutional framework by promulgating national standards and amending the Law on the Elderly. Concurrently, it is crucial to create substantive investment incentives, standardize professional workforce training, and establish sustainable financial models, such as piloting a long-term care insurance scheme. Finally, advancing the application of technology and leveraging public communication are essential to shift societal perceptions.
Keywords: Population Aging, Elderly, Silver Economy, Legal, Socialization
Viet Nam is facing major changes in its population structure, as the speed of population aging is increasing rapidly and has become an increasingly prominent phenomenon in modern society. The growing proportion of the elderly not only creates pressure and new challenges for the social security system but also raises urgent requirements for the development of specialized health care services for this population group. As traditional family caregiving practices gradually decline, centralized care models, community-based care, as well as services supporting health, mental well-being, and daily living of the elderly are becoming increasingly essential. To adapt to this trend, the State has been focusing on improving the legal framework, preferential investment policies, and promotion of socialization in order to expand and enhance the quality of the service market for the elderly. However, in practice, there remain many legal gaps, inconsistent enforcement mechanisms, and policies that are not sufficiently attractive or appropriate to the increasingly diverse and sophisticated needs of the elderly in the context of modern life. Recognizing this situation, the article focuses on analyzing and assessing the current legal framework related to investment and health care services for the elderly in Viet Nam; thereby proposing specific solutions and recommendations to improve the legal institutions and develop an effective and sustainable service market for the elderly – a sector rich in potential and humanitarian significance in the context of increasingly profound population aging in our country today.
The development and diversification of the specialized health care service market for the elderly has become a key factor in ensuring healthy and safe living conditions for this population group. To meet these practical needs, the legal framework and policies promoting investment and socialization of health care services for the elderly must be built, improved, and effectively implemented. In recent years, Viet Nam has gradually improved its legal system relating to the elderly with a number of legal documents such as the Law on the Elderly 2009; the Law on Medical Examination and Treatment 2023; the Law on Health Insurance 2008, as amended and supplemented in 2014 and 2024; and many guiding documents. However, implementation shows that there remain numerous inadequacies in preferential investment policies, standardization of service quality, linkage within the care network, as well as shortages in geriatric human resources.[1]
Viet Nam officially entered the aging population stage in 2011. During the 2009–2019 period, the elderly population increased from 7.45 million to 11.41 million, equivalent to a rise from 8.68% to 11.86% of the total population. Population projections to 2069 under the assumption of a medium fertility level indicate that the number of the elderly will reach 17.28 million (accounting for 16.5% of the total population) in 2029; 22.29 million (20.21%) in 2038; 28.61 million (24.88%) in 2049; and 31.69 million (27.11%) in 2069. The increase in the elderly population is mainly due to the growth of the middle-old and oldest-old groups.[2] Population aging not only raises issues concerning social security financing but also generates new demands for health care services, rehabilitation, home care, and social services for the elderly.[3]
The rapid speed of population aging in Viet Nam presents a major challenge, requiring the formulation of effective policies based on accurate identification of the specific characteristics and needs of the elderly in the country. Unlike developed countries, Viet Nam’s particular economic and cultural context has shaped distinct characteristics and needs of the elderly as follows:
First, the elderly in Viet Nam face the paradox of “aging before becoming wealthy”, with a weak financial foundation, incomplete social security coverage, and incomes largely dependent on their children.[4] At the same time, the decline of multi-generational family structures has increased the proportion of elderly people living alone.
Second, the elderly are burdened with a double disease load, consisting of age-related chronic illnesses and long-term consequences of earlier health conditions. This creates multilayered demands for health care, particularly specialized services and home-based care, which remain significantly lacking.[5]
Third, the elderly have a strong need for social connection and a sense of usefulness in order to overcome loneliness.[6] They require spaces for interaction and opportunities to be heard and contribute their experience, thereby maintaining life purpose.
Fourth, the elderly need a safe and friendly living environment, from renovating homes to prevent falls to ensuring accessibility in public spaces (sidewalks, buses).[7] Safety also includes protection from fraud and easy access to information.
Fifth, the needs of the elderly for learning, recreation, and personal development are increasing. They wish to learn new skills such as digital technology and soft skills, and to participate in cultural and tourism activities to enrich their mental life, maintain their health, and integrate into society.
The rapid increase in the elderly population, together with their diverse characteristics and needs, is opening up an entirely new economic development opportunity in Viet Nam, which the European Union (EU) refers to as the “silver economy”. According to the EU, this economy is “the sum of all economic activities serving the needs of people aged 50 and over, including the products and services they purchase directly, as well as other economic activities driven by such expenditures”.[8] Accordingly, the “silver economy” encompasses all economic activities that serve and are driven by the population aged 50 or 60 years and above. Instead of viewing the elderly as a burden, the silver economy recognizes them as a large customer group and a strategic market.
