How rural do you mean? We are 25 miles from the nearest town of any size. In our early 70's.
The escort service could instead be a volunteer service to take people to appointments.
My children are wanting my husband and I to move from our rural area since it takes an ambulance 20 minutes on its fastest time to get here and his health is very bad. So my list would include fast response time from ambulance service.
Also reasonably priced and vetted cleaning services. Food take out opportunities (one of the things I miss most since we moved to a rural area.) Grocery stores with delivery service.