A growing ageing population in Taiwan poses serious challenges to care-giving services, especially for the Indigenous population, who experience health disparities and insufficient care-giving resources. The Taiwan government implemented universal long-term care (LTC) services in the early 2000s, aiming to alleviate LTC resource disparities in rural regions, including major Indigenous areas. However, empirical research on LTC generally suggests that gaps and challenges remain between policy implementation goals and Indigenous cultural values that may undermine the effectiveness of implementation. This article investigates this problem by asking: Why do implementation challenges persist for LTC services for Indigenous older adults in rural Taiwan? The study employs a multi-method case study of adult foster care (AFC) to investigate this question with a decolonizing perspective. This research selected AFC facilities as study sites because of their strengths in home settings and cultural embeddedness. Empirical data include participant observation (n = 500 hours) at five AFC facilities across five rural Indigenous villages of Taiwan, supplemental interviews (n = 4), and public legal and regulatory documents, analysed through thematic coding. The findings underscore inherent tensions between LTC policy and Indigenous cultural values in Taiwan around safety, scientific metrics of care and market competition that persisted even in an LTC model that emphasizes cultural embeddedness and local community (i.e. AFC). These government priorities contradict the values of Indigenous care that emphasize belonging and solidarity. Centring cultural context and creating communal participatory spaces is one crucial solution to prevent incompatibilities and hegemony in service towards Indigenous older adults.