In Viet Nam, based on the current situation of population aging and the specific needs of the elderly mentioned above, the potential of the silver economy is immense. Within this, the field of investment and health care is identified as the core segment, with the highest and most urgent potential. It is also considered the “backbone” of the silver economy, as it directly and simultaneously addresses the two greatest challenges currently faced by the elderly in Viet Nam: declining health and insufficient financial security.
The focus is an investment and health care ecosystem that responds to the characteristics of the “double disease load” and “aging before becoming wealthy” among the elderly in Viet Nam, thereby creating enormous and urgent demand for integrated medical and care business models. This represents a “blue ocean” for investors, including:
First, specialized medical and elderly care infrastructure
The potential is not limited to traditional geriatric hospitals. The market is strongly demanding new‐generation nursing homes combined with high-end wellness services; rehabilitation centers for post-stroke or post-surgery recovery; and networks of clinics and daytime care centers dedicated to the elderly. These models not only provide medical services but also serve as social spaces that meet the demand for interaction and connection.
Second, home healthcare services
Given the strong cultural preference for family attachment, the market for home healthcare services is extremely promising. Enterprises may invest in technology platforms that connect doctors, nurses, physiotherapists, and professional caregivers directly with clients in their own homes. This represents a flexible investment model with lower costs compared to developing fixed physical infrastructure.
Third, health-tech and smart medical devices
The growing need for continuous health monitoring creates opportunities for technological products such as smartwatches that measure heart rate and blood pressure; home-based fall detection systems; and mobile applications that remind users to take medication and connect with doctors online. This is a sector that attracts venture capital and demonstrates rapid development.
Fourth, pharmaceuticals, nutrition, and functional foods
This is a broad consumer market. Investment in research and development of pharmaceutical products and functional foods specifically targeting chronic diseases among the elderly (cardiovascular diseases, diabetes, musculoskeletal conditions) will generate sustainable revenue.
At the same time, other sectors such as finance, real estate, and tourism will act as satellite ecosystems, supporting and benefiting from the development of the core health-care segment. For example, health insurance products will be designed to cover nursing care services; real estate will develop “retirement villages” with integrated medical centers.
In summary, in the context of population aging in Viet Nam, the silver economy is synonymous with building a comprehensive health-care industry for the elderly. Concentrating investment resources in infrastructure, services, and medical technology is not only a smart business decision but also carries profound social significance, directly improving the quality of life for millions of people and creating a sustainable economic growth driver for the country.
The viewpoints of the Communist Party of Viet Nam on the elderly are consistent, coherent, and imbued with profound humanitarian values, considering the elderly as “the valuable asset of the nation, an important component of endogenous resources, and the nucleus for social stability and development.” These viewpoints are increasingly translated into strategic actions, including shaping and developing the Silver Economy and the investment and healthcare sectors. This is specified as follows:
First, affirming and promoting the role of the elderly, shifting the strategic focus from “care” to “care and empowerment”.
The Party’s viewpoint reflects a strategic shift, moving beyond the approach of solely providing care and social protection toward a more comprehensive perspective: ensuring proper care while fully promoting the role, experience, and knowledge of the elderly. This shift is consistently expressed from macro-level orientations to specific strategies. The Documents of the 13th National Party Congress identified the task to “Adapt to the ageing population process, strengthen healthcare for the elderly”,[9] creating a foundation for promoting their role. To operationalize this viewpoint, the National Strategy for the Elderly emphasizes: “Maximizing the potential, role, experience, and knowledge of the elderly... is an important task of the entire political system and the whole society.” Accordingly, the guiding viewpoint has been institutionalized into concrete actions, considering the elderly not only as beneficiaries of social welfare but also as a valuable resource for development.
Second, developing a multi-tier and flexible social security system as the cornerstone to adapt to the ageing population process.
The Party identifies responding to population ageing as a strategic mission, and the core foundation to undertake this mission is building an inclusive and sustainable social security system. To implement this orientation, Resolution No. 28-NQ/TW on social insurance policy reform sets the goal of “moving toward universal social insurance”. This is a strategic step to ensure income security for the elderly through pensions or allowances, minimizing the risks of poverty and dependence on children.[10]
To realize this goal, the overarching direction is to establish a “multi-tier social security system”. This model combines the State’s primary role through pensions and health insurance with market participation through commercial pension insurance and the shared responsibility of communities and families. Accordingly, the Party’s strategy is to proactively build a robust, multi-layered “safety net”, not only ensuring welfare for the elderly but also strengthening social stability amid rapid population ageing.
