Social Prescribing and Family Caregivers in Viet Nam: Where Could Community-Connected Support Add Value, and What Should We Not Assume?

Social Prescribing and Family Caregivers in Viet Nam: Where Could Community-Connected Support Add Value, and What Should We Not Assume?

Category: Evidence & Evaluation

Family caregivers are often part of the largely invisible infrastructure of care. They accompany people to appointments, help with medicines and daily activities, arrange transport, respond when health changes, manage paperwork, provide emotional support and connect parts of care that might otherwise remain fragmented. Yet healthcare can easily see the caregiver mainly as the person who helps the patient, rather than as someone whose own health, relationships, social participation and everyday life may also be affected by caregiving.

This creates an important question for social prescribing. If community-connected support is intended to respond to needs that clinical treatment alone cannot address, should family caregivers sometimes be considered people who may benefit from that support in their own right?

The answer may be yes in some situations, but the evidence requires caution. A 2026 scoping review specifically examining social-prescribing programs involving unpaid caregivers identified only 17 studies. Most involved caregivers participating alongside the people they cared for, the programs varied considerably, and the review did not undertake a critical appraisal of study quality. Its updated search ended on 30 March 2025, and it used a relatively inclusive operational definition of social prescribing. Some included programs did not themselves use the term “social prescribing,” while virtual, knowledge-based and behavioral-therapy programs were excluded. Reported findings included potentially positive experiences relating to caregiver stress, social connection and caregiver–care-recipient relationships, but these should not be interpreted as proof that social prescribing reduces caregiver burden or improves health outcomes.

For Viet Nam, the evidence gap is even larger. None of the 17 studies in that review was conducted in Viet Nam. A more appropriate starting point is therefore not to assume that social prescribing is a proven caregiver intervention, but to ask a narrower question: where could community connection, navigation and meaningful participation realistically add value for family caregivers, and where would they be insufficient?

Unpaid caregivers and family caregivers are related, but not identical

The international review uses the term unpaid caregiver, which may include a spouse, family member, friend, neighbor or another person providing unpaid support. This article focuses more specifically on family caregivers because family-based care has particular importance in the Vietnamese context.

International evidence about unpaid caregivers should not automatically be interpreted as evidence about family caregiving in Viet Nam. Caregiving relationships are shaped by family structure, cultural expectations, employment, finances, geography, availability of formal services and the health condition or disability involved.

Viet Nam's Law on the Elderly No. 39/2009/QH12, as amended and reflected in Consolidated Text No. 23/VBHN-VPQH dated 26 February 2026, illustrates this balance between family responsibility and individual autonomy. Older people have the right to decide whether to live with their children or grandchildren or to live separately. Children, grandchildren and other people with legally defined maintenance responsibilities have rights and obligations in relation to care, and where care is entrusted to another individual or service provider, the older person's consent is required.

These provisions relate specifically to older people and should not be generalized to every caregiving relationship. They do, however, illustrate an important principle: a strong family role does not mean that family capacity is unlimited, that caregivers have no needs of their own, or that healthcare can assume relatives will automatically absorb whatever responsibilities are transferred into the home.

The caregiver should not disappear behind the care recipient

One of the most useful findings of the 2026 caregiver social-prescribing review concerns who the programs were actually designed to support. Of the 17 included studies, 13 - 76.5%, involved the caregiver and care recipient participating together. Programs included music, arts, museums, physical activity and nature-based experiences. Only three studies involved caregivers participating without the care recipient, generally with some form of respite arrangement.

The review also found that many publications considered for inclusion had to be excluded because caregivers merely facilitated the care recipient's participation rather than participating in the program themselves. This distinction matters. A caregiver transporting an older person to a community activity is not necessarily receiving caregiver support. Likewise, a spouse accompanying someone with dementia may enjoy an activity without the program ever identifying or responding to the spouse's own priorities.

For SPVN, the implication is straightforward: if a caregiver is intended to benefit from social prescribing, the pathway needs to understand what matters to that caregiver, not merely what helps them continue caregiving.

Where might community-connected support add value?

The existing evidence suggests several plausible areas, although they should not yet be described as established effects. Social prescribing may offer opportunities for social connection with other caregivers: 11 of the 17 studies in the 2026 review described opportunities to meet people facing similar circumstances, share experiences and develop a sense of belonging.

Shared activities may also help caregivers and care recipients experience their relationship outside the routines of illness and care. Eight studies discussed caregiver–care-recipient relationships, and programs involving music, arts, museums or movement sometimes created space for people to relate to one another as spouses, partners or family members rather than only as “caregiver” and “patient.”

