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Life for older people with dementia tends to be inactive. This paper reports on two case studies in which exercise games (exergames) were introduced in dementia special care units with a focus on patients’ well-being. The first case used a participatory design (PD) approach to engage the patients as users in the process. The results highlight the patients’ enjoyment in playing these games in a socially encouraging environment. We have found that exergames in dementia care provide patients with the well-documented health benefits of physical activity and also result in social and cognitive benefits. The results indicate that the notions of games/competition, social interaction, physical activity and challenges are valuable ingredients when designing for the well-being of older people who suffer from moderate to severe dementia.