Third, the Party advocates promoting socialization to develop the system of elderly care services, thereby paving the way for the growth of the "silver economy".
Although the term “silver economy”[11] has not been widely mentioned in official documents, the strategic orientation for its development has been clearly demonstrated through the Party’s policy of socializing public services. Specifically, the Party advocates mobilizing all societal resources, particularly the private sector, to participate in providing services for the elderly, a viewpoint that has been institutionalized in the Law on the Elderly and related legal documents.
This orientation is translated into actions as the National Strategy for the Elderly sets the goal of developing a diverse network of care facilities, ranging from home-based care to long-term care. This serves as the foundational step in creating the “supply side” for a vibrant service market. Under this model, the State assumes the role of enabler: developing the legal framework, issuing standards, and creating a favorable business environment, rather than directly providing all services.[12]
Accordingly, the Party’s strategic perspective on developing the Silver Economy is explicit: it is regarded as a dual-solution approach, simultaneously addressing the challenges of population ageing effectively while generating a new driver for economic growth. By promoting socialization, the State not only reduces the fiscal burden but also facilitates the emergence of a professional service industry that meets the increasing needs of the elderly and their families.
Viet Nam has made significant progress in establishing a solid legal framework that affirms the rights of the elderly and encourages the participation of society, particularly the private sector. This framework is not only aligned with international commitments (such as the United Nations Convention on the Rights of Older Persons) but also contributes to raising public awareness of population ageing. The key legal documents include:
First, the Constitution 2013: Clause 3, Article 37 of the Constitution 2013 affirms the responsibility of the State, family, and society to respect, care for, and promote the role of the elderly, thereby serving as the highest legal basis for all relevant policies. This has facilitated the mainstreaming of elderly care into national development agendas, such as the Population Strategy by 2030.
Second, the Law on the Elderly 2009: As the first sector-specific legislation regulating the rights of the elderly, this Law stipulates their entitlement to prioritized healthcare, social assistance, and participation in community activities. It also encourages socialization by providing support for entities investing in elderly care services, with priority given to elderly persons who are poor, living alone, or residing in rural areas.
Third, the Law on Medical Examination and Treatment 2023: The Law further reinforces the elderly’s entitlement to prioritized healthcare and treatment, and provides a legal basis for the development of long-term care, home-based care, and geriatric services.
Fourth, the Law on Investment 2020 and Decree No. 31/2021/ND-CP dated 26 March 2021: Elderly care services are classified as an incentivized investment sector (Appendix II, Decree No. 31/2021/ND-CP), with incentives such as corporate income tax reduction or exemption (for up to 10 years), land-use incentives, and preferential credit. These incentives aim to attract foreign and private investment into nursing homes and specialized healthcare establishments serving the elderly.
Fifth, Decision No. 383/QD-TTg dated 21 February 2025 of the Prime Minister approving the National Strategy on the Elderly to 2035, with a vision to 2045 reflects the viewpoint that the elderly are an important national resource whose potential, experience, and knowledge must be fully utilized. The Strategy’s overarching objective is to develop a comprehensive policy system ensuring that the elderly are provided with material and spiritual care and access to essential social services such as healthcare, assistance, and rehabilitation, with particular priority given to those in difficult circumstances. The Strategy sets out specific targets for each implementation phase. For the period 2025–2030, it focuses on ensuring that at least 50 percent of the elderly with labour demand will have employment opportunities, supporting 100,000 elderly persons in vocational training, and providing preferential loans for 100,000 households with elderly members to expand livelihood activities. By 2030, the Strategy aims to ensure that 100 percent of the elderly do not live in temporary or dilapidated housing, and at least 80 percent of the elderly who are financially disadvantaged or victims of abuse receive legal aid. For the subsequent period 2031–2035, these targets will be heightened, with the goal that at least 70 percent of the elderly with labour demand are employed. To achieve these targets, the Strategy sets out key tasks and solutions, including: completing policies to encourage labour participation among the elderly; improving the healthcare and long-term care system; and strengthening communication to raise social awareness and support the elderly’s access to information technology.[13]
The above-mentioned legal framework has generated positive and measurable impacts in practice, demonstrated through the following three main aspects:
First, enhancing social awareness and changing perceptions
The provisions of the Constitution and the Law on the Elderly 2009, together with annual communication campaigns such as “Action Month for the Elderly” held every October, have fundamentally contributed to shifting social perceptions. Public views on the elderly have gradually moved away from imagining them as dependents or a “burden” towards recognizing them as a valuable “social resource” rich in experience and knowledge, consistent with the spirit of the National Strategy for the Elderly.[14]
Second, promoting the initial formation of the service market
Investment incentives under the Law on Investment 2020 have begun to take effect. They have become an important catalyst encouraging major enterprises and pioneering investors to inject capital into this sector.
