With the change in patterns of population mortality and the acceleration of the aging process, the end-of-life quality of elderly people has become a social issue of public concern. This study refers to the “biopsychospiritual homeostasis” resilience integration model to construct an analytical framework and utilizes semi-structured interviews and physical analysis methods to deeply explore the risk and protective factors influencing the end-of-life quality of elderly individuals, as well as their pathways of influence. The study indicates that physical frailty, illness, and psychological distress are risk factors for the end-of-life quality of elderly individuals, all of which can undermine their existing state of balance, and the negative impacts of physical and mental factors reinforce each other. On the other hand, intrinsic spiritual abilities and external social support serve as protective factors that can help elderly individuals enhance their preparedness for death and reconstruct their life status. Based on these findings, the study focuses on discussing the development direction of social work intervention in elderly palliative care from the perspectives of body, mind, society, and spirituality.