With China’s rapidly aging population and the growing preference for aging in place, digital monitoring technologies have emerged as potential tools to support older adults in managing their activities of daily living (ADLs). This study explores the perceptions and acceptance of these technologies among elderly individuals living alone and their informal caregivers (ICs) in Nanshan District, Shenzhen. Grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), the study employed semi-structured and photo-elicitation interviews to analyze how performance expectancy, effort expectancy, social influence, and facilitating conditions shape technology adoption. The findings reveal clear intergenerational differences: caregivers show higher acceptance and a better understanding of the benefits and functionalities of wearable and environmental monitoring devices, while older adults often express skepticism due to concerns over privacy, usability, and cost. Many elderly participants also cite discomfort, technical complexity, and lack of training as barriers to adoption. Despite these obstacles, both groups acknowledge the potential safety and health benefits of such technologies. The study highlights the need for privacy-by-design features, customized user interfaces, and enhanced digital literacy programs tailored to both elderly users and their caregivers. The research contributes to a sociotechnical understanding of aging-in-place technologies in China and provides actionable insights for developers, policymakers, and healthcare practitioners aiming to enhance home-based elder care.