- Regarding centralized care facilities
The policy of socialization has generated significant momentum for the development of care institutions. According to statistics, by the end of 2021, Viet Nam had 425 social assistance facilities providing care for the elderly, including 195 public facilities and 230 non-public ones.[15] This number clearly reflects the growing role of the private sector in service provision. Their participation has led to the emergence of high-quality nursing home models, offering more diverse options for the public.[16]
- Regarding specialized medical care
Provisions under the Law on Medical Examination and Treatment 2023 have driven action across both the public and private healthcare systems. Many central and provincial hospitals, such as Bach Mai Hospital, the National Geriatric Hospital, and Cho Ray Hospital, have established and expanded specialized geriatric departments, applying modern diagnostic and treatment techniques to serve tens of thousands of elderly patients each year.
Third, mobilizing resources and reducing the burden on the public system
By identifying elderly care as an investment-incentivized sector, the policy has created strong “pull factors” that encourage enterprises and social organizations to allocate capital to the construction of nursing homes, day-care centers, and the development of home-based support services.[17] Such participation not only provides diverse and high-quality service models that meet the rapidly growing demand of society, but also directly shares the fiscal burden on the State budget and the public social security system, which is facing multiple pressures. Instead of entirely subsidizing care, the State can now concentrate its resources on policy facilitation, inspection and supervision, as well as supporting vulnerable elderly groups in particularly difficult circumstances, thereby contributing to a more comprehensive and sustainable care structure.
In summary, the legal framework has succeeded in establishing the necessary “foundation” to unlock initial investment flows and shape an emerging market for elderly care services. However, these achievements remain only an early stage, and the market scale is still modest compared to the actual needs of a rapidly ageing society.
Despite a relatively comprehensive legal framework institutionalizing the socialization orientation, practical implementation has revealed considerable shortcomings and inconsistencies. The discrepancy between policy design and implementation capacity has resulted in a major bottleneck, limiting the effectiveness of investment attraction and leaving service supply unable to meet the care demands of millions of the elderly. Three core constraints explain this situation:
First, investment incentives exist “on paper” but remain difficult to access and lack real attractiveness.
In theory, elderly care projects fall under the highest incentive category for land and credit support under the Law on Investment 2020 and Decree No. 31/2021/NĐ-CP. However, in practice, investors face multiple barriers. The most prominent and widespread challenge lies in access to land and land clearance, which is complex and time-consuming in many localities. Meanwhile, current incentives remain insufficiently attractive when compared with the high capital requirements and long payback periods of elderly care projects. For reference, developing a high-quality nursing home typically requires investment of several hundred billion VND, with a payback period of 10–15 years.[18] This mismatch discourages private investors. As a result, only a few hundred non-state facilities nationwide have been established, most of them small-scale and concentrated in major cities.
Second, the absence of national standards has led to market fragmentation and quality risks.
This is one of the most significant legal gaps directly affecting service quality. Viet Nam has not yet promulgated a national technical standard (TCVN) for elderly care facilities. The lack of unified standards for infrastructure, care procedures, nutritional norms, or staff-to-resident ratios makes it difficult for both regulators and enterprises. According to the United Nations Population Fund (UNFPA) in Viet Nam, this regulatory gap is a key cause of uneven quality and potential health and safety risks for the elderly.[19] Without standards as the basis for supervision, the market is vulnerable to disorder, eroding public trust and deterring serious, long-term investors. Để thấy rõ sự khác biệt, có thể nhìn vào mô hình của các quốc gia đi trước: A comparison with countries that have developed elderly care systems highlights this contrast. In Japan, the Long-Term Care Insurance system (Kaigo Hoken), implemented since 2000, enforces detailed service standards, covering staff qualifications, the scope of services, and a seven-level care needs assessment scheme for tailored service provision.[19] In Germany, residential care quality is stringently monitored through a transparent inspection and rating system administered by the Medical Advisory Service (MDK). Evaluation criteria are publicly disclosed, covering 64 quality indicators across medical care, daily living assistance, social care, and user satisfaction, thereby creating a trusted reference for consumers.[20]
Third, a human resources crisis in caregiving: insufficient in quantity and weak in quality
While the quality of the workforce is a decisive factor determining the success of services, it remains the critical weakness of the elderly care sector in Viet Nam. Although training codes for elderly care have been officially issued for qualification levels ranging from elementary, intermediate to college, actual implementation and training scale remain very limited and have not kept pace with the rapidly ageing population. The bottleneck lies in the fact that the number of students enrolling in this field is still very low, due to limited social recognition of the profession and the absence of a clear career development pathway. As a result, the workforce in existing nursing homes currently faces two major issues:
First, a shortage of professionally trained personnel
The majority of care workers are still unskilled laborers or only attend short-term, on-the-job training courses. The number of personnel graduating from formal training programmes is too small to meet market demand.[21]
Second, insufficient specialized competencies
Even where training exists, the standardized curriculum is sometimes not sufficiently in-depth.[22] Overall, the care workforce lacks critical professional skills, such as specialized medical care for chronic conditions, post-stroke rehabilitation techniques, and especially competencies in mental health care (communication with persons with depression, crisis intervention, and support for elderly persons with Alzheimer’s disease).
