• Friday, Jul 10, 2020
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OP-ED: Ageing in Asia is a tricky business

  • Published at 06:31 pm June 5th, 2020

Are we ready to take care of our elderly population?

The most significant demographic challenge facing many countries in Asia is the ageing of the population, and the social and economic impacts that will occur because of the rapid pace and scale of this change.

As a consequence, the growing demand for affordable elderly care services exceeds supply in many countries and needs to be urgently addressed. But it is not only about quantity. Elderly care facilities must be of high quality and designed to provide a supportive physical environment.

A supportive physical environment means a design that improves the quality of life and psychological wellbeing of the elderly as the key users of these facilities, in addition to satisfying the basic functional and safety requirements. These include safety features to prevent the elderly from falling over, emergency aid, fire control, and, particularly, infection control, which has been a prominent issue recently.

These measures will help protect the fragile health condition of elderly people and make their aging process as comfortable as possible. They enable free movement, facilitate perception and cognition, and encourage communication.

Moreover, a supportive physical environment improves the efficiency of the care givers. With circulation flow and visibility within the facility optimized, the number of care workers needed in a facility can be minimized. This will help to reduce the overhead costs and strengthen the financial sustainability of the facility, since the profit margin is usually low even with government subsidies.

Elderly facilities are also a testing place emotionally for care workers, so it is crucial to provide them relief from a high stress environment at both psychological and physical levels through architectural design.

Although many countries have developed general design codes and regulations to guide the basic building configurations of elderly care facilities, a dogmatic adoption of such codes and regulations is far from enough to create a supportive physical environment.

Based on international best practice, here are six key design principles that help create a supportive physical environment at elderly care facilities:


The location of the elderly care facilities should be inside or near a regular thriving community with convenient traffic connections and close access to complete everyday services. Services of elderly care facilities, such as the activity room, should be shared with surrounding neighbourhoods.


Care-centred design provides psychological and physical support to promote autonomy, independence, and privacy. It also helps improve the elderly’s mobility and cognition. Most important, the design must fulfill all kinds of special care needs such as long-term-care, dementia care, rehabilitation, and palliative care. 

Working efficiency

The layout of functional spaces and movement circulation in elderly care facilities should be arranged in accordance with organizational structure and working procedure, creating a shortest-path system and best visual accessibility for care workers. Appealing rest areas and common spaces for the caregivers should also be included.


An inclusive design caters for all, regardless of their age, gender, ability, or status in life, and integrates usability, accessibility, and affordability while diminishing the physical and cognitive barriers. It incorporates gender-sensitive design features, taking into consideration the different lifestyles and emotional demands between male and female elderly residents, as well as the dominant number of female caregivers.


The physical configuration and appearance of elderly care facilities should be designed to be as appealing and relaxing as possible to create a residential environment that fosters a homelike atmosphere. This could be achieved by using domestic furniture, fixtures, and hardware fittings.


Sustainable design reduces energy consumption and pollution emissions during the life cycle of the buildings. Passive energy saving measures and green technologies should be applied in accordance with budgetary and investment considerations. Sustainable design also allows a certain flexibility to adjust to changes in care needs of elderly persons in the long run.

So far, the technical support for these design principles has largely been practiced on a project-by-project basis. As the number of elderly care projects grows in developing countries around Asia and the Pacific, such technical support can be streamlined in a more effective manner.

For example, a collective technical hub can be formed to support multiple projects with a relatively stable expertise pool. This can keep accumulating experience and lessons learned from previous projects and producing operational knowledge accordingly to make a more profound impact in promoting a supportive physical environment for elderly care facilities. 

These measures can provide safe, comfortable, and supportive care facilities for the region’s senior citizens that are sustainable over the long-term. 

Jie Bai is Urban Development Specialist, East Asia Regional Department, ADB. This piece was first published on the Asian Development Blog and has been reprinted with permission.

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