Can Vietnam's Elderly Care System Handle Its Rapidly Ageing Population?

Blogs - Vietnam: July 16, 2018

With one in 10 people aged 60 or older, Vietnam is slowly en route to an “ageing phase”, a term to describe a situation where about 10 percent of the country’s population is above the age of 60. However, with an ageing population comes the increased need for infrastructure and resources catering to elderly healthcare.

And this is where the problem lies.

Vietnam’s population is expected to creep into the “aged population” range, where 10 to 20 percent of people are aged 65 and above, within the next 20 years. However, the current social safety net for the elderly such as pensions and support schemes can only cover about 30 percent of the overall required costs.

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According to Carlos Galian, an expert with the International Labor Organization in Vietnam, “the pension scheme will start running a deficit in 2020 and the reserves could be totally depleted by 2029, causing big problems for Vietnam’s economy.”

Falling Through the Cracks

According to data from HelpAge Global Network’s Global AgeWatch Index, a non-contributory social pension of about US$9/month is offered to elders above the age of 80 and to those aged 60-79 who are identified as “poor”; those aged 60-79 who have a severe disability as well as those 80 and above who are poor, living alone and without family support receive US$13.50/month; and those over 80 with a severe disability receive US$18/month.

There are about 1.4 million people across the country above the age of 80, along with about 100,000 people between the ages of 60-79 receiving this pension. An additional 1.8 million pensioners receive a formal pension as part of social insurance.

This leaves a gap of about five million elderly people who do not receive any form of pension or benefits.

Lack of Knowledge

In October, Deputy Minister of Health Pham Le Tuan emphasised that long-term care for the elderly in Vietnam is a common process in which social care takes a leading role. Currently, 80% of the elderly are receiving care at home and in the community, but caregivers still lack knowledge and there should be a strategy to improve their knowledge.

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This sentiment is shared by Dr. Thao Tran Phuong, specialist at the Gastroenterology and Hepatology Department at Victoria Healthcare Vietnam. “Most caregivers that families employ to look after the elderly are general caregivers, not specialised in elderly care and they may not have the necessary training and experience to handle elderly patients,” he said.

The Allure of Geriatrics (or Lack Thereof)

The dearth of specialist caregivers for the elderly can be narrowed down to a few reasons according to Dr. Thanh Nguyen, nutritionist at Victoria Healthcare Vietnam and lecturer at Pham Ngoc Thach University of Medicine.

“Geriatrics is still pretty new in Vietnam. Medical schools only started this program about 10 years ago” she said.

Dr. Thao added that “geriatric studies is not very popular among medical students, so out of each graduating batch, very few actually end up as geriatric doctors.”

“In most countries, the gap could easily be filled in by foreign doctors, but in Vietnam, everything is done in Vietnamese and that language barrier will be a huge problem,” he said.

The biggest reason, however, according to both doctors, is the lack of a dedicated medical facility for the the elderly in Vietnam. “At this point in time, only certain hospitals have wards dedicated for geriatric care, and this is just in Ho Chi Minh City, which has the best standards for geriatric care in Vietnam.” said Dr. Thao.

Medical facilities aside, what about the elderly living at home?

Home Improvement

Dr. Thanh believes other social factors play a part too. “In Vietnam, it is common for the family to look after the elderly at home. Therefore, the idea of a nursing home is almost considered a taboo.”

“When a family decides to put their elderly in a nursing home, there is a chance that they will be viewed by their neighbours and relatives as unfilial.” she said.

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“However, most of these families don’t have the knowledge of how to properly take care of the elderly,” she said. “There are no materials or resources available that teach them how to do so, and this can be quite dangerous.”

According to Dr. Thao, the most common issues among the elderly include cardiovascular diseases; diabetes; stroke; dementia; complications from falls; and cancer—especially lung cancer among men..

What Next?

Dr. Thao strongly believes that the right way forward is for the authorities to establish a new hospital dedicated to elderly patients. Not only will it ease the load on geriatric wards in current hospitals, it will also kickstart interest in the field.

“When a new dedicated hospital is built for the elderly, it will open up many opportunities for the recruitment of geriatric specialists and in turn, will raise more interest in this field.” he said.

“With more specialist doctors and nurses available, the standards of elderly healthcare will improve dramatically.”

Dr. Thanh believes that besides a dedicated facility, there should also be more daycare centers available for the elderly within the city, and also in the various provinces.

Mindsets towards nursing homes also have to be changed, and more resources for elderly care should be made readily available for families who prefer keeping their elderly at home to equip them with knowledge on how to properly care for them.

Dr. Thao believes that human resources can play a huge part in shifting the mindset of would-be doctors towards geriatrics, and hopes to see this change happen soon to alleviate the shortage of geriatric specialists, and to better prepare for the increased demand in the future.

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