China’s rapid modernization and deepening population aging are reshaping later-life risks—especially for rural older adults living alone (“solidary elders”). Using social support, social network, and modernization theories, we qualitatively examine instrumental, emotional, and formal support among seven solidary elders in Village X (Shandong Province) through semi-structured interviews and participatory observation. Updated 2024–2025 population and policy evidence situates the study within China’s evolving Basic Elderly Care Service System and long-term care insurance pilots. Findings show: (1) instrumental support covers basics yet leaves substantial safety, information, and health cost burdens; (2) emotional support is the most deficient domain, with pervasive loneliness but promising peer mutual-aid assets; (3) formal support works as a floor but lacks precision and continuity. We propose a social work-led, multi-level service architecture—micro (case/family/mutual-aid), meso (community/social organizations), and macro (policy)—aligned with WHO’s ICOPE and Age-friendly frameworks and with China’s 14th Five-Year Plan for aging services. We also incorporate robust fall-prevention evidence to target the highest-impact interventions.