This dual shortage makes it difficult for elderly care services in Viet Nam, despite their potential, to improve quality and grow in line with international standards.
In addition, the high‐pressure working environment, combined with low wages and limited social recognition, makes it extremely difficult for the sector to attract and retain workers. This “human resources crisis” not only reduces the quality of care but also runs counter to the goal of relieving the burden on families in the context of a rapidly ageing population.
Meanwhile, developed countries have long considered the professionalization of the workforce as a top priority, with a clearly legislated training and certification pathway. For example, in Germany, the elderly care profession (Altenpfleger) is regulated under the Professional Nursing Training Act (PflBG). It is a formal profession within the renowned dual vocational education system. Trainees must undergo a three-year training programme, combining intensive theoretical study at school (2,100 hours) and paid practical training at medical facilities and nursing homes (2,500 hours), ensuring comprehensive professional competencies upon graduation.[23] Similarly, in Japan, to become a nationally certified care worker (Kaigo Fukushishi), candidates must pass a rigorous national examination administered by the Government. To be eligible for the examination, applicants must satisfy strict qualification requirements,[24] most commonly graduation from designated specialized training institutions or at least three years of practical work experience combined with completion of a practical training course. The Japanese Government also provides multiple financial support programmes and tuition loans to encourage enrollment in this field.[25] These models demonstrate that investing in a formal, State-recognized and legally institutionalized training pathway not only enhances the professional skills of care workers but also elevates the social status of the caregiving profession, thereby addressing the root causes of the human resources crisis.
Fourth, barriers to credit access
This is one of the greatest paradoxes and also the most profound barrier hindering the potential of the silver economy in Viet Nam: the elderly appear to be excluded from the formal credit system. Despite possessing substantial accumulated assets, especially real estate, the elderly are almost unable to access bank loans. Traditional financial institutions usually assess risks based on income streams from salaries or business activities, which are typically no longer available to the elderly. This has created an invisible “wall” that prevents them from converting their “static” assets into “dynamic” financial resources. The direct consequence of this barrier is that the elderly, even when owning assets, still fall into a state of cash shortage to pay for essential needs, particularly rising healthcare costs. They are unable to use their own homes as collateral to obtain loans for a surgery, to pay for home-care services, or to enter high-quality nursing homes. The financial burden is thus shifted to their children or relies on the limited support of social security, placing heavy pressure on both families and the public system.
From a broader perspective, this credit barrier is a bottleneck that slows down the development of the entire silver economy. When the largest target customer group – the elderly – cannot afford to pay, businesses will not be confident in investing in geriatric hospitals, nursing homes, or professional care service chains. The market cannot be formed when “demand” is real but lacks purchasing power. The vicious cycle continues: the elderly lack access to quality services because they lack financial resources, and enterprises do not provide services because they cannot foresee revenue streams. Therefore, the inability to access credit is not merely a personal financial issue of the elderly, but rather a systemic obstacle preventing the potential of a “silver economy” from being unlocked.
First, formulate and promulgate a National Technical Standard (TCVN). This is a prerequisite task to address the situation of a “chaotic market” and to create a clear “rule of the game”. This standard must specify detailed requirements concerning facilities, care procedures, nutrition, and human resources for each type of service, aligned with the practical conditions of Viet Nam and with reference to developed countries. With standards in place, regulatory authorities will have a legal basis for licensing and supervision, while the public and enterprises will have a foundation for implementation and selection.
Second, amend and supplement the Law on the Elderly 2009. The current Law has revealed multiple limitations after a long period of implementation. Amendments are needed to establish a legal framework for modern care models such as end-of-life care, intergenerational housing, and retirement communities, and to create favorable conditions enabling the elderly to access financial resources to develop business activities and support entrepreneurship, thereby promoting the development of the “silver economy”.
First, design distinctive and superior investment incentive packages. Instead of generic incentives, a dedicated policy package should be formulated for this sector with substantive incentives such as: maximum exemption or reduction of land rental fees, application of a 0% corporate income tax rate in the initial phase, and establishment of preferential credit funds with low interest rates.
