In this paper, wireless sensors are used to design and build a location management system for smart aging, and the optimization of this system is analysed. The function and structure of the positioning system are designed and implemented. Next, the system commissioning process and field implementation results are summarized and analysed to guarantee the reliability and integrity of the system. Finally, the system requirements and implementation are integrated to realize the basic requirements of the IoT‐based elderly positioning management system and reserve the interface for later expansion. Finally, the system excellence and functional usability tested through unit testing as well as comprehensive testing. In this paper, a theoretical analysis of the prediction algorithm is carried out for the disease prediction module in the health monitoring software of the smart senior care system. To improve the accuracy of the prediction, the traditional BP neural network algorithm is optimized using DS evidence theory, thus fusing multiple sets of prediction results obtained from the BP neural network into a more accurate set of data, and the performance of the algorithm before and after the improvement is compared. The IoT‐based home health management for the elderly starts from the health service demand of the elderly, explains the basic concept of IoT technology and home health management for the elderly, and analyses the feasibility of home health management for the elderly and the advantages of IoT technology in‐home health management for the elderly; through the field research, the IoT‐based home health management platform for the elderly is carried out from three aspects of users, business, and technology. The design covers the platform architecture and functional modules of the IoT‐based senior home health management platform, which can solve the problem that the elderly can spend a comfortable life in their old age without going home.