Background and Motivation:
Monitoring the functional health of older adults living independently in the community presents a significant biosensing challenge. Conventional clinical assessment is episodic and retrospective, relying on scheduled visits to evaluate wellbeing. This limits the ability to detect subtle but clinically meaningful changes in mobility, sleep, and daily routine, the earliest behavioural biomarkers of functional decline. This gap is particularly acute in regional and rural settings, where workforce constraints and geographic dispersion further reduce care visibility. Compounding this challenge, older adults frequently under-report symptoms due to fear of losing independence, further reducing opportunities for early clinical detection. There is a compelling need for continuous, passive biosensing solutions that capture real-world health signals without increasing burden on users, caregivers, or overstretched care systems.
Biosensing System Architecture:
Homeara+ is a smart ambient biosensing platform deployed in the homes of community-dwelling older adults in regional Australia. The system integrates a wireless network of passive environmental sensors, including passive infrared (PIR) motion detectors, door contact sensors, and environmental monitors to continuously capture behavioural biomarkers of daily living. Unlike wearable biosensors, Homeara+ requires no active user engagement: the sensor array operates unobtrusively within the existing home environment, generating high-frequency longitudinal data streams that reflect real-world patterns of mobility, activity, and sleep. This design makes the system particularly suited to populations who may not tolerate or sustain engagement with body- worn sensing devices.
Machine Learning and Behavioural Signal Analytics:
Raw sensor data are processed through a machine learning pipeline designed to extract and analyse individual behavioural patterns over time. The analytical framework identifies personalised baseline behavioural signatures and detects statistically meaningful deviations that may indicate changes in functional health status. Rather than generating discrete real-time alerts, the system applies retrospective pattern recognition to characterise gradual shifts, such as changes in sleeponset timing, reduced kitchen activity, or altered mobility trajectories across the home. This approach aligns with emerging paradigms in AI-enabled, data-driven biosensing, where clinical value derives not from isolated point-of-care measurements but from longitudinal behavioural signal analytics applied at the individual level.
Real-World Deployment and Implementation Findings:
Supported by ARIIA funding, this study deployed Homeara+ across multiple regional Australian households in partnership with community aged care providers and academic collaborators from the University of the Sunshine Coast and the University of California Davis Betty Irene Moore School of Nursing. Findings from real-world deployment highlight multi-level contextual factors, spanning policy, funding, service delivery, workforce capacity, and individual digital literacy that shape the translation of ambient biosensing technology into routine care practice. In response, the project developed a suite of open-access educational resources to support informed engagement with the technology across older adults, family caregivers, clinicians, and service providers.
Conclusion:
Homeara+ demonstrates that smart ambient biosensing, combined with machine learning-driven behavioural analytics, offers a viable and scalable pathway to continuous, non-intrusive functional health monitoring for older adults. This work advances the application of next-generation biosensing technologies in healthcare and personalised medicine, with implications for AI-enabled care models in community settings globally. It further contributes a real-world implementation perspective to the growing body of evidence on how ambient biosensing systems can be meaningfully embedded within complex health and social care environments.