Introduction. Rural populations in Poland, and the United States, are ageing. Longevity, as well as the individualization, feminization, and singularization of old age, are characteristic of this process. This raises challenges in terms of support and care that enable a good quality of life and ageing in place. Aim. The aim of this article is to identify informal, and extra-familial care and support, practices for older adults living in rural communities in Poland and the United States, as well as factors that may strengthen or weaken them. Methods and materials. The empirical part of the article is based on qualitative data from the author’s own research conducted in 2023 in three rural communes in Poland, as well as a study of four small rural towns in Iowa from 2022. The data is drawn from in-depth interviews with residents aged 65 and over, and local stakeholders. Results. Informal and extra-family care and support practices identified include neighbourly “watchfulness” and help, mutual support within networks created by older adults, as well as help from local institution representatives that goes beyond their formal duties. These practices most often concern IADL (Instrumental Activities of Daily Living), e.g., shopping, transportation, and emotional support. They are facilitated by strong neighbourhood ties, as well as relationships created through engagement in local organizations or religious groups or churches. Such help and support very rarely include assistance with ADL (Activities of Daily Living), e.g., personal hygiene, or financial assistance. People who exhibit deviant behaviours may be excluded from access to informal care and support practices within the community. The dominant role in informal care is played by the family, but extra-family support can be its substitute to some extent, and certainly an important complement.