Some caregivers may benefit from meaningful activity that belongs to their own life, physical activity, creative participation, learning, peer connection, volunteering or simply reconnecting with interests that have gradually disappeared because of caregiving. Navigation itself may also have value when useful services or activities exist but caregivers do not know what is available, whether they are eligible or how to access them.

Evidence published after the cutoff of the scoping review reinforces the need for caution. A German randomized controlled trial published in June 2026 assigned 58 dyads of people with dementia and their informal caregivers to guided or unguided museum visits. Caregivers' health-related quality of life improved in the guided intervention group, but caregiver burden remained stable immediately after the intervention and worsened in both groups at six-month follow-up. The study therefore offers a useful reminder: a community or cultural intervention may have psychosocial value without substantially reducing the underlying burden of caregiving.

A beneficial experience is not the same thing as a comprehensive solution to caregiver strain.

Access can be difficult precisely because someone is a caregiver

Offering a community activity does not mean a caregiver can realistically use it. Transportation and scheduling were recurring barriers in the 2026 review. Low or waived costs, accessible transport and small-group arrangements could support participation, while incompatible schedules and transport difficulties prevented attendance. Some caregivers also worried about the person they cared for when participating without them.

A weekly peer group may technically be available but unusable for someone who cannot leave an older parent alone. A cultural or exercise program may be attractive but inaccessible because of transport. An online option may remove travel barriers while excluding someone with limited digital access or someone who strongly prefers face-to-face interaction.

A responsible pathway therefore needs to ask not only “Does a community resource exist?” but also “Can this caregiver realistically use it?” Depending on local circumstances, that may involve flexible timing, activities that caregiver and care recipient can attend together, respite-linked options, transport support, hybrid formats or other adaptations. Current evidence is not strong enough to prescribe one model, but it is sufficient to show that accessibility and logistics are part of implementation rather than minor details.

Family presence is not the same as usable care capacity

Vietnamese research provides useful context without establishing that social prescribing is effective for caregivers. A study of 201 family caregivers of adults aged 65 years and older in Hanoi examined familism, social support and caregiver burden. Familial obligation and interconnectedness were associated with greater social support, while greater social support was associated with lower caregiver burden. Because the study was cross-sectional and observational, these associations should not be interpreted as showing that familism or social support caused lower burden. They do show that family values, perceived support and caregiver experience are closely connected in the Vietnamese context.

A separate 2026 qualitative study based on 90 interviews with older adults, family carers and local stakeholders in urban and rural southern Viet Nam adds another layer. Complex needs became more difficult when functional limitations interacted with low income, transport barriers and inconsistent assistance. The authors emphasized looking at the actual care tasks required, who can perform them, whether that support is sustainable and whether needs remain unspoken because older people are reluctant to burden relatives.

Someone may therefore live with adult children and still lack meaningful help during working hours. Several relatives may be present but most responsibilities may fall on one person. Family members may be willing to help but lack time, money, skills or transport. An older person may avoid asking for assistance because they do not want to become a burden.

Counting family members does not tell us whether caregiving is sustainable.

Caregiver burden is not uniform

It would also be inaccurate to describe every family caregiver in Viet Nam as highly burdened. A 2026 cross-sectional study of 137 caregivers of stroke patients at the National Geriatric Hospital reported that most caregivers experienced low-to-moderate burden, while 11.2% had moderate-to-high burden. Poorer sleep quality was significantly associated with greater caregiver burden.

The study involved a particular tertiary-hospital population: most participants lived in urban areas and more than three-quarters had a university education or higher. Its results should therefore not be generalized to all Vietnamese caregivers. The broader lesson is nevertheless useful: caregiver status alone should not become an indication for intervention. Some people may be coping well, have strong support and not want assistance, while others may be under considerable strain despite appearing capable.

The relevant question is not simply “Is this person a caregiver?” It is “What is caregiving doing to this person's life, what matters to them, and do they want support?”

Social prescribing is not caregiver treatment

This is one of the most important boundaries to protect. Caregiver strain can involve sleep disturbance, depression, anxiety, physical exhaustion, financial hardship, relationship conflict, grief, complex dementia-related behaviors or lack of caregiving knowledge and skills. Community activity may be valuable for some people, but social prescribing is not a substitute for clinical assessment, psychological treatment, professional social work, caregiver training, respite care or condition-specific intervention when these are needed.

