Smart wearable is expected to give the elderly more peace of mind and experience in a comfortable home environment. This not only satisfies their desire to live relatively independently, but also avoids the waste of resources caused by the lack of timely detection and feedback of aging and health problems, and contributes to the sustainable development of society. In order to meet the current demand for high development of smart wearable products for the elderly at home, and to lay out the limited design resources on the key design factors so as to enhance the consumer experience, a design element system is constructed from a sustainable perspective. The textual measures of academic literature and product evaluations are used to analyze the relevant theoretical foundations and the current state of the market category products. Based on this, the user’s needs at the instinctive, behavioral and reflective levels are captured through expert panel interviews, and the initial requirement importance is calculated. The QFD quality house model is used to translate the needs into design factors and score them based on the relationship degree of the needs, and finally construct the design factor system of smart wearable for the elderly at home in a sustainable perspective.