Purpose – Identifying opportunities for adaptive reuse of (potentially) vacant offices and care facilities in an increasing market driven context.Design/methodology/approach – This paper is based on research through (re-)design of adaptive reuse of vacant offices and conversion into assisted living facilities (ALF) and two student theses, both case-based analyses of care facilities, the first one with a focus on adaptive-reuse of existing nursing homes and conversion to inter alea an assisted living facility, the second one with a focus on financial feasibility based on a life-cycle cost approach.Findings – Due to new legislation and financing systems in the Dutch care industry further extramural development of healthcare is expected to result in high levels of vacancy in old peoples’ homes Adaptation to new user groups or adaptive re-use for other functions are both means to cope with increasing vacancy. It is expected that new programs will be defined for current care accommodations. However, one of the lessons from transformation projects so far is that a search for highest best use is needed to improve financial feasibility. Decisions about which new functions fit best should be supported by a LCC-based assessment.Research limitations/implications – The number of included cases is limited. Furthermore this research is limited to the Dutch context. However, it is expected that the findings can be applied elsewhere as well, due to international trends on economizing care facilities.Social implications (optional) – Adaptive reuse of vacant offices and care facilities can help to reduce vacancy, to revitalize obsolete buildings and areas, and to avoid missed opportunities and notable societal losses.Originality/value – This paper combines knowledge from different fields – adaptive reuse, feasibility studies, LCC-analysis) and different sectors: offices and care facilities. It also combines more traditional assessment methods with research through design.