Second, reform administrative procedures toward a “one-stop” mechanism. It is necessary to establish a “single-window, interconnected” mechanism specifically for projects providing care for the elderly to definitively address the situation of complex and prolonged procedures, particularly in land access and construction, which remain the greatest barriers discouraging investors.
To address the human resource issues as identified above, it is essential to shift from merely providing basic training to establishing a comprehensive and attractive career ecosystem for the elderly care sector.
First, expanding the scale and improve the quality of training based on the existing framework. Formal training codes for elderly care workers have already been issued. The current challenge lies in implementation. Accordingly:
- Regarding scale: The State should adopt strong incentive policies (such as tuition support and ordered training schemes) to attract students to enroll in colleges and vocational schools. At the same time, communication efforts should be strengthened to change societal perceptions, affirming that this is a professional career that delivers real value.
- Regarding quality: Training programs should be regularly reviewed and updated in line with international standards, particularly by deepening modules on chronic disease care, rehabilitation, geriatric nutrition, and most importantly, psychology of the elderly. Practical training hours at nursing homes and hospitals should be increased to ensure that graduates are able to work immediately.
Second, establishing a clear career pathway and appropriate remuneration policies. Training is only the first step; retaining qualified personnel is the decisive factor. Accordingly:
- Developing a promotion pathway: It is necessary to establish a competency framework and a clear career pathway. Care workers must be able to see their development trajectory from a basic caregiver to higher positions such as specialized care practitioner (in Alzheimer’s care, rehabilitation), supervisor, or facility manager.
- Improving remuneration policies: There should be regulatory policies governing minimum wage levels, hazardous allowances, and job-specific allowances in this sector to ensure that workers’ income is commensurate with the effort and pressure they face. This is a fundamental solution to transform caregiving into a genuine “profession” with attractiveness and the capacity to retain high-quality workers, rather than merely a temporary job.
First, urgently study and pilot a Long-term Care Insurance model. The State needs to immediately initiate research, formulation of a scheme, and pilot implementation of this model in localities with rapid population ageing. This is the most fundamental and sustainable solution to secure financial resources for care services in the future.
Second, diversify voluntary retirement products. The State should create an enabling regulatory environment that encourages insurance companies and investment funds to develop flexible voluntary retirement products linked to elderly care services, thereby offering an additional safe channel for financial accumulation.
Third, remove credit access barriers for the elderly. Policy changes are required in the credit practices of commercial banks, which often classify the elderly as high-risk customers due to the absence of salary-based income. A legal framework should be established to develop and mainstream appropriate financial products such as reverse mortgages, which have been widely adopted in developed countries like the United States, Japan and the United Kingdom.[26] Under this product, the bank or financial institution pays the elderly homeowner on a monthly basis. The elderly are not required to make any payment. Instead, the debt amount, including the received payments and accumulated interest, increases over time, while the net equity value of the home decreases accordingly. This solution helps “liquify” accumulated assets and convert them into cash flow directly serving consumption and healthcare needs.
First, organize national communication campaigns to change social perceptions. It is necessary to emphasize that the use of professional care services is a civilized option, demonstrating care and ensuring the best quality of life for family members, rather than being considered an act of “filial impiety” or “abandonment” of parents.
Second, promote the Age-tech ecosystem (Technology for the elderly). The Government should adopt policies to support and encourage enterprises and start-ups to develop technological solutions such as smart health monitoring devices, fall detection systems, and platforms connecting caregivers, thereby effectively supporting home-based and facility-based care.
Population aging is a reality that is occurring and posing significant challenges to Viet Nam’s social security system and development model. The above analysis indicates that the Communist Party and the State of Viet Nam have early recognized the strategic importance of this issue and have formulated sound and progressive guiding viewpoints, reflected in three main pillars: considering adaptation to population ageing as a strategic task; building a multi-tiered social security system as the cornerstone; and promoting socialization to pave the way for the development of the “silver economy”. On that basis, a foundational legal framework has been established, from the Constitution to sectoral laws such as the Law on the Elderly and the Law on Medical Examination and Treatment, creating an initial legal corridor for care and promotion of the role of the elderly, while encouraging the participation of the private sector.
However, there exists a substantial gap between the Party’s orientations, legal regulations, and practical implementation capacity. Implementation has revealed inherent “bottlenecks” constraining the development of the elderly care services market. These include investment incentive policies that remain insufficiently attractive and difficult to access; the absence of a national set of quality standards; a human resources crisis in both quantity and quality; along with a legal vacuum concerning sustainable financial models such as long-term care insurance. To address these challenges and materialize the Party’s orientations, a strong transformation is required, from mindset to action. The recommended groups of solutions must be implemented in a synchronous and decisive manner, focusing on: (1) urgently improving the legal framework and promulgating service standards; (2) creating substantive and breakthrough investment incentive mechanisms; (3) formulating a national strategy for developing the care workforce; (4) piloting and scaling up sustainable financial models; and (5) strengthening communication to transform social perceptions.
