In this paper, we reflect on developing a course in design of health promoting technology for elderly, within the field of Tangible Interaction Design (TID). The pedagogical goal is to develop profound design education in an important, complex and new evolving field, which lies in the intersection between diverse health perspectives, technological possibilities and cultural values and expressions. A field with goals beyond tools, functionally and biomedical health, into increased vitality and quality of life for individuals. Through reflections on teaching and cycles of courses, and many years of research, we have acquired insights in what qualities courses in this field should have, regarding Learning models, Teaching resources and Tools, to be successful. In short, it can be formulated as “the closer to reality, the better results”, regarding both student deliverables and learning outcome. Practically that means more user and care home interaction, more interdisciplinarity on many levels, and more advanced technology to develop high-level testable prototypes.