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In smart home systems (SHS), devices intercommunicate to create an intelligent environment that can monitor the inhabitant's health state and provide adapted services.However, existing health monitoring systems (HMS) do not provide adapted services to the patient autonomy degree. Furthermore, in these critical systems, the Quality of Service (QoS) aspect is very important; therefore, service level agreements (SLA) are the best solution to define and guarantee the expected QoS levels, nevertheless, existing SLA specification languages lack expressiveness in terms of user preference specification, dynamic service management and pricing. In this work, we propose an elderly health state-aware SHS to offer adapted services according to the elderly health state, it is based on three main parts: (a) the functional autonomy measurement system (SMAF) for calculating the inhabitant's profile or autonomy degree, (b) domain-specific language (DSL) for SLA that aims to increase patient-awareness through the use of preferences, facilitate the SLA management using microservices, and manage the QoS dynamically using multilevel SLA (ML-SLA) concept, and (c) smart contracts for the provision of adapted services and the verification of SLA terms.

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