Viet Nam already provides an important comparison. The culturally adapted REACH VN intervention was tested in a cluster randomized controlled trial involving 350 family caregivers of people with dementia across 40 clusters in northern Viet Nam. REACH VN was a structured, multicomponent caregiver intervention delivered through assessment, dementia education, problem solving, mood and stress-management strategies and tailored support. Compared with the enhanced-control group, caregivers receiving REACH VN had lower psychological distress at three months and lower caregiver burden at six months. Some other improvements seen earlier were not sustained at six months.

REACH VN is not social prescribing. The distinction is useful because it demonstrates that some caregiver needs require structured and targeted intervention. Social prescribing may sit alongside those services, for example, by helping someone rebuild social participation — but it should not become a cheaper label for replacing them.

Community connection cannot solve structural caregiving problems

If someone has left paid employment because they provide full-time care, joining a community group will not replace lost income. If nighttime dementia symptoms leave a spouse chronically sleep deprived, social connection may help emotionally but will not provide overnight respite. If a family cannot access affordable long-term care, navigation cannot create a service that does not exist.

A responsible social-prescribing pathway should therefore distinguish between needs that may reasonably benefit from community connection and needs that require financial assistance, respite, formal care, professional intervention, service development or broader social policy.

This distinction is particularly important in Viet Nam because formal care remains uneven and families continue to carry substantial responsibility. Decision No. 1116/QĐ-TTg dated 22 June 2026, amending the national health-care program for older people to 2030, sets targets including at least one older-person care club and one volunteer care team in 90% of communes, wards and special zones by 2030, as well as piloting or developing daytime older-person care facilities in at least 20% of communes, wards and special zones. These targets may gradually strengthen the community infrastructure available for care navigation, but the Decision does not establish social prescribing and does not guarantee that caregiver needs will be met.

Social prescribing can help people connect with capacity that exists. It cannot substitute for capacity that has not been built.

Whose needs are being addressed?

A social-prescribing pathway involving caregiving can take at least three different forms. The care recipient may be the primary participant, with the caregiver helping them reach an activity. The caregiver and care recipient may participate together in a dyadic activity that offers something meaningful to both. Or the caregiver may be the person whose own needs and priorities are being addressed independently of the care recipient.

These are not interchangeable pathways. If the caregiver is the intended beneficiary, the conversation should focus on their priorities. They may want to reconnect with friends, exercise, return to a hobby, meet other people in similar circumstances or reclaim some reliable time away from caregiving. They may also have no interest in being referred to something labeled a “caregiver program.”

This is another reason to interpret the current evidence carefully. Much of the literature concerns caregiver–care-recipient dyads, while caregiver-specific needs and outcomes have received less consistent attention. Caregiving is part of a person's life; it is not their entire identity.

Respite and social prescribing can complement one another, but they are not the same thing

Three studies in the caregiver scoping review allowed caregivers to participate without the care recipient and generally provided some form of respite. The authors therefore suggest exploring whether social-prescribing opportunities could be linked more deliberately with respite care.

The idea is promising but still underdeveloped. Respite provides temporary relief from caregiving responsibility. Social prescribing connects people with non-clinical community opportunities that may support health, well-being or participation. Combining them may sometimes be useful, but one does not replace the other.

Offering a caregiver an exercise or arts program is not meaningful respite if there is nobody safe and appropriate to care for their relative while they participate.

Professional boundaries and privacy still matter

Caregiver navigation can begin with an apparently simple conversation and uncover severe exhaustion, depression, family conflict, neglect, financial crisis, inability to continue caring or concerns about the safety of either person. These situations should not be managed through community activity alone.

Viet Nam's Decree No. 110/2024/ND-CP on Social Work establishes the national framework for social-work practice, and from 1 January 2027 people practicing social work must hold the applicable social-work practice registration certificate in accordance with the Decree. Circular No. 29/2026/TT-BYT, effective from 25 August 2026, further regulates social-work practice and the updating of professional knowledge. Where caregiver navigation moves into professional assessment, counseling, case management or other activities falling within regulated social-work practice, the applicable professional framework needs to be respected.

Family-centered care also involves two people whose interests and information should not simply be merged. A caregiver may have legitimate information needs in order to provide care, and their experience may be important to understanding what happens at home. The care recipient nevertheless retains their own preferences, autonomy and privacy. Information disclosed by caregivers about their own health, finances, stress or relationships is also their personal information.

Viet Nam's Law No. 91/2025/QH15 on Personal Data Protection has been in force since 1 January 2026. Article 26 requires the data subject's consent for the collection and processing of personal data relating to health except in the circumstances specified in Article 19(1). Decree No. 356/2025/ND-CP, also effective from 1 January 2026, includes health status among categories of sensitive personal data and establishes additional requirements for the protection of personal data.

