The development of institutional elderly care facilities started relatively late in China, and due, in part, to uneven economic development, the level of care facilities is patchy, and layout designs require improvement and further optimisation. This paper looks at layout design models for institutional care facilities in the US, Germany and Japan, and analyses their evolution and corresponding spatial patterns. Through comparative analyses of these three countries, one can observe the similarities and differences in their development. Using environmental behaviour psychology, this paper examines the reasons for certain layout designs in institutional care facilities in these countries, analysing from a human-centered perspective how to balance the needs of daily life and mental health of the elderly within the architectural design of such care facilities, as well as the impact it has on the architectural layout. Finally, based on the above analysis, this paper introduces a layout model for institutional elderly care facilities across China suitable for different regions with different levels of economic development.