Persons with dementia often have nighttime activity that can put them at significant risk or injury or death. The most common injuries result from falls in the home, and include fractures and skin injuries. In addition, persons with dementia who are up while the caregiver is sleeping may leave the home unattended and become lost in the community, which can lead to injury or death. Caregivers become overly fatigued by supervising during the night and seek nursing home placement. The purpose of this research was to test a novel technology designed specifically to assist informal caregivers in managing nighttime activity, prevent nighttime injuries and unattended exits. Fifty-three subjects were enrolled in a 12-month randomized pilot study with 26 subjects receiving the system. The system was successfully installed in these subjects' homes and operated correctly throughout the trial. All experimental subjects were very satisfied with the system and used it on a nightly basis. All experimental subjects who completed the study chose to keep and continue to use the system. There were a number of attempted home exits that were prevented due to notification by the system. About twenty percent of subjects in the control group had an event (fall or unattended exit) that was potentially preventable if the system had been in use. This technology represents a novel technology that can significantly reduce the negative consequences of nighttime activity including falls and unattended home exits.