Caregiver or family status alone therefore does not automatically authorize unrestricted access to, or sharing of, another person's personal data. A responsible pathway should determine what belongs to the caregiver, what belongs to the care recipient, what information needs to be shared for the agreed purpose and what does not.

What could an early caregiver pathway look like in Viet Nam?

An early Vietnamese pilot should probably be narrow rather than attempting to establish a general “social prescribing for caregivers” service. It could begin in one setting with one clearly defined population, for example, family caregivers of people living with dementia, selected stroke caregivers after discharge or caregivers of older people with substantial functional dependency. The population should be selected because there is a real implementation problem and credible community capacity, not because it is easy to recruit.

The first conversation should establish whose needs are being addressed. Is the care recipient seeking community support? Is the caregiver asking for help? Are both interested in participating together? If the caregiver has needs of their own, navigation could explore what matters to them, what activities or relationships caregiving has displaced, where they feel unsupported and what kind of help they actually want.

The appropriate response might involve peer connection, meaningful activity, physical or cultural participation, information, respite, caregiver education, professional social work, mental-health support or another service. Not all of these are social prescribing, and that is exactly the point: the pathway should identify the appropriate response, not try to maximize social-prescribing referrals.

Implementation should then ask whether the option is genuinely usable. Can the caregiver attend? Who supports the care recipient while they are away? Do transport, scheduling or cost create barriers? Is the community organization prepared for the needs of both caregiver and care recipient? Does the connection require follow-up?

The objective is appropriate and usable support, not referral volume.

Evaluate the caregiver as a person, not only as a resource for the patient

If a caregiver-oriented social-prescribing pathway is tested, success should not be measured only by whether the care recipient attends more activities or uses fewer healthcare services. Caregiver-specific outcomes need to remain visible.

An early pilot could examine acceptability, uptake, participation, social connection, perceived access to support, ability to resume meaningful activities, caregiver–care-recipient relationship, time and transport burden, and whether connections actually reach suitable resources. Caregiver burden, stress, well-being or quality-of-life measures may provide useful signals, but changes observed in a small pilot should not be treated as proof of effectiveness unless the study design supports causal conclusions.

The community side also matters. Can community organizations accommodate caregivers and care recipients appropriately? Are activities accessible to people with dementia, disability or mobility limitations? Are facilitators being asked to manage risks beyond their role? Does caregiver-specific participation or respite create additional costs and workload that have not been funded?

Current evidence supports further implementation and evaluation. It does not yet justify treating social prescribing for caregivers as an established evidence-based intervention.

What should we not assume?

We should not assume that having family nearby means support is adequate, that every caregiver is highly burdened or that every caregiver wants help. We should not assume that participating beside a care recipient automatically means the caregiver has received support designed around their own needs.

We should not assume that social support and social prescribing are equivalent. Vietnamese observational evidence showing an association between greater social support and lower caregiver burden does not demonstrate that a social-prescribing intervention would produce the same effect.

We should not assume that social prescribing can replace respite, professional caregiver training, psychological treatment, clinical care, professional social work or long-term-care infrastructure. Nor should we assume that a community organization has capacity simply because its name appears in a resource directory.

Most importantly, we should not assume that the caregiver's role is simply to make someone else's care plan work.

Support the caregiver without reducing the person to caregiving

Family caregiving is neither only a burden nor automatically a source of resilience. It can involve obligation, affection, reciprocity, identity, exhaustion, meaning and conflict at the same time.

Recent Vietnamese qualitative research captures this complexity well. Older people may continue contributing to their families through work, advice, income or care even as their own support needs increase. Some limit requests for assistance because they fear burdening relatives. The practical question is therefore not simply whether a family exists, but whether the relationships and resources around the person are available, responsive and sustainable.

Social prescribing may have a useful place within that landscape. It may create routes to social connection, meaningful activity, peer support and community resources. It may give a caregiver and care recipient opportunities to relate to one another outside the routines of illness. It may help a caregiver reconnect with a part of life that has gradually been squeezed out by caring.

Its value should nevertheless be judged against a simple standard:

Does this connection respond to something that matters to the caregiver, and can the caregiver realistically use it without creating another burden?

For Viet Nam, that is a more responsible starting point than assuming every caregiver needs a social prescription. The aim should be to recognize family caregivers as people with their own goals, limits and support needs, while preserving the autonomy of the person they care for and ensuring that community support complements rather than substitutes for professional care.

That is where social prescribing and community-connected care may add value, and where careful implementation and evaluation are still needed.

References

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