Literature on sounds inside institutions has shown that sounds are indispensable to the working of hospitals, schools, prisons, and other institutional environments. Drawing on ethnographic fieldwork in three eldercare homes in Germany this article suggests that the more permanent care context of institutional homes for the elderly compared to a hospital setting is decisive for people’s interpretation of and engagement with sounds. This is true at multiple levels, such as “monitory listening,” the use of “music as a technology of self,” or sounds as a tool of care. In fact, in this long-term care context even silences prompt action. Based on their experience with individual residents, for example, caregivers can direct their monitory listening not only to existing sounds, but also to the silence of expected but absent sounds. Throughout the article, additional consideration is given to the role of the technologies that produce the sounds, showing how in their design and functioning they shape, complement or prevent people’s attention to sound and silence. Finally, I propose that research is needed that goes beyond an understanding of silence as a healing environment for the vulnerable and sick and instead attends to the complexity of this acoustic event within the context of eldercare homes.