Remote healthcare has made a revolution in the healthcare domain. However, an important problem this field is facing is supporting patients who are subjected to severe emergencies (as heart attacks) to be both monitored and protected while being at home. In this paper, we present a conceptual framework with the main objectives of: 1) emergency handling through monitoring patients, detecting emergencies and insuring fast emergency responses; 2) preventing an emergency from happening in the first place through protecting patients by organising their lifestyles and habits. To achieve these objectives, we propose a layered middleware. Our context model combines two modelling methods: probabilistic modelling to capture uncertain information and ontology to ease knowledge sharing and reuse. In addition, our system uses a two-level reasoning approach (ontology-based reasoning and Bayesian-based reasoning) to manage both certain and uncertain contextual parameters in an adaptive manner. Bayesian network is learned from ontology. Moreover, to ensure a more sophisticated decision-making for service presentation, influence diagram and analytic hierarchy process are used along with regular probabilistic rules (confidence level) and basic semantic logic rules.