This paper constructs an evaluation index system for the suitability of community home and institutional elderly care land development, respectively, from different elderly care modes with the data of urban POI, OSM road network, and expert questionnaires in Changsha urban area in 2021, in order to alleviate the pressure of insufficient land for elderly care brought on by the increasingly serious aging problem. The suitability evaluation index system is based on the intersection of Thiessen polygons with the current elderly care facilities as the center point as the supplementary land for the elderly and explores the optimization path of the land for the elderly in combination with the existing residential land in Changsha. The results show the following: ① The spatial variation of land suitability for both community home and institutional elderly facilities is significant, exhibiting a pattern of “high in the middle and low in the surroundings, with high-value areas clustered in the center of the city, decreasing in suitability toward the periphery, and occasional scattered clusters in the suburbs.” Among them, Furong District has the highest proportion of suitable areas for the elderly; ② Utilizing Changsha’s Tianxin and Yuhua districts as case studies, the optimal path of land use for the elderly are investigated to provide a foundation for land use planning for the elderly in Changsha.