Improving the quality of human resources for elderly health care in the context of a silver economy

TCCS - In the context of rapid population aging, elderly care has become an issue of both humanity and strategic significance for the country's sustainable development. Many important documents, such as the Law on the Elderly, the National Strategy on the Elderly to 2035, the Elderly Health Care Program to 2030, etc., have been issued, creating a legal framework and guiding actions. However, implementation still has many gaps, requiring synchronous, long-term solutions, associated with training, standardization, finance - insurance and application of scientific and technological achievements.

The need to improve the quality of human resources for elderly health care in the context of a silver economy

Silver economy is an economy that includes all economic activities, products and services related to the elderly. The elderly are not only the subjects that need to be cared for and protected, but they are also an important resource in the cause of building and defending the Fatherland. Paying attention to health care and implementing good policies for the elderly has profound humanistic significance, while contributing to promoting the role, potential, experience and knowledge of this force in the economic, political , cultural and social development of the country.

Currently, Vietnam is among the countries with the fastest aging population in the world. The rapid aging process has posed an urgent need to innovate and adjust the social security system, labor market and health services to better meet the growing demand for health care, rehabilitation and psycho-social support for the elderly.

In 2011, our country officially entered the population aging stage; in 2019, the proportion of elderly people accounted for 11.86% of the population and is forecast to increase to 26.1% by 2049 ⁽¹⁾ . The rapid increase in the proportion of elderly people means that the demand for comprehensive care services is increasing. This is the practical basis for the requirement to synchronously develop specialized care human resources, considering it as one of the pillars for building and developing a silver economic ecosystem.

The aging population poses challenges, but also opens up new economic opportunities. The change in population structure creates the premise for the formation and development of a specific economic sector - the silver economy. This is an economic model associated with the needs, capacity, and participation of the elderly in social life, focusing on policy making, product and service development to promote the intelligence, life experience, and labor potential of the elderly, meeting the increasingly diverse needs of the elderly. The birth and development of the silver economy demonstrates the concern and respect for the elderly, recognizing their great contributions, and affirming the consumption potential of this population group. Not only bringing in significant profits, the silver economy also promotes the formation of many specialized industries and occupations, creating new jobs, posing an urgent need to build a team of professional, high-quality elderly care workers. In the entire elderly care service ecosystem, human resources are the key factor, determining the quality, efficiency and accessibility of services. For Vietnam, developing a silver economy is still in its infancy, both posing challenges and opening up great opportunities. In that context, improving the quality of human resources for elderly health care in the community, while effectively mobilizing social resources to develop a team of staff and specialized care facilities, has become an important priority. This is not only a core task of the political system, but also a common responsibility of the whole society, aiming to improve the quality of life for the elderly, strengthen social security and contribute to realizing the goal of building a prosperous country and happy Vietnamese people.

Elderly health care at Nguyen Dinh Chieu Hospital, Vinh Long province_Photo: VNA

Current status of improving the quality of human resources for elderly health care in Vietnam

Realizing that the trend of population aging is an objective necessity that every country must face, Vietnam has issued many policies and strategies to ensure health care for the elderly, with special attention to the task of building and improving the quality of specialized care workers. Vietnam issued the Law on the Elderly, creating an important legal foundation for the rights of the elderly, including the right to health care.

To specify the provisions of the Law, many sub-law documents have been issued, such as Decree No. 06/2011/ND-CP, dated January 14, 2011, of the Government, detailing and guiding the implementation of a number of articles of the Law on the Elderly; Circular No. 35/2011/TT-BYT, dated October 15, 2011, of the Ministry of Health Guiding the implementation of health care for the elderly... Documents regulating the care and support of the elderly, elderly care facilities; Contents and responsibilities of elderly health care at medical examination and treatment facilities, such as the Central Geriatric Hospital as the final line of expertise, general hospitals, specialized hospitals (except for specialized pediatric hospitals, nursing - rehabilitation hospitals), traditional medicine hospitals with a scale of 50 beds or more must arrange inpatient beds and organize separate examination rooms for the elderly in the examination department, medical station... Based on the actual needs of medical examination and treatment, hospitals are also encouraged to establish a Geriatric Department when they have sufficient conditions in terms of facilities, equipment and human resources.

This move demonstrates the State's efforts in building a policy framework and healthcare infrastructure, aiming at the goal of developing human resources and synchronous elderly care services, in line with the requirements of the rapid population aging process in Vietnam.

The National Strategy on the Elderly to 2035, with a vision to 2045, issued under Decision No. 383/QD-TTg dated February 21, 2025, of the Prime Minister, sets out the goal: “Building and perfecting a comprehensive, modern, inclusive, sustainable system of policies on the elderly, ensuring social progress and equity. Continuously caring for and improving the material and spiritual life of the elderly; creating conditions for the elderly, especially the poor, those in difficult circumstances, and those living in areas of particularly difficult socio-economic conditions, to access basic social services, especially health care, rehabilitation, and social assistance...”.

