Thermal comfort in aged care: review of systems, envelope, and spatial design

Thermal comfort plays a critical role in shaping the dignity, health, and well-being of older adults in residential care settings, where occupants spend the majority of their time indoors and have limited adaptive capacity. This systematic review examines how the built environment influences thermal comfort in aged care facilities. Following the PRISMA 2020 framework, 16 studies published between 2019 and 2025 were identified and analyzed. An inductive thematic synthesis revealed three interrelated domains: (1) Performance and Control of Environmental Systems in Resident Rooms; (2) Building Envelope, Openings, and Passive Environmental Moderation; and (3) Spatial and Operational Context of Care Facilities and Thermal Experience. The findings highlight that thermal comfort outcomes are shaped by the interaction of these domains, rather than by isolated factors. In particular, user control and adaptive opportunities are associated with improved comfort and well-being, while centralized systems and restrictive operational practices can undermine both. This review highlights the need for integrated, person-centered approaches that align building design, environmental systems, and institutional practices to support thermal comfort in aged care environments.