Aging Adaptation Transition of Health Care Buildings for Accessibility Optimization for the Elderly

Abstract

As society develops, the aging population issue is becoming more serious and gaining global attention. Meanwhile, the building industry worldwide is focusing on making buildings more convenient for the elderly. This study focuses on a health care building, analyzing its aging-friendly design. It examines issues related to walking situations and activity spaces and proposes optimization strategies based on relevant codes and actual needs. Through optimization and transformation, the walking distance to the nearest exit for the elderly in the building has been reduced by 36.8%, the walking distance to activity space for the elderly has been reduced by 8.4%, and the average public activity space of each elderly person has been increased by about 23.5%. In addition, the handrails of the accessible stairway have been changed to double handrails, which is more suitable for the different needs of the elderly, and the space of the wheelchair-accessible elevator has been expanded, which is more convenient for the elderly’s activities in elevators. This paper explores the feasibility and design direction of the aging-friendly architecture, and it aims to provide a valuable reference for the renovation of aging buildings.

1. Introduction

1.1. Backgrounds

Nowadays, China’s society and economy are developing rapidly, but at the same time, the problem of an aging society is becoming more and more serious. According to the World Health Organization, China is a country with one of the fastest rates of population aging in the world, and it is forecasted that the population of people over 60 years old will reach 28% by 2040 [1]. One of the problems caused by the aging problem is the increasing burden of chronic diseases. Currently, in China, people over 40 years old suffer from at least one non-communicable disease, and the number of people suffering from non-communicable diseases will continue to increase in the future; among them, about 50% are over 65 years old [2]. According to the China Research Center on Aging, in 2013, 100 million of China’s 202 million elderly people suffered from at least one chronic non-communicable disease [3], and many of them even suffered from multiple chronic diseases at the same time. The proportion of deaths due to non-communicable diseases gradually increases with age, and about 80% of elderly people aged 60 years and above will die from chronic non-communicable diseases. The increase in the number of elderly people and the number of people suffering from chronic diseases will also lead to a significant increase in the number of care-dependent elderly people in China, with the dependency rate of China’s total population projected to rise from 5.6% to 6% from 2010 to 2050 [4], and about 60% of elderly people will seek institutionalized care when they no longer consider themselves suitable for aging in their own homes [5]. All these points have led to an increasing demand for elderly care institutions in China.

In the face of these problems, the construction of social infrastructure is faced with great challenges, and the government has begun to pay more attention to building facilities that meet the needs of the elderly and enable them to enjoy equal public services. In the building industry, many kinds of architectural design have also begun to pay more attention to aging-friendly design. As the process of urbanization is accelerating, many elderly people are moving to cities, and the pressure of family support is high; in response, many health care buildings for the elderly have been developed. However, as living standards rise, the requirements of elderly people for health care buildings have also gradually increased. According to Maslow’s hierarchy of needs, human needs are divided into five categories, including physiological needs, security needs, belonging and love needs, esteem needs, and self-actualization needs; similarly, for the elderly, there is also the need to think about spiritual and emotional needs [6]. At present, the design of many health `care buildings is only considered to comply with the national codes, neglecting the higher needs of the elderly. In addition, according to the study, in 2010, 19% of elderly people over 60 years old had difficulties in daily activities [7], while 26% of elderly women and 11.3% of elderly men were unable to walk 1 km or use stairs [8]. This leads to a very high susceptibility to falls, and falls are officially the main cause of injuries among the elderly, so paying attention to the accessibility of the elderly is also very important. All in all, there is a pressing need to optimize and transform these buildings to better serve the elderly population.

1.2. Literature Review

Population aging has become an important global issue, and if measures are not taken promptly, the aging problem will further lead to other social problems, such as labor shortages, GDP decline, and social care burdens. According to the guidelines of the World Health Organization, there are eight aging-friendly domains: outdoor space and architecture, transportation, housing, social participation, respect and social inclusion, civic engagement and employment, communication and information, and community support and health services [9]. As the elderly age, their physical functions decline and their movement is restricted; buildings become important for their activities, so it is very urgent to optimize and retrofit the interior of buildings for the elderly. Nowadays, because of the various practical needs of many families, the elderly will choose to live in health care buildings, and the services provided by health care buildings can be divided into 24 h care and day care, and health care buildings not only take care of the physical health of the elderly but also take care of the mental health of the elderly. If the elderly experience loneliness, they will be more likely to experience psychological problems [10], so the public activity space renovation and walking distance optimization of elderly health care buildings is very necessary, and the optimization of the renovation can provide the elderly with a more convenient opportunity to find companions.

