With an increase in the proportion of Australians aged over 65, and high government expenditure on residential care, there is a strong imperative to find smart, safe solutions to support older people to stay in their own homes. There is a growing interest in Australia for assistive technologies that provide home monitoring to promote health and wellbeing. This solution will only be viable if it meets with the expectations of older residents and their families. In the first smart homes pilot in Australia, we sought to ascertain barriers and facilitators of this technology. There was an overall positive response to the system, despite a slight tendency for residents to modify their behaviour due to perceived surveillance. Positive outcomes included increases in family communication, health autonomy and advances in technology uptake. Our findings suggest that a combination of considered placement of in-home technology, straightforward medical devices and a supportive human element will ensure that the technology meets the balance of service provision and preservation of dignity. Smart homes could mitigate the challenges associated with aged care while affording peace of mind for seniors and families.