This chapter explores how exclusion from care provision in rural areas can be understood as place-based social exclusion. The analysis focuses on case studies of Czechia, Poland and Germany and compares their approaches to providing care to older rural dwellers. While recognising the heterogeneity of these nations and their rural areas, a spatial framework is used to illustrate how some specific features of rural areas may influence the provision and availability of care. Two examples are explored: the use of professional homecare services by older people; and informal care and assistance provided by older people in the community. Our research shows that, regardless of the size of the country or its proportion of remote or depopulating areas, discourses on care in rural areas share various common features. A large amount of informal care is provided in both the family-oriented Polish countryside and in Czechia, a country with a midsize rural population and comparatively common use of professional homecare services. In Germany, a growing number of rural communities were found to have established local aid associations to support disadvantaged older people in the past decade; however, this approach is viewed as unsustainable given the specificities of the rural contexts.