Fallah et al. [11] highlight the increased demand for age- and disability-friendly residential design as the world’s population ages. An inclusive design approach allows designers to design products and services that meet the needs of a wider group of users, regardless of age and ability. Liu et al. [12] discuss the problem of currently designed buildings being unsuitable for older people under the concept of age-friendliness, and they present the influencing factors, principles, and problems and solutions for the spatial design of modern buildings for the elderly. Han et al. [9], using a scient metric approach, proposed a theoretical framework that considers the active role of older people in community spaces, as well as the physical and social aspects of community spaces, to provide guidance for the development of age-friendly community policies. Furthermore, in another article, Han et al. [13] explored how the concept of age-friendly cities and communities (AFCC) can be integrated into sustainable urban development (SUD), emphasizing the importance of policy integration and proposing a strategy that uses the silver-haired market as an entry point. A study by Han et al. [14] guides “active aging” community regeneration in modular residential areas based on community spatial characteristics and neighborhood interactions and suggests using existing resources to improve spatial organization and community communication. This article suggests using existing resources, improving spatial organization and community communication, and targeting the increase and optimization of the layout of elderly care facilities. Tao et al. [15] studied five communities in Singapore known for their “aging-in-place” strategies and found that adequate physical facilities and connectivity to the city were critical to older people’s satisfaction with the community. According to Ayala et al. [16], the principles of age-friendly home design include a holistic definition of home and its impact on older adults, emphasizing their mobility and physical needs in the home environment. Liu [17] uses computer data analysis software to data mine user behavior in interior spaces to guide the design of more rational spaces. A replicable methodology is proposed for all remodeling processes. Fang et al. [18] further proposed the concept of the co-creation of inclusive spaces and places, emphasizing the importance of intergenerational and age-friendly living ecosystems to enhance public health planning. The study by Luciano et al. [19] introduced a framework for assessing the aging of housing by detecting and identifying physical and non-physical features of home environments through qualitative and quantitative metrics to support older adults’ independent living at home. Tao et al. [20] assessed the thermal, light, and acoustic environments of Care and Attention (C&A) homes in Hong Kong through field measurements and occupant surveys. The study found that older adults preferred warmer environments, while actual measurements showed lower indoor temperatures and higher humidity. A study by Jiao et al. [21] explored the thermal environment characteristics of transition spaces in elderly care buildings in Shanghai and their effects on the thermal adaptation of older adults through field surveys and physical measurements. It was found that the temperature difference between the transition space and the indoor environment had a significant effect on the indoor thermal satisfaction of the elderly, with the highest thermal satisfaction at 6 °C in winter and 2 °C in summer. Ideal transition space designs should utilize semi-open exterior porches to help older adults adapt to temperature changes through activities such as sunbathing and exercise.

These studies indicate that age-friendly buildings are not only just technical issues but also involve multiple social, economic, and cultural dimensions, requiring interdisciplinary collaboration and policy support to ensure that the elderly can maintain independent living in a safe and comfortable environment. One of the most important aspects of enabling older people to live independently is to ensure that they are safe and have enough recreational activities during their daily activities, so it is very important to study activity spaces and walking of the elderly.

1.3. Objects and Focus

In order to better study the area of public activity space and walking for the elderly and optimize elderly health care buildings, this paper takes a designed elderly health care building as the object of study and reveals how to enhance the comfort and functionality of senior living environments through careful study of these key elements and then improve their quality of life and social interaction. The research is structured into the following sections: (1) Analyze the existing health care building and clarify the nature and type of the health care building as well as its existing condition. (2) Analyze the relevant building codes to determine the requirements for the access and public activity spaces for the elderly, ensuring that the walking distance, safety facilities, and public activities space in the building meet the requirements of codes, and then conduct further optimization on this basis. (3) Propose feasible optimization strategies to improve the accessibility and safety of the health care building and aim to provide a valuable reference for the aging-friendly renovation of other aging buildings.

