This paper presents ongoing research to define the framework of a computational design approach based on the ideas of spatial analysis and spatial synthesis to implement multi-criteria evaluations and provide evidence of the performance of the design alternatives in the specific case of home adaptation for healthcare at home. The European health systems place among their priority objectives the strengthening of the provision of healthcare at home to guarantee the well-being of elderly people and to limit, at the same time, the unnecessary use of resources. Therefore, existing homes must provide adequate safety, comfort, and accessibility features to ensure a high quality of life for the care receivers and facilitate the carer' tasks. To address the complexity of the requirements to be met, we propose a spatial decision support system (SDSS) to implement multi-criteria assessments to ergonomic design problems at a spatial scale of apartment homes. The system is intended to streamline and assist designers and homeowners in planning interventions for home adaptations for healthcare. Such design problems can be formulated as decision problems with costs and benefits modelled within the constraints of validity and quality criteria. Concerning the specific field of study, the system evaluates the degree of compliance with the accessibility and visibility quality criteria of each design alternative. The reiteration of the evaluation mechanism allows for the classification and supports the selection of satisfactory technical solutions identified with an informed and well-balanced trade-off between the relevant quality criteria.