Recent shifts toward individual choice and consumer-directed practices largely conflict with traditional expectations of familial obligation and informal caregiving. The research reported on in this paper aimed to understand how practitioners’ perspectives of spousal caregiving obligations impact on choice in rural communities. Seven focus groups were conducted in rural and outer regional areas of North East Victoria, comprising 42 practitioners who work with older couples who reside in the community. Thematic analysis revealed practitioners’ personal values and constraints of the direct practice environment impact on the experience of choice for older Australians. This discussion considers the problematic nature of choice in policy and practice for older people and their caregivers in light of these findings.