2. Materials and Methods

This section first introduces the subject of this paper, a health care building for the elderly located in Sanya, Hainan, China, so that readers can understand the internal situation and geographical location of the subject. Then, it analyzes the relevant codes so that readers can understand the minimum requirements for public activity spaces, walking distances, and accessibility of stairs and elevators in health care buildings for the elderly. These minimum standards are compared with the existing design to find out the problems of the existing buildings and propose optimization strategies according to these problems (Figure 1).

2.1. Illustrative Case and Current Situation

A health care building for the elderly is the subject (Figure 2). This health care building is one of the newly designed community centers. The design starts with solving the practical needs of residents and aims to design a neighborhood community center that considers all age groups and covers multiple functions.

Due to the limited research resources, it is not possible to cover multiple cases, so this study chooses to conduct an in-depth excavation study on a single case. This study chose this recreational building for analysis mainly based on its data availability, with complete design information, and the fact that the building faces typical problems such as insufficient public space and a long walking distance, which makes it a good sample for studying optimization strategies.

According to the research, it is known that the health care building for the elderly has a very important and positive effect on the health of the elderly [22]; in today’s society, the aging problem is very serious, and it is very important to set up a health care building for the elderly in the community center. This building can provide simple consultation for the elderly’s daily health issues as well as a place for routine health check-ups. In addition, this building offers 24 h care for the elderly, with a total of 28 beds, of which there are 16 nursing care beds and 12 non-nursing care beds (Figure 3).

According to the data of the Seventh National Population Census Bulletin of Sanya City, among the population of Sanya City, aged 0–14 years old are 17.67%; aged 15–59 years old are 71.92%; and aged 60 years old and above are 10.42%, of which aged 65 years old and above are 6.95%, and the proportion of the population aged 60 years old and above increased by 3.41% compared with that in the Sixth National Population Census in 2010, with the proportion of the population aged 65 years old and above increasing by 2.25% (Figure 4). Compared with the Sixth National Population Census in 2010, the proportion of people aged 60 and above increased by 3.41%, of which the proportion of people aged 65 and above increased by 2.25% [23]. Sanya, as a well-known tourist city, is especially popular in winter, when many elderly people from the cold northern regions come to Sanya for short stays. Therefore, the design of community centers also needs to give full consideration to the needs of the elderly in order to adapt to the needs of all-age living. Therefore, it is necessary to build new health care buildings for the elderly in community centers.

Elderly people are very likely to have their conditions aggravated because they are unable to seek medical treatment in time; the newly built health care building can avoid this situation, which is usually equipped with professional nursing staff and advanced medical equipment to provide high-quality geriatric care services, so that elderly people can receive timely and comprehensive medical support under the care of professional staff. Furthermore, health care buildings are not only places for the elderly to live and receive treatment but also serve as community activity centers to enhance the interactions between the elderly and the outside world and their sense of social participation. This socialized lifestyle can effectively improve the overall health of the elderly population.

The project is located in the Hailuo area of Jiyang District, Sanya City, Hainan Province. Jiyang District is located in the central and eastern part of Sanya City, it is the seat of the party and governmental organs of the Sanya Municipal Party Committee and City Government, and the area has been recognized by the Ministry of Culture and Tourism of the People’s Republic of China as the first national demonstration area of regional tourism. With the development of the city, the Hailuo area is planned to be an international business headquarters park and a super-exclusive supporting service community with integrated industry and city, blending mountains and water and forming a functional structure of “one axis and one belt, one chain and multiple corridors, and three districts and multiple clusters” (Figure 5). Among them, “one axis” refers to the central business green axis; “one belt” refers to the waterfront cityscape belt of Linchun River; “one chain” refers to the green lifestyle service chain; “Multiple corridors” refers to the formation of multiple green corridor spaces relying on the Linchun River, the central business green axis, and the water catchment corridors; “three districts” refers to the Hailo International Business Service area, the International Talent Residential area, and the All-age Friendly Residential area; and “multiple clusters” refers to the central business green axis [24].

Society keeps developing, and the city needs to be renewed. In order to promote the development of the city and improve the quality of life of the residents, the Sanya government has decided to renovate and upgrade the Hailo area. Nowadays, part of the land grant and demolition work has been completed in this area, and the related municipal infrastructure and supporting facilities construction projects are also being planned and implemented.