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16.Quang Vinh, Policies Needed to Create a Breakthrough for Elderly Care Real Estate Development, Numbers and Events Magazine, https://consosukien.vn/can-co-chinh-sach-tao-cu-hich-de-phat-trien-bat-dong-san-duong-lao.htm (Sept. 28, 2024).
17.M. Iwagami & N. Tamiya, The Long-Term Care Insurance System in Japan: Past, Present, and Future, JMA J., 2(1), 67–69 (2019).
18.H. Rothgang, Social Insurance for Long-Term Care: An Evaluation of the German Model, Soc. Pol’y & Admin., 44(4), 436–460 (2010).
19.Mai Hoa, Professionalizing Elderly Healthcare, General Office for Population – Ministry of Health, https://vnpa.moh.gov.vn/tin-tong-hop/chuyen-nghiep-hoa-cham-soc-suc-khoe-nguoi-cao-tuoi (accessed Aug. 11, 2025).
20.Mehdi, Z., & Nasser, R. N., German Nurse and Healthcare Workers Staffing: Their Professional Education and Training Outcomes, Int’l J. Health Sci., 6(S5), 596–613 (year not provided).
21.P. S. Raikhola & Y. Kuroki, Aging and Elderly Care Practice in Japan: Main Issues, Policy and Program Perspective; What Lessons Can Be Learned from Japanese Experiences?, Dhaulagiri J. Soc. Anth., 3, 41–82 (2009).
22.N. Nakamura & A. Suzuki, Occupational Credentials and Migrants’ Return Aspiration: Evidence from the Foreign Elderly Care Workers in Japan (2024) (publication outlet not provided).
23.Prime Minister, Decision No. 383/QD-TTg of 2025 Approving the National Strategy on the Elderly to 2035, with Vision to 2045 (2025).
24.Pham Thi Thanh Tra, Improving the Quality of the Healthcare Workforce for the Elderly in the Context of the Silver Economy, (Oct. 20, 2025), https://www.tapchicongsan.org.vn/web/guest/kinh-te/-/2018/1154603/nang-cao-chat-luong-nguon-nhan-luc-cham-soc-suc-khoe-nguoi-cao-tuoi-trong-boi-canh-nen-kinh-te-bac.aspx
25.Thuy Linh, Severe Shortage of Geriatric Healthcare Workforce, (Oct. 7, 2024), https://laodong.vn/y-te/thieu-tram-trong-nhan-luc-nganh-lao-khoa-1404277.ldo.
26.Marcela Ponce & Jose Felix Etchegoyen, Silver Opportunity: Financial Innovation for an Aging Population in Latin America, (Jul. 30, 2025), https://blogs.worldbank.org/en/latinamerica/financial-innovation-aging-population-latin-america.
27. Rocío Martínez-Lacoba, Isabel Pardo-García & Francisco Escribano-Sotos, The Reverse Mortgage: A Tool for Funding Long-Term Care and Increasing Public Housing Supply in Spain, 36 J. Hous. & Built Env’t 367 (2021).
* Dr., Head of the Department of Economic Law, Intracom University; Email: luannguyenthanh@ecopark.edu.vn; Tel.: 0869.908.238; accepted for publication on November 28, 2025.
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[2] U. V. Nam & N. M. Duc, Population Ageing and Older Persons in Viet Nam (General Statistics Office 2021).
[3] Minh, N. H., Elderly Care in Vietnam and Some Policy Issues, Vietnamese Journal of Sociology, No. 3 (143), pp. 42–54 (2018).
[4] Nguyen, A. T., Population Ageing and Social Security for Older Persons in Vietnam, VNU Journal of Social Sciences and Humanities, 1(1), pp. 46–53 (2015).
[5] Trang, N. T. T., Dat, Q. T., Giang, N. T. B., & Sinh, N. H., Home Healthcare Needs Among Older Adults with Chronic Diseases, Vietnam Medical Journal, 529(1B) (2023).
[6] Nghia, B., Family Responses to Older Persons: International Experiences and Vietnamese Evidence, Ho Chi Minh City Open University Journal of Social Sciences, 11(1), pp. 3–9 (2016).
[7] Huong, L. D. T. et al., Elderly Satisfaction with Bus Services under Free-Fare Policy, Journal of Transport Science, 76(3), pp. 198–212 (2025).
