Taking the K nursing home institution in Fuzhou City as a case，this study employs the analysis framework of the politics of care to argue that care is not merely a technical service practice，but a social practice involving the distribution of responsibilities，negotiation of power，and ethical responses. From this perspective，the research re-examines the institutional care process for older adults with dementia and finds that although healthcare professionals，care workers，family members，and social workers each undertake distinct caring roles，the uneven distribution of power undermines the collaborative effectiveness among care providers and constrains improvements in overall care quality. Accordingly，this study highlights the crucial potential of social workers to reconstruct shared care practice by utilizing their unique strengths in communication coordination，emotional support，and ethical advocacy. Looking forward，it is vital to further clarify the professional functions of social work，enabling social workers to play an integrative and empowering role in interdisciplinary collaboration within nursing homes. It is imperative to enhance the professionalism and humanistic quality of institutional dementia care，thereby guiding institutional care toward a more coordinated， people-oriented，and sustainable development trajectory.