One of the key tasks and solutions emphasized in the Strategy is “improving the capacity of civil servants, public employees and collaborators in assisting the elderly”. This content is specified through focusing on training and fostering to improve the capacity of social assistance and rehabilitation staff; equipping specialized skills in social work in elderly health care for civil servants, public employees, employees and social work collaborators. At the same time, the Strategy sets out requirements for organizing periodic training and coaching, developing a team of local resource lecturers, encouraging links and coordination with medical and pharmaceutical universities in training doctors, as well as improving the qualifications of medical staff and elderly support staff.

Implementing those correct policies and guidelines, the work of improving the quality of human resources for elderly health care in Vietnam has always been of interest, initially achieving important results. This workforce is increasingly diverse, including geriatric medical staff (doctors, nurses) at hospitals; non-professional caregivers; volunteer teams in the community; and staff with primary training at private nursing homes. The grassroots health staff, commune health station staff, village health workers and population collaborators directly involved in elderly health care in the community are also increasingly equipped with basic knowledge and skills, contributing to expanding the elderly health care network.

Notably, the Department of Geriatrics has been established in a number of medical and pharmaceutical universities across the country; geriatric training programs for general students and postgraduate training have been introduced in recent years. This is an important step forward, contributing to creating the initial foundation for the formation and development of a team of human resources specializing in elderly health care, meeting practical needs.

However, the human resources for elderly care in Vietnam are still limited in both quantity and quality, such as the lack of a formal team of elderly care staff, the lack of a separate occupational code, and the lack of formal training programs at the intermediate, college or university levels. This leads to a serious shortage of human resources in the field of elderly care. The number of doctors, nurses and medical staff specializing in geriatrics is still very modest, not meeting the increasing needs of a country with an aging population like ours.

At the grassroots level, many commune health workers, village health workers, population collaborators, social workers and volunteers have not been fully trained in geriatric knowledge, rehabilitation, nutrition, geriatric psychology or communication skills with the elderly. In reality, most people involved in elderly care work still operate based on personal experience, spontaneously, lack professional background and society has not properly assessed their role and position. Meanwhile, care workers often have to work at high intensity, face great psychological pressure, but lack support mechanisms, leading to a high rate of job abandonment and increasingly serious human resource shortages.

The biggest bottleneck in improving the quality of human resources for elderly care today is the limitation in training. In fact, the training of specialized nurses for the elderly in Vietnam is still "not up to standard" . Training duration is limited, output standards are not given due attention, teaching materials are mainly based on the foundation of general practitioners, lacking specialization in the psychological characteristics and complex pathologies of the elderly. There is no national standard training program specifically for geriatric nursing; the number of specialized training facilities is still small, and there is a lack of highly qualified lecturers to undertake training. As a result, the shortage of specialized human resources is increasingly evident, putting great pressure on the existing team, and directly affecting the quality of health care services for the elderly in the community and specialized facilities.

Nursing students at Nguyen Tat Thanh University during a practice session_Source: ntt.edu.vn

Solutions to improve the quality of human resources for elderly health care in the context of silver economic development in Vietnam

Rapid population aging in Vietnam is an inevitable and irreversible trend. If properly recognized and approached, this is not only a challenge, but also an important driving force for sustainable development. The formation and expansion of the silver economy is creating a huge potential market, in which human resources for elderly care are considered the center.

To adapt to trends, seize opportunities, and promote the development of the silver economy, Vietnam needs to focus on implementing the following basic solutions:

Firstly, raise community awareness and the responsibility of the whole society for the work of caring for the elderly as well as the importance of the care profession in modern life. Incorporating education on respect, care and gratitude for the elderly into the school curriculum, combined with mass media, will contribute to building a friendly social environment that values ​​the role of the elderly. Promote propaganda and honor the care staff, thereby affirming that the profession of caring for the elderly is an important profession, rich in humanity and brings practical contributions to society.

The gradual development and standardization of the profession of elderly health care workers will help Vietnam proactively respond to the increasing demand in the context of an aging population. This is not only the basis for ensuring comprehensive quality of care, both physical and mental, for the elderly, but also opens up the prospect of becoming a potential industry and profession with millions of jobs, promoting the development of the social service system and directly contributing to the country's socio-economic growth.

Second, perfecting policies and legal frameworks for building and developing human resources for elderly health care. To meet practical requirements, Vietnam needs to soon build a strategy for developing a silver economy that is appropriate to the context and characteristics of the population, focusing on developing human resources for geriatric medicine and the elderly health care team. The strategy must be long-term, innovative, closely combining the improvement of the legal system with strong investment in specialized training. The silver economy not only serves economic growth, but is also a tool to perform the social functions of the State, ensuring social security for the elderly. There needs to be high political commitment, while raising awareness of policymakers and managers at all levels about promulgating and organizing effective implementation of labor, employment and social security policies to adapt to the aging population in the new period.

