Anthropologists have paid increasing attention to the home-based provision of care, particularly as it is affected by aging. In Africa, caregiving challenges are compounded by limited healthcare infrastructure and social and cultural expectations. Urbanisation, outmigration for work, local unemployment, and changing family structures combine to contribute to a decline in material family support for older adults, placing greater pressure on individual caregivers, especially those most involved in care work. In South Africa, the situation is particularly acute in rural areas, where caregivers must often manage with minimal resources and support. These challenges are compounded by geographic isolation, limited access to healthcare services, and cultural stigmas associated with seeking external help. This presentation focuses on the dynamics of family conflicts and the isolation experienced by caregivers of elderly individuals in rural South Africa. The study setting was in the Agincourt Demographic and Health Surveillance site in north-eastern Mpumalunga Province, where the research was nested in a larger study on health and aging, particularly dementia. The dual methodological approach of quantitative surveys with 1012 caregivers, and ethnographic research with 21 households, provides a rich understanding and insight into personal experiences and coping strategies adopted by caregivers to address the multifaceted challenges created in poor settings. As I will describe, these challenges contribute to family conflicts, personal distress, social disconnectedness, and perceived isolation. I then describe how these were addressed by caregivers and care-recipients in the context of limited available support from the state. I aim to contribute to the broader discourse on caregiving in low-resource settings, underscoring the importance of integrating social support mechanisms to alleviate caregiver burden and enhance their wellbeing.