Taiwan has a rapidly increasing aging population with a considerably high life expectancy rate, which poses challenges for healthcare and medical systems. This study examines three key factors: safety concerns, family expectations, and privacy concerns, and their influence on surveillance system installation decisions. A cross-sectional study was conducted involving a group of physically active older adults in Taiwan, using a questionnaire to collect data on the reasons for in-stalling a surveillance system and preferences for three image privacy protection techniques: blurring the face and transformation to a 2D or 3D character. The study concluded that while safety concerns and family expectations facilitate the adoption of surveillance systems, privacy concerns serve as a significant barrier. Furthermore, older adults showed a clear preference for avatar-based privacy protection methods over simpler techniques, such as blurring. The outcomes of this research will be instrumental in shaping the development of privacy-conscious home surveillance technologies, adeptly balancing safety and privacy. This understanding can pave the way for technology design that skillfully balances privacy concerns with remote monitoring quality, thereby enhancing the well-being and safety of this demographic. These results could possibly be extended to other demographics as well.