China’s urban community-based eldercare is often delivered through government-backed, project-driven safety-net programs. Devices can be procured and installed quickly, yet many are installed but unused or abandoned after brief trials. Existing research often attributes this to device performance or older adults’ acceptance, but rarely treats policy implementation, community response reach, and residential spatial conditions as a coupled system. Taking Hefei—an early smart-eldercare pilot city whose institutional arrangements resemble typical non-megacity contexts—as a case, this study explains why fall-detection sensors fail to persist in community home care. We combine multi-stakeholder semi-structured interviews and field observations with grounded theory coding and a human–technology–environment analysis. We map high-risk daily activity routes and key home nodes against sensor placement and effective coverage, and trace the pathway from policy execution and device allocation to frontline handling and longer-term maintenance. Results show abandonment is driven by three linked misalignments: project-style rollouts that separate installation from operations and leave maintenance responsibilities and resources unclear; placements that do not align with everyday movement patterns, creating blind spots or false alarms that undermine trust; and upstream control of data and decisions that reduces community visibility and weakens local response within feasible service radii. We propose a spatial–governance framework for scaling urban smart eldercare that defines minimum necessary coverage along risk routes, specifies community response and maintenance nodes, and embeds operations, accountability, and data-use rules into project design so smart eldercare shifts from deploying devices to sustaining care capacity. It offers transferable lessons for similar Chinese cities.

Authors:
Yuanchen Zhao, Tsinghua University, China
Mi Xu, Chongqing University, China
Xiaoqing Cheng, Tsinghua University, China

About the Presenter(s)
Yuanchen Zhao is a PhD candidate at Tsinghua University School of Architecture and joint PhD researcher at Politecnico di Torino. Interests include urban renewal, healthy and age-friendly cities, and human factors for older adults’ mental wellbeing.

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