The project site (Figure 6) is located at the intersection of the planned Xueyuan Road and Wangshan Road, with Hailuo Ridge to the southeast and the Linchun River winding through the northwest. These two planned roads are directly connected to Sanya’s main arterial roads, Yingbin Avenue and Fenghuang Road. The site enjoys a prime geographical location with convenient transportation and is surrounded by a beautiful natural ecological environment. According to the land use planning layout, the surrounding area of the site is diverse in terms of land functions. To the northwest, there is commercial land with high foot traffic; to the east, there is residential land with target groups served by wellness centers; to the south, there are urban green spaces and financial zones, which can enhance greenery. This environment plays a positive role in improving the quality of life for residents and attracting people. Additionally, in the future, the surrounding area will feature well-developed public service facilities, providing a convenient and comfortable living environment for the residents of the district.

2.2. Building Codes Analysis

The first step is to review the code and understand the requirements related to evacuation distances, safety assistance facilities, and activity spaces of health care buildings for the elderly. The building codes relevant to this study include the “Standards for design of care facilities for the aged” JGJ450-2018 [25], the “General code for fire protection of buildings and constructions” GB 55037-2022 [26] and the “Codes for accessibility design” GB 50763-2012 [27] (

Table 1. Relevant regulations in the codes.

Codes	Regulations
“Standards for design of care facilities for the aged”	There should be entertainment and fitness rooms in the senior building	Seats in dining room: nursing care: ≥40% of beds; 4 m2/seats non-nursing care: ≥70% of beds; ≥2.5 m2/seats		Area of entertainment and fitness rooms ≥ 2 m2/bed (person)
“General code for fire protection of buildings and constructions”	“The evacuation distance from any point in a room to the room’s evacuation door should not exceed the maximum allowed evacuation distance from the evacuation door of rooms located on either side or end of a pocket corridor to the nearest safe exit”.
“Codes for accessibility design”	The size of cabin: 1500 mm (width) × 2700 mm (length) Handrails 850~900 mm high Mirrors: 900 mm high to the top		Single-layer handrails: 850~900 mm Double-layer handrails: upper 850~900 mm lower 650~700 mm

).

Regulation 5.1.5 of the “Standards for design of care facilities for the aged” stipulates the following: “The entertainment and fitness rooms of 24 h care facilities for the aged shall be set up to meet the corresponding activity needs of the elderly, and may have rooms or spaces for reading, internet, chess and cards, calligraphy and painting, classrooms, fitness, and multifunctional activities”. And regulation 5.3.1 stipulates the following: “The total usable area of the entertainment and fitness rooms in care facilities for the aged shall not be less than 2.00 m²/bed (person)”. Additionally, the number of seats in the dining room of 24 h care facilities for the aged shall be configured according to the number of people served; the number of seats in the dining room of care units for nursing care beds shall be configured according to not less than 40% of the number of beds served, and the usable area of each seat shall not be less than 4.0 m²; the number of seats in the dining room of non-nursing care beds shall be configured according to not less than 70% of the number of beds served, and the usable area of each seat shall not be less than 2.50 m² [25].

Regarding evacuation distance in the building for the elderly, the “General code for fire protection of buildings and constructions” stipulates the following: “The evacuation distance from any point in a room to the room’s evacuation door should not exceed the maximum allowed evacuation distance from the evacuation door of rooms located on either side or end of a pocket corridor to the nearest safe exit”. Furthermore, the fire resistance rating of elderly care buildings should not be lower than Class 3. In the new fire code, there is no clear data on the evacuation distance, so the evacuation distance is still calculated and discussed according to the original fire code. In the original code, if an automatic sprinkler system is installed, the evacuation distance can be increased by 25%. And the maximum allowed evacuation distance from the room’s evacuation doors located on both sides or ends of the pocket corridor to the nearest safe exit in an elderly building with a fire-resistance rating of Class 3 is 15 m. Therefore, the maximum evacuation distance of elderly care buildings is 18.75 m [26].

We need to do more than think about the passing distance of the elderly; we also need to think about the safety of the elderly when they are walking. In the “Codes for accessibility design”, there also are stipulations about accessible stairways and wheelchair-accessible elevators. The height of the handrail of the accessible stairway should be 850~900 mm, if it adopts a single-layer handrail; and if it adopts a double-layer handrail, the height of the upper handrail should be 850~900 mm, and the height of the lower handrail should be 650~700 mm. About the wheelchair-accessible elevator, the elevator should be specially chosen for hospital beds, and the size of its cabin is generally 1500 mm (width) × 2700 mm (length), and the cabin’s three walls should be set up with handrails 850~900 mm high, on the front side of the cabin, a mirror or mirrored material should be installed from 900mm to the top of the cabin, which is convenient for the elderly in wheelchairs [27].

