Understanding how vulnerable patient populations perceive healthcare design can improve the mental, emotional, and health outcomes for all. The goal of this study was to explore geriatric in-patients’ perceived comfort, well-being, and stress in relation to design features in healthcare environments. Environmental factors identified through a review of the literature were categorized, used to evaluate three different hospital settings, and scrutinized in relation to geriatric in-patients’ perceived stress. Analysis revealed subtle preferences and significant insights into the architectural features enhancing comfort and reducing stress for geriatric patients during their hospital stays. Notably, the quantity and type of furnishings, proximity to services and environmental control features, and attributes affording privacy were revealed to be most influential for patient comfort, control, and anxiety.