Language intervention for older adults is currently experiencing a paradigm shift from “structural linguistic repair” toward “functional communicative facilitation”. The essence of this shift lies in redefining its objective from the restoration of tested linguistic proficiency to the reconstruction of older adults’ capacities for participation in everyday life. Neuroplasticity, cognitive reserve, the Behavior Change Wheel, and communication theories jointly underpin the mechanistic pathway of functional communication interventions, spanning from neural mechanisms to behavioral outcomes, and from the individual to the environmental context. A multidimensional implementation framework of functional communication interventions is proposed, comprising the core, instrumental, and contextual layers. At the core layer, individual protective factors such as life experiences are activated; at the instrumental layer, multimodal communication resources and pragmatic ability training are employed; at the contextual layer, interventions are embedded in everyday discourse activities and social environmental support is improved. Guided by the principles of active aging and holistic health, language intervention is reconceptualized as a lifelong health investment, elevating “linguistic wellness and care” to a strategic domain within national aging initiatives and social welfare systems. The dialectical tensions between standardization and individualization, technology and humanity, and ability training and environmental modification constitute theoretical and practical problematics that remain to be resolved.