2.3. Existing Problem

As the physical function of the elderly declines with age, the speed, frequency, stride length, etc., with respect to walking, undergo changes; body regulation systems can show signs of aging or even lesions, and while walking, elderly people will appear to lift their feet slowly, dragging them on the ground, and they will show signs of stride shortening and so on. Studies have shown that the average step width for older men is 0.105 ± 0.016 m, for younger men is 0.122 ± 0.026 m, for older women is 0.090 ± 0.023 m, and for younger women is 0.103 ± 0.021 m [28]. In order to facilitate the calculation, we use the average data to calculate the number of walking steps; the average step width of the elderly is calculated as 0.098 m, and the step width of young people is calculated as 0.106 m.

In the original design, according to measurement, the number of service beds is 28 people, the total area of activity space is 842.18 m², and the average activity space is 30.08 m²/bed(person). According to codes, the minimum area of activity space in this building is calculated as shown in Equations (1)–(3):

$$S_{min}=S_{entertainment}+S_{canteen}$$

(1)

$$S_{entertainment}=P·c_1$$

(2)

$$S_{canteen}=P_{nursing}·\alpha ·c_2+P_{\mathit{\text{non-nursing}}}·\beta ·c_3$$

(3)

where S_min is the minimum area of activity space, m²; S_{entertainmnet} is the minimum area of the entertainment and fitness rooms, m²; S_canteen is the minimum area of the dining room, m²; P is the total number of people (person); P_nursing is the number of nursing care beds (person); P_non-nursing is the number of non-nursing care beds(person); the value of $c_1$ is 2 m²/bed (person); the value of $c_2$ is 4 m²/bed (person); the value of $c_3$ is 2.5 m²/bed (person); the value of α is 40%; the value of β is 70%. After calculations are completed, the minimum area of activity space in this building is 102.6 m²; this building is conformed to coeds, but during design, there was little consideration for the spiritual and entertainment needs of the elderly. The activity spaces are often large and empty without thinking about the diversity of activities, and only a few activity rooms are set up, which is far from meeting the needs of the elderly in their daily activities. Additionally, these rooms are far away from the living space of the elderly, resulting in excessive walking distances, and as the physical strength of the elderly declines, it is necessary to further shorten the elderly’s walking distance in the building in order to better meet their needs. We took four representative points (Figure 3) in the living space section for measurement (see

Table 2. Walking distance in the original health care building for the elderly.

	Point 1	Point 2	Point 3	Point 4	Average
To the nearest exit	28.82 m	17.82 m	33.75 m	32.62 m	28.25 m
To activity room on the first floor	48.69 m	37.69 m	53.63 m	52.49 m	48.12 m
To outdoor activity room	59.47 m	48.47 m	64.40 m	63.27 m	58.90 m
To communication space	58.33 m	6.12 m	5.88 m	7.81 m	19.54 m
To psychological counseling room	47.53 m	47.18 m	50.76 m	33.74 m	44.80 m

), and the average distance from the living space to the activity space is calculated as shown in Equations (4)–(6):

$$\stackrel{-}{d_i}={\displaystyle \frac{d_1+d_2+d_3+d_4}{4}}$$

(4)

$$\stackrel{-}{D}=\sum _{i=1}^4\stackrel{-}{d_i}=\stackrel{-}{d_1}+\stackrel{-}{d_2}+\stackrel{-}{d_3}+\stackrel{-}{d_4}$$

(5)

$$F={\displaystyle \frac{\stackrel{-}{D}}{x}}$$

(6)

where $\stackrel{-}{d_i}$ is the average distance from every point to one of the activity spaces, m; $d_i$ is the walking distance from four points to one of the activity spaces, m; $\stackrel{-}{D}$ is the average distance between the selected four points and every activity space, m; F is the average number of steps; x is the average step width, m, after the calculation can be obtained, the average distance from the living space to the activity space is 42.84 m, and the average number of steps for young people is 404, but the average number of steps for an elderly person is 437, which is 8.2% more than a young person. And the walking distance from the living space to the nearest safety exit is 28.25 m, and the average number of steps for a young person is 267, but the average number of steps for an elderly person is 288, which is 7.9% more than a young person, and the distance to the nearest exit has far exceeded the requirement of codes, and it is urgent to correct this. In addition, regarding the safety of walking, the handrail height of the original design is set unreasonably; the height of the height is 1100 mm, which is too high for the elderly, and there is only a single handrail; and the elevator design did not take into account the use of hospital beds, and the size of the cabin is relatively small. Furthermore, the placement and quantity of stairs and elevators were not adequately considered, resulting in some rooms at a considerable distance from both the elevator and staircase.

