Background: Spain has an increasingly aging population in rural areas. These individuals often face the burden of illness and the limitations it causes in solitude, leading to greater impacts on their health and quality of life. Therefore, the aim of this study was to evaluate the effectiveness of a combined IoT-based home monitoring and Silver Caregiver support intervention on health-related quality of life and functional, cognitive, emotional, and social outcomes in older adults living alone in rural settings. Material and methods: A longitudinal study was conducted with a sample of 144 older adults from rural areas who received home support through a Silver Caregiver and IoT technology. Results: Statistically significant differences were observed in cognitive status, anxiety, depression, family functionality, social support, life satisfaction, and quality of life. Conclusions: The findings indicate that the combined intervention primarily enhances psychological well-being, social connectedness, and perceived quality of life while contributing to the maintenance of basic physical function in older adults living in rural areas.