This article uses datasets of older people from four provinces; these are data from 2017 for Ha Tinh and Quang Ngai provinces (307 individuals) and data from 2016 for Ninh Binh and Tien Giang provinces (407 individuals), collected as part of the project “Strengthening Social Commitment to Care for the Elderly in the Face of Changing Economic and Family Structure in Asia: Policy and Practical Dialogues Between Local Communities in Vietnam and Japan”. This article attempts to assess the role of family members, especially women, in caring for the elderly and to analyze the difficulties that families face today in relation to the role of the community and the state. In particular, this article defines the socio-cultural conditions that affect how each family member cares for their seniors. Our research results indicate that families play a very important role in caring for the elderly, and that the role of women in this regard is still crucial, regardless of the circumstances. Family is the most important support for older people in Vietnam during illness. The economic situation of the family, health status, illness, gender, age and employment have a significant impact on the well-being of older people. It has been noted that caring for the well-being of older people is one of the burdens that the family must bear, which in the context of increasing migration and recent structural and functional changes in the family causes the need to create a more comprehensive system of social security and social services for older people, especially in rural areas.