[8] Marcela Ponce & Jose Felix Etchegoyen, Silver Opportunity: Financial Innovation for an Aging Population in Latin America, (Jul. 30, 2025), https://blogs.worldbank.org/en/latinamerica/financial-innovation-aging-population-latin-america.
[9] Communist Party of Viet Nam, Documents of the 13th National Party Congress – Vol. 1 (National Political Publishing House – Truth 2021).
[10] 12th Central Committee, Resolution No. 28-NQ/TW on Social Insurance Reform (2018), https://baochinhphu.vn/toan-van-nghi-quyet-so-28-nq-tw-ve-cai-cach-chinh-sach-bao-hiem-xa-hoi-102239258.htm.
[11] M. Zsarnoczky, Innovation Challenges of the Silver Economy, VADYBA, 28(1), 105–109 (2016).
[12] Prime Minister, Decision No. 383/QD-TTg (2025) Approving the National Strategy on the Elderly to 2035, Vision to 2045 (2025).
[13] Prime Minister, Decision No. 383/QD-TTg (2025) Approving the National Strategy on the Elderly to 2035, Vision to 2045 (2025).
[14] Do Hong Thanh, Older Persons as a Key Force in National Development, Tuyen Quang Provincial Party Committee Portal (Sept. 30, 2024)., https://tuyenquang.dcs.vn/DetailView/147981/2/Nguoi-cao-tuoi-la-luc-luong-quan-trong-tham-gia-tich-cuc-vao--%C2%A0xay-dung-va-phat-trien-cua-dat-nuoc.html.
[15] Minh Hoang, Tung Duy, Thanh Phuong & Ha Thu, Improving Quality of Life for the Elderly, Nhan Dan Newspaper, https://special.nhandan.vn/cai-thien-chat-luong-song-cho-nguoi-cao-tuoi/index.html (Dec. 10, 2023).
[16] Anh Tuyet, Nursing Homes with Medical Care: An Effective Model, Voice of Viet Nam (VOV2), https://vov2.vov.vn/suc-khoe/nha-duong-lao-co-cham-soc-y-te-mo-hinh-hieu-qua-trong-cham-soc-nguoi-cao-tuoi-48519.vov2 (May 26, 2024).
[17] Minh Ngo & Le Lanh, Tam An Elderly Care Center in Ho Chi Minh City: A Socialized Care Model, Ngay Moi Online Magazine, https://ngaymoionline.com.vn/mo-hinh-xa-hoi-hoa-cham-soc-nguoi-cao-tuoi-54522.html (Jan. 29, 2025).
[18] Quang Vinh, Policies Needed to Boost Elderly Care Real Estate, Con So va Su Kien Magazine, https://consosukien.vn/can-co-chinh-sach-tao-cu-hich-de-phat-trien-bat-dong-san-duong-lao.htm (Sept. 28, 2024).
[19] M. Iwagami & N. Tamiya, The Long-Term Care Insurance System in Japan: Past, Present, and Future, JMA J., 2(1), 67–69 (2019).
[20] H. Rothgang, Social Insurance for Long-Term Care: An Evaluation of the German Model, Soc. Pol’y & Admin., 44(4), 436–460 (2010).
[21] Thuy Linh, Severe Shortage of Geriatric Workforce, (Oct. 7, 2024), https://laodong.vn/y-te/thieu-tram-trong-nhan-luc-nganh-lao-khoa-1404277.ldo.
[22] Pham Thi Thanh Tra, Improving the Quality of the Healthcare Workforce for the Elderly in the Context of the Silver Economy, (Oct. 20, 2025), https://www.tapchicongsan.org.vn/web/guest/kinh-te/-/2018/1154603/nang-cao-chat-luong-nguon-nhan-luc-cham-soc-suc-khoe-nguoi-cao-tuoi-trong-boi-canh-nen-kinh-te-bac.aspx.
[23] Mehdi, Z., & Nasser, R. N., German Nurse and Healthcare Workers Staffing: Their Professional Education and Training Outcomes, Int’l J. Health Sci., 6(S5), 596–613.
[24] P. S. Raikhola & Y. Kuroki, Aging and Elderly Care Practice in Japan: Main Issues, Policy and Program Perspective; What Lessons Can Be Learned from Japanese Experiences?, Dhaulagiri J. Soc. Anth., 3, 41–82 (2009).
[25] N. Nakamura & A. Suzuki, Occupational Credentials and Migrants’ Return Aspiration: Evidence from the Foreign Elderly Care Workers in Japan (2024) (publication outlet not provided).
[26] Rocío Martínez-Lacoba, Isabel Pardo-García & Francisco Escribano-Sotos, The Reverse Mortgage: A Tool for Funding Long-Term Care and Increasing Public Housing Supply in Spain, 36 J. Hous. & Built Env’t 367 (2021).
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