2.4. Optimization Strategies

The current situation and the problems of this health care center for the aged are integrated, and the optimization idea mainly starts from the perspective of improving the walking situation for the elderly and enhancing the public activity space (Figure 7). Through the analysis of the current situation and the study of the problems, it can be known that this health care building for the elderly has excessive walking distances, inadequate safety assistance facilities, and limited public activity spaces that lack a comprehensive design, which need to be optimized and renovated. Two optimization strategies are proposed to address the above problems: (1) Increasing activity spaces. Expanding the area of the public activity space, breaking up the large and empty activity space, adding different types of activity spaces, and integrating the activity space into other functional spaces to reduce the walking distance from the living room to the activity space. (2) Improving accessibility and safety. Increasing the number of accessible stairways and wheelchair-accessible elevators and shortening the average distance from each room to the safety exit. In addition, we should change the handrails of the staircases to a double-layer design and lower the height of the handrails to adapt them to the various needs of the elderly. At the same time, we should enlarge the size of the cabin to ensure that the wheelchair and the hospital bed can have sufficient space and add appropriate handrails on three sides of the elevator, along with a mirror on the front side.

After optimization, the building is still able to provide 24 h care for the elderly, and the area of medical consultations and check-ups has been reduced. In addition, increasing the number of people that can be served and improving the living environment for the elderly are important. After optimization, the total number of beds is 30, of which 18 are nursing care beds and 12 are non-nursing care beds (Figure 8).

3. Results and Discussions

3.1. Activity Space

In order to meet the spiritual and entertainment needs of the elderly, based on the original design, we undertook optimization and renovation projects. In the original design, the activity spaces were limited to basic functions, such as sporting, dining, and communication, but they lacked more targeted entertainment and social features. To address this shortcoming, we added a variety of activity spaces designed for seniors during the renovation process, such as a mahjong room, a projection room, and a dance area. The addition of these features not only enriches the daily activities of the elderly but also increases the possibility of social interaction, thus improving the overall quality of life. And the area of each activity room is more compact than the original [29], but the total area of the activity space as well as the per capita area of the activity has increased. After the renovation, the number of beds (people) served by the health building is 30, the total activity area is 1114.18 m², and the per capita area of the activity is 37.14 m²/bed (person), a 23.5% increase compared with the original design (Figure 9). So, this redesign not only provides the elderly with more diverse options for their daily activities but also ensures a more comfortable and spacious environment. By offering a variety of engaging and well-structured spaces, the health care building promotes a better quality of life for its residents, fostering both their physical and mental well-being.

3.2. Accessibility of Walking

To enhance the accessibility of the building and reduce the walking distance for elderly residents, a series of optimizations were made to the original design. These improvements focus on making it easier and safer for elderly individuals to move in the building. Key modifications include increasing the number of stairways and elevators, which significantly shortens the distance to safety exits. Additionally, activity spaces have been strategically integrated into functional areas of the living spaces, minimizing the distance elderly residents need to travel to reach public activity areas. Taking four representative points within the living space for analysis (Figure 8), we obtained the following results (Figure 10): After the renovation, the average walking distance from living areas to the nearest safety exit has been reduced to 17.83 m, with an average of 182 steps, representing a 36.8% reduction compared to the original design. Similarly, the average walking distance to activity spaces has decreased to 39.25 m, with an average of 401 steps, marking an 8.4% improvement over the original design. So, these renovations ensure that elderly residents can move more conveniently and quickly within the building, whether heading to safety exits or accessing activity spaces.

3.3. Safety of Walking

To enhance the safety and accessibility of the building for elderly residents, key modifications were made to the staircases and elevators. The single handrail was optimized by replacing it with a double handrail of a reasonable height. This adjustment ensures that elderly individuals of varying heights can easily grip the handrails, providing greater stability and reducing the risk of falls [30]. Similarly, the elevators were upgraded to improve both safety and comfort. The cabin size was increased to accommodate mobility aids such as wheelchairs and walkers, ensuring ease of use. Handrails were installed inside the elevator to offer additional support and stability during movement, and mirrors were also added to the elevator interiors. These improvements create a safer and more user-friendly environment for elderly residents.