One of the important tasks is to review, supplement and perfect the system of relevant legal documents, and at the same time build specific mechanisms and policies on salaries, allowances and satisfactory treatment regimes, in order to attract and retain human resources for geriatric medicine, especially at the grassroots level and in preventive medicine. Along with that, the State needs to perfect the legal framework to encourage socialization, attract organizations and individuals to participate in investing in developing nursing homes and high-quality health care facilities, thereby diversifying the types of home and community care services, better meeting the increasingly diverse needs of the elderly.

Third, develop professional standards for the elderly care team to professionalize the workforce in this field. Developing professional standards is an urgent requirement to clearly define standards, functions, tasks, scope of activities as well as professional and technical training content for elderly health care staff. Professional standards need to specify the qualifications, capacity and ethical qualities that caregivers must have, meeting the increasing demand for health care services in the context of an aging population.

Elderly caregivers must have a firm grasp of basic medical knowledge to ensure the health and safety of the care recipient, including regular health checks and monitoring, nutritional management, medication management, and basic care techniques. At the same time, in addition to medical knowledge, soft skills in intelligence and emotions are also key factors to improve service quality, such as the ability to communicate effectively, manage emotions, and show empathy for the elderly. Elderly care requires a strong ethical commitment, dedication, honesty, and love for the profession, because the nature of the work is difficult, high-pressure, and can easily lead to physical and mental exhaustion.

Establishing occupational standards with specific requirements on qualifications, skills and qualities not only helps professionalize the workforce, but also creates the basis for forming a team of high-quality care staff, capable of providing comprehensive and effective services, meeting the increasingly diverse needs of the elderly.

Fourth, strengthen training in geriatrics and elderly health care . Human resources for elderly health care need to be trained in depth in specific areas, including physical care, mental care and support for daily activities. Therefore, it is necessary to research and develop systematic and scientific training programs and curricula on elderly care and rehabilitation, while focusing on social work skills to support this special group. Training content must be standardized, closely combining theory and practice, ensuring that it is suitable for the physical and mental health characteristics, meeting the diverse needs of the elderly.

Universities and medical colleges need to expand their training in geriatrics, social work and elderly nursing. At the same time, it is necessary to organize short-term training courses and improve skills for the workforce directly working in the field; focus on professional training so that staff have enough knowledge and skills to support both physical and mental health of the elderly. In addition, it is necessary to encourage human resources in the nursing and elderly health care sector to participate in regular training programs, increase international experience exchanges, contribute to improving the quality of care services, gradually forming a high-standard working environment, meeting the increasingly diverse needs of the elderly.

Fifth, develop financial support policies, health insurance and social insurance to ensure benefits and stable income for the team working in elderly health care . Elderly health care is a special field, requiring high labor intensity, great pressure, and often facing the risk of disease infection and occupational risks. Without knowledge, skills, love for the job, dedication, patience and a sense of responsibility, it is difficult for workers to stay long-term. Therefore, designing and promulgating financial support policies, health insurance mechanisms, social insurance and a worthy reward system are urgent requirements to encourage, retain and develop a high-quality workforce in this field.

In addition to the State's guarantee, it is necessary to expand the socialization mechanism to mobilize resources from the private sector to participate in the development of elderly care services. This is both a solution to help reduce the budget burden and contribute to diversifying service types, while demonstrating the recognition and honor of society for the important contribution of the elderly health care workforce in the process of sustainable socio-economic development.

Sixth, promote the application of science and technology in training, care and health monitoring of the elderly, to reduce pressure on staff, while improving work efficiency and the quality of care services in a comprehensive and personalized direction. The application of modern scientific and technological achievements, such as electronic medical records, remote monitoring systems, online examination, treatment and consultation, although not able to replace the central role of humans in health care activities, is a powerful tool to help the medical team work more effectively, make more accurate decisions, and ensure timely and thoughtful care for the elderly.

From the above analysis, it can be seen that in order to proactively catch up with the silver economy wave, Vietnam needs to soon build and implement a national policy system related to the elderly, linked to the orientation of sustainable development. Developing a team of human resources for elderly health care both in the community and in specialized facilities must be focused on synchronously in terms of scale, quality and level of specialization. In the context of rapid population structure change, when the "golden population" period is gradually coming to an end and society is entering the aging stage, the State, enterprises and the whole society need to proactively take advantage of the opportunities that the silver economy brings.

By learning from the experiences of leading countries, and systematically implementing solutions on training standardization, building appropriate regimes and policies, perfecting the legal framework and promoting the application of science and technology, Vietnam can turn the challenge of population aging into a new driving force for developing the silver economy, contributing to bringing a better quality of life and happiness to the elderly, and actively contributing to the prosperous and sustainable development of the country./.

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(1) See: General Statistics Office, “Vietnam population forecast for the period 2019 - 2069”, Hanoi, November 2020, https://vietnam.unfpa.org/sites/default/files/pub-pdf/sach_dan_so_va_du_bao_dan_so_a4_vn_2106.pdf

Source: https://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