Long-Term Care (LTC) for older adults (65+) in Sub-Saharan Africa (SSA) is shouldered by family caregivers: breeding burden, economic loss, and abuse, which undermine the welfare of caregivers and care recipients. This calls for alternative LTC models that effectively augment the prevailing family-centred LTC. Using Ghana, indicative of SSA, family caregivers’ perceptions and willingness-to-pay (WTP) for formal residential elderly care was investigated from a cross-regional perspective. An exploratory qualitative design was leveraged to obtain textual data from thirty (30) family caregivers of older adults from Ghana’s three socio-cultural/ecological zones: i) southern/coastal belt—Greater Accra Region; ii) middle belt/forest belt—Ashanti Region; and iii) northern/savanna belt—Northern Region. Individual in-depth interviews (IDIs) conducted between January 21 and March 15, 2026, lasted 55 minutes on average (47 – 120 minutes) and were analysed through thematic content analysis (TCA). The findings revealed that divergent views co-exist among caregivers on residential elderly care, with some describing it as “abominable” and “non-African”, while others viewed it as a “gamechanger”—easing care burden and financial strain from economic dormancy. Caregivers in the Greater Accra and Ashanti Region reported higher WTP for formal residential elderly care than their compatriots in the Northern Region. Young age, higher education and higher economic status were associated with higher WTP, whereas spousal and secondary caregivers were less willing to opt for such care arrangements in the three regions. Region-centric and intersectional considerations must be prioritised in the deployment of formal residential elderly care in Ghana and SSA by extension.