Taking the nursing home of a private tertiary hospital in Fujian Province as an example，this article examines how private medical and senior care institutions implement preparatory end-of-life care through internal cooperation based on the analysis framework of Relationship - Space - Function，as well as how such practices influence the quality of life for older adults in their later years. The study reveals that nursing homes promote a semi - institutionalized preparatory end - of - life care by developing quasi - familial relationships and creating an enclosed space. However，this practice suffers from the lack of medical social workers，insufficient depth in service relationship，constrained service space，and limited effectiveness of preparatory end - of - life care. To address these challenges，institutions can take full advantages of the integrative strengths of medical social workers to link the caring relationships and use professional methods to connect the caring space. Furthermore，institutions can also employ the policy advocacy functions of medical social workers to reinforce the effectiveness of preparatory end-of-life care.