3.4. Daylight Factor and Ventilation

Lighting and ventilation are important criteria to judge whether the building is suitable for the elderly to live in or not; this paper does not specialize in the light environment and ventilation of the building, but here we can use these two indicators to evaluate whether the transformed building is suitable for the elderly to live in or not.

According to the “Standard for daylighting design of buildings” (GB 50033-2013 [31]) and the “General code for building environment” (GB 55016-2021 [32]), we used the Dali2023 of the Thsware to calculate the lighting coefficient of the building. This project adopts the simulation method of Radiance to simulate lighting and calculate the daylight factor. In the simulation analysis, the CIE full cloudy sky is used to simulate the lighting conditions, and the light reflection is set to be three times, the functional rooms take a height of 0.75 m from the ground as the reference plane, while the public space takes the ground as the reference plane directly. The calculation grid is divided according to the size of the room to ensure the accuracy of the simulation: for rooms with an area of less than or equal to 10 square meters, the grid size is set to 0.25 m; for rooms with an area between 10 and 100 square meters, the grid size is 0.50 m; and for rooms with an area of more than or equal to 100 square meters, the grid size is 1.00 m. Outdoors, the shading effect between neighboring buildings was considered, while indoors, the effect of indoor furniture and other facilities was ignored, and only indoor permanently fixed structures, such as ceilings, floors, and walls, were considered.

According to research findings, the elderly not only have a greater need for daylight due to a decline in the ability of the physiological perception system but also have a psychological need; adequate sunlight can reduce the emergence of psychological problems in the elderly [33]. In this building (Figure 11), on the first floor, the highest daylight factor is 17.8; it is mainly found in the corner area, where windows are opened on both sides for lighting. This area receives sufficient natural light and has the best lighting effect. The lowest daylight factor is 0, which mainly occurs in the hallway section. Due to the lack of direct window lighting, the aisles rely on artificial lighting to meet the light demand. And the main activity spaces are well-lit and meet the requirements of the relevant codes, ensuring that these spaces are in good condition for use. However, some of the transportation spaces lack windows with direct access to the outside, so natural lighting in these areas is limited and relies on artificial lighting as a supplement, and the light factor of the consulting rooms on the first floor near the atrium does not meet the light requirements (Red box in Figure 11). On the second floor, the highest daylight factor is 14.9, which is mainly found in the connecting corridors, where more natural light is available due to the high number of windows. The lowest daylight factor is 0, which occurs in the interior of the communication hall and part of the transportation space. Due to the limitations of the architectural layout and the location of the windows, these areas are unable to obtain natural light directly, and they can only satisfy basic lighting needs through artificial lighting. The main living space for the elderly on the second floor has sufficient lighting; it meets the requirements of the relevant codes and takes into full consideration the needs of the elderly to ensure their comfort and safety in daily life. Overall, the building design has fully considered the lighting needs of each functional area, and in the main activity space and living area, the daylight factors are good and meet the standards of the design specifications, while in part of the transportation space, the insufficient light is supplemented by artificial lighting to ensure the lighting needs in the overall environment.

Elderly people in health care buildings spend a very long time indoors, and air quality is an important factor in the health status of older people; if effective measures are not taken, elderly people will be exposed to poor air most of the time, and ventilation is a very effective measure to improve indoor air quality [34]. According to the “Assessment standard for green building”, the indoor and outdoor airflow distribution and flow rate of the building were calculated using VENT2023 of Thsware and CFD calculation method.

Based on the simulation results, we obtained the following results: the ventilation of the exterior of this building is good, and the maximum wind speed can reach 1.9 m/s (Figure 12). It is mainly concentrated in the corners of the building, and these locations usually have high wind speeds due to the geometric shape of the building and the influence of the surrounding environment. The overall design of the building takes into account the need for natural ventilation, ensuring that the wind speed in the external environment is appropriate and conducive to air circulation. Inside the building (Figure 13), the highest wind speed on the first floor is 1.59 m/s, and the highest wind speed on the second floor is 1.67 m/s. This indicates that the air circulation inside the building is good, especially in the activity space and the living space for the elderly, it can achieve effective air exchange and keep the indoor air fresh and smooth. Overall, the ventilation effect of the building is satisfactory both externally and internally, providing a healthy and comfortable living environment for the occupants and giving full consideration to the needs of the elderly.

