As China transitions into a deeply aging society, the elderly population’s growth has driven a rapid increase in elderly care institutions and facilities during the “13th Five-Year Plan” period, rising by over 235% compared to the “12th Five-Year Plan”. The ongoing normalization of COVID-19 prevention measures has underscored the urgent need to improve natural ventilation in elderly care residential facilities. This study conducted empirical surveys to assess the current state of natural ventilation in typical elderly care facilities and analyzed the architectural elements influencing it. By examining the needs and preferences of the elderly for natural ventilation, two basic living space layout types were identified through typological analysis. Suitable CFD simulation software was then employed to model key elements, and effective methods to enhance ventilation were summarized. This study found that modifying the floor plan to reduce the depth of south-facing rooms to 8.4 m, relocating external openings to the center of the rooms, adjusting the ratio of ventilation openings to room area to greater than 1/12, and adding 0.5 m high windows facing internal traffic roads can significantly improve indoor ventilation while maintaining privacy. Furthermore, placing the main activity and resting areas of the elderly in well-ventilated zones with minimal drafts can enhance both comfort and ventilation effectiveness. The research provides a scientific basis and methodological guidance for the construction and renovation of elderly care residential facilities.