Smart healthcare monitoring systems require precise action recognition to ensure well-being and timely intervention in critical situations such as falls, particularly for mobility-challenged individuals. Existing datasets are often clip-based, lacking the frame-level detail needed to recognize actions online, as they unfold. To address this, we introduce SAFER-Activities, a dataset for fall detection and physical activity monitoring, with a dedicated subset for wheelchair use scenarios. It comprises over 66 hours of video data captured by multiple cameras, with 85,310 action instances and frame-level annotations for 30 action classes. We benchmark action recognition on SAFER-Activities with 2D and 3D skeleton models, RGB models with frozen backbones, and multimodal fusion strategies, and evaluate on in-lab, out-of-distribution, and cross-dataset test sets. Skeleton-based models generalize best under domain shift; fusing frozen RGB features with the skeleton stream improves in-domain recognition over the baseline CNN1D, most clearly on the wheelchair subset, but degrades out of distribution. Cross-dataset and qualitative evaluations confirm that models trained on SAFER-Activities transfer well to unseen environments and external fall data. To support research on robust fall detection and activity monitoring, we release the dataset and code at https://safer-activities.github.io/.
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