This chapter reviews and discusses changes in Vietnam’s economy, household structure, as they affect the roles and relationships of women, especially older women. It focuses on ways that traditional cultural values and living arrangements place limits on how older adults express multiple forms of intimacy with their adult children and grandchildren. The chapter describes the responsibilities of older women to care for their families and to maintain family harmony and the ways in which those responsibilities are changing both in urban and rural areas. The analysis is based on scientific articles and documents collected from different media sources in Vietnam. Results shows that socioeconomic changes and the persistence of traditional values are the main factors contributing to intragroup variation with respect to women’s roles and relationships in multigenerational families living in nuclear as well as multigeneration households. The chapter emphasizes the enduring role of filial piety, as well as closeness, intimacy, and mutual help between parents and adult children that continues to be highly valued in the Vietnamese society despite economic, social, and other changes. Evidence suggests that other forms of intimacy besides sex are central to the lives of older women who are expected to play vital roles in preserving family happiness, resolving family conflicts, sharing life experiences, and providing economic support for their children. The chapter shows a shift toward addressing healthy sexuality/sex behavior as pleasure. It highlights a need for further study that situates sexuality as a component of well-being in the life circumstances of older adults in different cultural settings of Vietnam and contributes to understand what barriers may exist in achieving sexual well-being as defined by WHO.