BACKGROUND There is a global challenge related to the increase in the number of people with dementia (PwD) and the diminishing capacity of governments, health systems, and caregivers to provide the best care for them. Cost-effective technology solutions that enable and ensure a good quality of life for PwD via monitoring patients and interventions have been investigated comprehensively in the literature. OBJECTIVE The objective of this study was to investigate the challenges with the design, deployment and functioning of a Smart Home In a Box (SHIB) approach to monitoring PwD wellbeing within a care home. This could then support future implementations and present further opportunities for the SHIB approach. An important consideration was that most care homes do not have the appropriate infrastructure for installing and using ambient sensors. METHODS The SHIB was evaluated via installation in the rooms of 3 PwD with varying degrees of dementia. Sensors from the SHIB were installed in the rooms of the PwD to test the capabilities of these sensors for detecting Activities of Daily Living (ADLs). The sensors used were (i) thermal sensors, (ii) contact sensors, (iii) Passive Infrared (PIR) sensors, and (iv) audio level sensors. Data was collected, stored and handled using a ‘SensorCentral’ data platform. RESULTS This study highlighted challenges and opportunities that should be considered when installing and using a SHIB approach in a dementia care home. Lessons learned from this investigation are presented in addition to recommendations that could support the wellbeing monitoring of PwD. This study also presents results from initial data analysis and demonstrates how activities, falls and abnormal behaviors could be detected and acted upon. CONCLUSIONS This study was conducted by Ulster University’s Pervasive Computing Research Group (PCRG) as part of the Northern Ireland Connected Health Innovation Centre (NI-CHIC) project. The design, deployment and functioning of the SHIB approach within Kirk House Care Home in Belfast provided the community with useful lessons, that will continue to be applied to improve future implementations of the SHIB approach. Several challenges arose during the installation, functioning and data collection at Kirk House Care Home, for example, regarding the adaption of technology to a building that was not originally designed for the integration of ambient sensors. The main findings of this study are (i) most care home buildings were not originally designed to appropriately install ambient sensors, and (ii) installation of SHIB sensors should be adapted depending on the specific case of the care home where they will be installed. It was acknowledged that in addition to care homes, the homes of dementia patients were also not designed for an appropriate integration with ambient sensors. Hence, another possible use of a SHIB approach.