The ageing population as well as the tight labor market put pressure on future health care. In this article, we explore the role of monitoring systems in small-scale housing for older people with dementia. By incorporating principles of value-sensitive design in a human centered design process we developed a system for remote monitoring at night in dementia care. The performance of the working system was evaluated in the real-life context of a nursing home and is currently being implemented in small-scale housing. Next to reporting the iterative design and evaluation of the monitoring system, we reflect upon the approach taken.