The lighting factor and wind speed inside the building should only be increased to a certain extent; they have ranges that make the residents feel the most suitable; the lighting and ventilation of the building basically meet the requirements of the code, but the question of how to make the building more suitable for the elderly to live in should be further studied.

3.5. Discussions

This paper is in line with the direction of most previous research on age-friendly buildings, with the goal of improving the comfort and convenience of the elderly in buildings. However, most of the previous studies on public activity space and walking distance for the elderly are set in outdoor environments, while this paper focuses on the optimization of public activity space and walking distances for the elderly in buildings.

Shortening the walking distances of the elderly in the building can reduce the burden of the elderly when walking and make the elderly more willing to go out of their rooms to go out for activities. And the optimization of the public activity space in the recreational building for the elderly can provide a richer choice of activities for the elderly, encourage the elderly to carry out activities, and provide a space for the elderly to socialize and maintain social relationships, reducing the loneliness of the elderly [35]. According to relevant research, elderly people who carry out daily activities and maintain a healthy lifestyle will have a favorable mental health impact, increase their positive emotions, and improve their subjective sense of well-being and life satisfaction [36].

Thanks to the results of this study, it is hoped that future aging-friendly buildings can be designed with reasonable spatial layouts, with core functional areas arranged in easily accessible locations to effectively shorten the walking distance of the elderly in the building, and with resting nodes and auxiliary facilities set up on the walking paths to improve the safety of the elderly walking. And, in the design of public activity space, a moderate size is adopted, and a variety of functional activity spaces are designed to meet different activity needs and enhance the flexibility and practicability of space.

This optimization is expected to provide long-term comfort and convenient lives for the elderly. In order to evaluate the effectiveness of this optimization over time, in the future, regular return visits and questionnaire surveys can be planned at certain intervals to collect the opinions of the elderly, check the frequency of the use of each flow line inside the building, and test the use of the accessible elevator and the staircase, to evaluate whether their safety and convenience can be maintained effectively over time.

4. Conclusions and Prospects

This paper focuses on the age-friendly renovation of health care buildings, primarily addressing two aspects: elderly accessibility and public activity spaces. The goal is to create a more suitable environment for the daily lives of the elderly. Through the improvement of the existing building layout and the optimization of the existing facilities, the walking distance to the nearest exit of the elderly in the building has been reduced by 36.8%, the walking distance to activity spaces for the elderly has been reduced by 8.4%, and the average public activity space of each elderly person has been increased by about 23.5%. Optimization enables the elderly to walk more safely and go to the targeted room more quickly in the building, while also addressing their entertainment needs and enriching their mental and emotional well-being.

However, there are limitations to this paper. This paper only analyses the retrofitting of aging buildings from the perspective of the public activity space in the buildings for the elderly and the walking distance inside the buildings; however, in practice, those retrofitting aging buildings have to consider more influencing factors, such as the existing building design, the physical conditions of the elderly, mental health problems, socialization, safety, the sense of belonging and identity, and so on. To address the shortcomings of this study, the following prospects are proposed for the future:

(1) A lot of research on age-friendly building renovation focuses on the physical factors of the elderly, but the mental health of the elderly is also an important factor that affects their happiness in daily life. Future research on age-friendly buildings for the elderly could consider and address the psychological needs of the elderly.

(2) In addition to the per capita area of public activity spaces, future research could further explore the association between the area of public spaces and the physical health of the elderly, in addition to how the planning of public spaces can help the elderly to be more active in various activities and help improve their health.

(3) Future research could also integrate age-friendly building design with sustainable development by conducting in-depth studies on lighting and ventilation in buildings for the elderly and using green and energy-efficient designs to reduce energy consumption, while making the built environment more suitable for the elderly to live in, thereby enhancing the quality of life and happiness of the elderly.

Although this research on the aging adaptation transition of the walking distance and average area of activity spaces cannot comprehensively examine the strategies for the aging adaptation transition of senior buildings, this renovation project hopes to serve as a reference and guide for future relevant age-friendly renovations and relevant studies of other aging buildings, contributing to the development of aged-friendly buildings’ design.