This article investigates the causes of the remarkable growth in and specialization of elderly care institutions in the Netherlands during the early modern period, and relates these developments to a number of major changes in the household formation process, which had both a direct and an indirect impact on the need for elderly care in general and on the relationships between the elderly and next of kin (partners, children, and other family members). Some specific features of the specialization in care, such as the care provisions for couples, point towards an underlying change in these relationships, which may have resulted from a combination of factors such as neolocality, high marriage ages for both men and women, and, related to this, the small spousal age gap and large numbers of singles. In the typical nuclear household society of early modern Holland, even when children lived close enough and were financially capable to provide help, parents often still relied on extra‐familial elderly care provisions. This article also argues that this practice was embedded in a persistent moral culture accentuating independence, agency, self‐help, investment in the younger generation, and community, instead of putting family responsibilities first.