The way we think about older people’s lives at the intersection of dementia and rurality, and our recognition of the importance of their world, is crucial to ensuring the delivery of more effective public supports that can enable them to realise full personhood and citizenship, connected to the people that they love and the places where they live. This chapter uses a social exclusion conceptual framework to unpack complex and multiple challenges facing rural older people with dementia and highlights the importance of adopting a multifaceted holistic approach to support full societal participation. The analysis provides an argument for the recalibration of current dementia policy towards a genuine social production model for rural dwelling people with dementia; one that focuses on supporting them to continue to enjoy active and connected lives in rural communities through practical social policies, such as additional home supports, innovative psychosocial provision and integrated transport arrangements.