Informal care for older people living with chronic life-limiting illnesses is associated with difficulties. The informal care system built around generational values and cultural norms is steadily weakening in rural Ghana because of economic challenges, migration, urbanisation, and changing family structure. In responding to this knowledge gap, we aimed to ascertain how the immediate family, extended family and community support impact on mechanisms underlying provision of informal care for older people living with chronic life-limiting illnesses. Ethnographic interviews were conducted amongst fifteen older people; fifteen informal caregivers; ten health care professionals, after participatory observations during six months of fieldwork utilised to gather the needed data. This study is guided by altruism, empathy, responsibility, self-interest, and social values theories, which provide a very significant structure to understand care relations in rural Ghana. While we find that informal care is sustained by cultural values, it is experiencing financial and human resource challenges.