Passive remote monitoring in Canadian home care: what the trial found, and how to write it into a care plan

What "passive remote monitoring" means

The Canadian trial protocol defines it as "the use of sensors that do not require any action by the individual for the system to work" (Caring Near and Far protocol, JMIR Research Protocols, 2020). Nothing to wear. Nothing to press. A pendant answers "I need help now." A passive sensor answers "has this person moved this morning?"

The main sensor types

What did the Canadian trial find?

The trial enrolled 313 client-caregiver pairs: 174 in Ontario, 139 in Nova Scotia. Each intervention home got a kit tailored to the client, which could include motion sensors, Wi-Fi cameras, fall-alert pendants, contact sensors, pressure mats and a medication sensor. Alerts went to a family or friend caregiver by email, text or phone, free for 12 months (JMIR Aging RCT, Methods, 2025).

Two entry conditions matter for agencies. A caregiver had to be "willing and able to receive the remote monitoring sensor notifications," and the client needed capacity or a substitute decision-maker to consent.

The result

At one year, passive monitoring plus usual home care did not significantly reduce admission to a higher level of care in either province (JMIR Aging RCT, Results, 2025). A hazard ratio below 1 means fewer moves; the 95% CI shows how uncertain the estimate is. Both ranges cross 1, so neither result is significant.

Do not read the Ontario hazard ratio of 0.7 as "30% fewer admissions." The true effect could be zero or harmful, and Nova Scotia showed no reduction.

Why "unproven" is fairer than "useless"

The trial planned 480 home care clients (160 intervention, 320 control) and enrolled 313 pairs. It stopped counting outcomes on February 28, 2020, to keep COVID-19 out of the data. The authors name the small sample and the pandemic as the main limits and ask for longer follow-up (JMIR Aging RCT, Limitations, 2025). A small trial that finds nothing is not proof of nothing.

What the rest of the Canadian evidence says

A 2023 Canadian scoping review found only 14 studies of passive remote monitoring for aging in place and concluded that "more high-quality research on this topic is needed" (Canadian Journal on Aging, 2023).

In New Brunswick's funded service, caregivers who used it reported relief and better sleep. Social workers described role confusion, and internet cost and rural power outages were barriers. Social workers — not clients or their caregivers — were the group most worried about cameras in the home (JMIR Aging, New Brunswick study, 2022).

The honest summary: families like it, and the effectiveness evidence is thin.

So why would an agency add it at all?

The case is modest and practical, not clinical. Among unpaid caregivers of home care clients, those providing more than 20 hours of care a week had nearly 3 times higher odds of reporting distress (Unpaid caregiver challenges and supports, CIHI, 2015-16 data, published 2018). New Brunswick caregivers said sensors eased that worry — a real, if soft, outcome.

For a client who gets two visits a week, nobody knows what happens in the gaps. The UK vendor Just Checking says Manchester City Council ran an "independent pilot of Just Checking technology in their reablement pathway" from July 2022 to May 2023, and reports that the pilot "saw an average reduction in care costs of £174 per week" (Reablement, Just Checking vendor page, 2023). The vendor does not publish the number of participants. This is a vendor's own claim, not a peer-reviewed evaluation, and the figure is in pounds under a UK council funding model. There is no Canadian equivalent.

How do you write passive monitoring into a care plan?

Write it in as "check-in and awareness" support, not a safety guarantee.

Step 1: Fit criteria. It suits a client who lives alone or has long gaps between visits, with someone willing to receive alerts. It does not suit a client who needs hands-on care now, has no responder, or objects to it.

Step 2: A goal you will measure. Missed-morning-routine alerts, night-time activity trends, or caregiver-reported worry. Set a 90-day review date.

Step 3: Alert routing. Name who gets each alert, during which hours, and what happens if nobody responds. The Canadian trial sent alerts to family. Toronto Grace's Remote Care Monitoring program routes alerts from its devices — a pendant, a medication dispenser and medical monitoring devices, not passive sensors — to its own 24/7 call centre (Toronto Grace Health Centre, accessed September 2026). The same routing model could be used for passive sensors. Either can work. Silence cannot.

Step 4: Consent and capacity. Follow your province's rules on substitute decision-makers, and document what data is collected, where it is stored, and who can see it.

Step 5: Install and baseline. Run the sensors for one to two weeks before acting on alerts.

Step 6: Review and exit. At 90 days, ask whether the goal was met and remove sensors nobody uses.

What does the law say about monitoring in Canada?

Which law applies depends on who collects the data. Ontario is one of the provinces whose health privacy law has been "declared substantially similar to PIPEDA with respect to health information" (Provincial and territorial privacy laws and oversight, Office of the Privacy Commissioner of Canada, accessed September 2026). In Ontario that law is the Personal Health Information Protection Act, 2004 (PHIPA, Ontario e-Laws). A commercial vendor may instead fall under PIPEDA. Ask your privacy officer to map the data flow before you sign a vendor contract.

Ontario's O. Reg. 187/22 (in force May 1, 2022) includes a Patient Bill of Rights that strengthens patient and caregiver participation in care planning (OHA Backgrounder on O. Reg. 187/22, 2022). Adding monitoring should be the client's choice, recorded in the plan.

Cameras also record personal support workers and visitors, who did not consent. A camera-free option removes that problem. See camera vs no camera.

The legal section above is general information, not legal advice.

Which technology should an agency choose?

Some motion and contact kits infer a possible fall from a long stretch of no movement. They do not see a fall, and WalledCare makes no fall claim at all. On funding, we could not find a publicly funded program outside New Brunswick, so check your own province's home care schedule, and ask vendors for the total cost, including internet and any call-centre charge.